Sun Life Group Benefits Insurance Reviews

I have been dealing with this insurance company through my own company and I have to say that their company culture is highly problematic. I went on long-term disability and I had issues regarding both drugs and disability.

Now, while complaints and issues happen with all insurances, the problem with Sun Life Financial is the way they do things. Not only do they seem to attract incompetent people ( 3/3 never returned calls/ e-mails over the course of weeks), they won't let you change whoever is assigned to your case, effectively stonewalling you in case things go bad.

For example, I was refused to be insured for a drug because it had the wrong code (never mind the fact that it was a refill of a drug that had been insured the other time). When I escalated this situation to the supervisor, I was told they would find the right code with the pharmacy. 6 weeks, 5 calls later, that supervisor, Mrs. X, is absolutely unreachable. Worst, whenever I called to ask to get in touch with Mrs. X's colleague or boss through the customer service, I was told it would be done before being transferred to Mrs. X's voicemail.

In the end, Mrs.X seemed to not appreciate my behavior of searching for a resolution as she called back and said there was nothing to do.

I've written enough for a review, but I have a similar experience with the disability department, letting me know that it's a company wide problem, not just a single person problem.

Word of advice: Avoid like the plague.

This is just some commentary regarding Sun Life, and judging by the 0 and 1 star ratings, I am not alone.

I work with quite a few retired Military people and we all have Sun Life as our secondary insurance. Practically every claim that any of us submits gets denied. I believe they do this to discourage people from submitting claims. They are an absolute disgrace and should be removed.

My rating for them is a BIG 0 Star.

I am 63 years old disabled certified by 3 doctors 2 occupational therapists they are offering me assistance to get retraining even if I could attend retraining Ill be retired before I finish and they will only cover a limited amount for tuition. I was dumbfounded when I heard this they are not anyone,s friend they do not tell you this in the Glossy brochures.

Please consider this your warning that if your employer provides you disability benefits from this company. Make sure you get other benefits elsewhere! I became disabled at no fault of my own and this company denied my long-term disability benefits. I fought to get benefits, was approved, to only be denied months later. This company is the scum of the earth and for those people who are unfortunate enough to need these benefits just be warned that they will not pay out those benefits to you when you need them. I hope one day that this company gets what's coming to it. Karma will haunt you Sun Life. For all those who are affected by their mistreatment, know that you are not alone.

Don't bother calling them if you have a group benefits question. They are not helpful and they are always screwing up.

LTD benefits were offered through my employer. I almost DIED and Sun Life DENIED the benefits that were part of my benefit package through my employer. They used ONE sentence in ONE medical record that indicated my condition was "improving" (ie, no longer DYING) and they denied me based on that.

My "customer service representative" was a poor excuse for a human being and should be ashamed of herself for treating other human beings like that!

Ended up having to get an attorney to get what I was owed, and they still SUCK! If there is a holiday, they don't prepare in advance and get the checks cut early! Oh no, they wait until AFTER the holidays and just send your check LATE!

They should be shut down!

If your employer offers you this insurance either refuse it or see if they are willing to look into other insurance companies. I have 100% on prescriptions, but today I have spent over an hour in my pharmacy trying to find out if an IUD is covered by my benefits. It got to the point that my pharmacist had to sit on the phone and firstly explain what an IUD was and that there were non-hormonal and hormonal ones. .. He had to explain multiple times that because it was not hormonal it did not have a drug identification number. They attempted multiple times to tell me to just pay for the item and submit a claim to see if it was covered but luckily my pharmacist stood his ground and made Sun Life search their systems until they found the item (which they had previously told us either didn't exist or was too new and so wasn't in their system). In the end I was told that the item was not covered (which is frustrating) but I was told still to attempt to submit a claim, so it it covered or not?!
My pharmacist told me that he has made claims with Alberta Blue Cross and other companies for this IUD without any trouble. I don't know why I was surprised since every other medical claim I've made in the last year has been 'randomly' selected for auditing. AVOID AVOID AVOID

I'm covered under group coverage through work, and there have been two times where they have denied dental coverage. First, my son had to go to a dental specialist (although is someone who provides similar dental services), and they said it wasn't covered, so they provided a 'similar' fee guide for services performed - which ended up being about 35% lower. Second, I paid $3400 for a dental surgery /services and the first part was put to my wife's benefit provider (also Sun Life), which ended up getting paid, but then, although my information for coverage was also on the form, they did not pay my portion. They told me I had to re-submit... which I did about 100 days later and they denied it saying it was beyond my plan's time limits. 90 days? Even though on the first submission everything was there. Enough said.... if you're thinking about going with a particular provider, well, you know what you should do...

I had a health plan through my group. Alberta
Took pre-authorization for orthodontal and endodontic expenses separately submitted by each of these specialists.
The Sun Life team approved both the pre-authorization separately.
These orthodontal and endodontic treatment expenses for the child are very expensive and not easily affordable for parents.
Despite the pre-authorization approval received from Sun Life, the insurance company refused to pay an amount of approx 463$ which is approximately 8% of the payment made by us ($10000) for these specialists.

A complaint was registed with Sun Life and case id was issued.
Their customer care representative Mr. G informed me that the pre-authorization approval was a mistake by their team and hence then cannot compensate the amount of $463

I followed up with Mr. G for several months and the case was open. But Mr. G states that he has put a write-off request to his senior management due to the error from Sun-life in the pre-approvals. But his senior management did not take steps.

Despite several follow-ups, Sun Life did not honor their pre-authorization approval and did not reimburse me for the expenses made

Result
Orthodontic Expenses for the treatment by us : $8000
Endodontic expense for the treatment by us : $2600

Pre-authorization sent out separately for the above to Sun Life
Approved pre-authorization amount for orthodontics : $2000
Approved pre-authorization amount for endodontics : $463

When expenses were submitted after treatment, Sun Life insurance company paid only 2000$ instead of the pre-approved amount of 2463$ with further loss of 463$

Experience
1) Despite taking approvals, the team is not professional enough to understand customer concerns and did not honor their commitment.

2) Why the customer has to always bear the loss due to the any lapses of Sun Life medical insurance team.

3) please be careful when you sign up with Sun Life plans and they will tweak the clauses to their own benefit despite preauthorization

4) they collect hefty premium for these plans

5) Sharing this information to all of you so that no other customer should have to face similar things while dealing with Sun Life health and dental insurance

I made a claim to Sun Life since last August. We are now in April and I problably talked to one of their representants 3 or 4 times at most. The rest of the time, I was talking to answering machines and nothing else. And when they do answer your call, it is to tell you nothing else but lies and excuses for refusing to pay you. From what they told me, they can change their reglementations whenever they feel like it. Even their superintendant won't answer the phone! All they do is changing representant to make you feel they care... but it all comes down to a restart with no end. I truly am hoping my company will change insurance company. I am fedup being forced to give my money to those crooks!