Approved Predetermination doesn't speed up reimbursement
by Just Me on Nov 19, 2024
1 out of 5 stars
The worst insurance company ever, I have ever since June waiting on my refund for insulin the worst company ever, would not recommend at all.
I literally couldn't recommend a company less. I have no idea why our HR switched to Canada Life, but it takes over 6+ months to get any money back. I put in claims over 8 months ago, then left the company, and now they're refusing to pay me. Literally, AVOID at all costs. Horrible company.
I am a retired public servant and since we have been dealing with Canada life, I felt valueless.
They don’t take the contract seriously. It takes me forever to receive compensation for a claim.
I am diabetic with complications in my vision and the doctor prescribed ozempic drug. I filled out the required form, and my doctor did his part as well. That form was sent in April 23 and got approved just yesterday!
They are doing this to me, although they will be paying only a small portion of the cost!
My wife went to the physiotherapist because she has an accident. Her insurance paid most of the cost, while Canada life has to pay only $15 per session, and they wouldn’t do it.
Also, the communication is terrible, and you have to call them every week to tell them the whole story again and again.
To be honest, I have been wondering why our union awards the contract to such a useless company!!
Worst service, 6 months still my claim not processed. They make you pay premiums for longer than my delayed processing. Hours of hold time. Pathetic service.
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!
The transfer from short term to long term disability has been nothing but horrible. Been going on about 2 months without pay because of them.
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.
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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.