Approved Predetermination doesn't speed up reimbursement
by Just Me on Nov 19, 2024
1 out of 5 stars
Please, don't take out an insurance policy with Canada Life. I called to obtain a proof of insurance for my daughter's university. No one knows what they're doing. Every time I called, they tell me to do something different. It's been 27 days now. Still can get a simple letter. My daughter will end up paying for insurance, which I have already paid for. They don't care that people have to lose money.
I applied for my common-law partner to be on my insurance last November. It only got approved the next April. In the meantime, her wisdom teeth started to come out, and we decided to go to the dentist. I called to make sure that we were not in the waiting contribution period. The agent told me to go ahead with my dental appointment in July. Eventually, my dental insurance claim for her got denied because the contribution period was 1 year in their policy and my common-law was considered as a late applicant. Well, I'm so angry that they gave me the green light when clearly their agents do not even know their own policy. What a nightmare of an insurance company. How unfair is it?
25 years veteran treated really poorly, agents are evasive or don’t answer clearly to clear questions. Agents who are not doctors or nurses ask medical questions …. Their process is really confusing. When asked about their process and policies … they are again evasive and don’t really answer … hard to know if it’s incompetence or fraudulent system. Their online system is not working … really time-consuming dealing with them… the 500 million that was given to them to manage veterans and public servants is going to waste…
Customer service is brutal, beyond pathetic. French or English customer service reps are often unknowledgeable about the products/services Canada Life provides. Estimates for procedures take as much as 3 months to be evaluated, contrary to their stated 5–7 days. Most of this dysfunction is related to Canada Life securing an insurance agreement with the Government of Canada civil servants. Embarrassing!
I haven't been able to get a single claim approved or processed for normal and fully covered expenses. They aren't helpful on the phone. They blame the service provider or the client instead of accepting responsibility for their broken processing. And they don't provide an email address to work through troubleshooting issues. Only over the phone! Mon to Fri. If you can get through.
Absolutely worst company to deal with. Long wait time to speak to agent or supervisor, long call back time, high rejection rates. It seems like Canadalife does not want to reimburse us for medication. They make you wait for a long long time before an agent answer you.
I put in 3 clams from mid October to mid Jan and 2 were rejected. For one of the claim, I had to paper file in and sent in thru email. I submitted the claim on Jan 10, 2024. I had called 3 times was told the paper claim would take a month before it would be reviewed. I called today and was told it was rejected and I wasn’t able to view the claim on canadalife website. The agent told me it was rejected due to incorrect DIN.
The DIN was provided to my pharmacy by Canadalife. Before doing the compounding, my pharmacy was on the phone with Canadalife agent for 20 minutes and was given the DIN and dosage and the agent assured my pharmacy that this should be approved by Canadalife. Fast forward one and a half month later, I am now told DIN is not correct. I can’t go back to my pharmacy now and ask to call Canadalife to get the correct DIN.
I told them I would like to talk to the supervisor and was told supervisor not available and she can only put in a callback and it could take up to 5 to 7 business days.
This is not acceptable. We never had such issues when we were dealing with SunLife.
I submitted my claims several times, they always try their best to postpone the settlement. I spent a lot of time to call them or sent email through their contact information, that is totally wasting your valuable time.
If you consider your life or healthy insurance, please consider other companies.
My employer has Canadalife as the insurance provider. I have consistently had poor experiences with them, not processing claims. Most recently, 3 months ago my hospital billed them for semi-private rooms. I called them several times, and they assured me it is processed and will be paid and reflected online in 2 days - but the claim is still pending. It looks like the customer service agents just try to pacify customers without providing truthful information.
I guess I’m the odd one out with all of these negative reviews. Every time I call Canada life, yes the wait times are long (45 mins max for me), but the customer service reps are knowledgeable and to the point. I got top of the line health & dental, it’s kinda expensive but 1000% worth it! Don’t be too discouraged with the negative reviews :)
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No clear, complete, instructions to ensure you submit everything to them that they require to process your claim in a timely manner and if they need you to re-submit the same information to them that was included in your initial predetermination request, which drags out reimbursement. They seem to give you more information with each call you make to them, inquiring on the delay. It would also be helpful if they included the details of your coverage for that item, in the predetermination response, e.g. Up to $150 coverage once every year. They do not send updates as to the status of your claim, you must sign in daily to see if it is still pending or not, and no added info is added there... their system can cause financial hardship if you are relying on a quick reimbursement... Much easier to deal with a company who pays the service provider directly. Benefit coverage should improve more, annually, to keep up with the always increasing high fees charged by service providers for services required.