Sun Life Health Insurance Reviews

My family , unfortunately has Sun Life for our secondary Dental insurance. Even though we pay for this insurance through my husband's employer they do not pay on claims . This has caused me to go into collections with a dentist office. Their customer service department is lousy. I have emailed them numerous occasions and they have only responded twice stating that they are not able to find the claim I'm questioning ,yet I received the EOB from them. HORRIBLE! If I could rate this company with zeros stars, I would. The company is no longer using them as of July 1st! Thank goodness!

I have been rejected twice years ago for massage treatments because they were preformed by NHPC. Before that they had never stated out the rule.
Dental coverage was never covered more than 50% as they claimed 80%. Some dental works were totally not covered, because Sun Life said teeth were not decayed to a point that need immediated treatment. Decisions were taken by dentist--NOT ME.
Sun Life is a KING of NO PAY.

I had my therapy recently and submitted the claim to my two coverages, one under my employer and the other one under my Husband, both Sun Life. I got reimbursed for a portion only from my plan and denied the balance under my spouse plan. The reason? Because they only paid according to their price limit! Coordination of benefit was never applied on this case plus this is my first claim for two years! There is no consideration. I got pregnant and taking care of my baby, and trust me. I feel all the pain in my back. But when I decided to have a massage from a decent spa, I never thought that I wouldn't be able to use my benefits.

This company are the Kings of no pay. I submitted phsio/massage therapy. There were the secondary provider. I submitted it thru mail!! yes Canada Post. I gave them the Px and the amount paid by Blue Cross on Blue Cross letter head. They denied it because I did not sent the original Px. I got the original from the clinic and sent it to them. Then they denied it because they said they were the seconday provider and they have no proof that the primary provider paid!! I sent them the Blue Cross form which clearly states BLUE CROSS PAYS, and they had the claim filled out online clearly showing the amount Blue Cross paid and they had 20% left to pay. Next they denied it because I reached my max for the year. The max for the year was $500 and I had submitted. It took me 3 months, 6 phone calls, 4 letters/written submissions and they paid me the $28 they owed me. $28!!! And I have since submitted other phsio/massage bills and each time they do the same actions. All the people who work with me get the same run around when they submit expenses. This should be shut down. They like taking my $175 a month in premiums. NO company should have this company as an insurance provider

Submission to a claim for wheelchair that claimant desperately needs to get around was denied because claimant has Cancer. After speaking to 17 different customer care and supervisors as Sun life purposefully delayed for 6 month requesting additional info after another before formally denying claim. Had to fax the same Doctor's referral notes 3 separate times as Sun life repeatedly denied they received such referral. Yesterday, March 01, 16 at 3:15pm phone conversation with Supervisor told us "price of wheelchair cost too high" "we might consider less expensive unit". Sun life could not shake us off of our claim and subsequently denied claim again.

Cancer Patient still does not have wheelchair to get around.

Bottom line at Sun Life: Profit maximization by undercutting its customers.

Don't take this company its having its worst service. They dont give money of CLAIM and eat them.Since 3 months I didnt got my claim money

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 have UHIP with Sun Life. Initially they say everything is covered 100% including doctor visits, but when you claim they decide what % you pay out of pocket all of a sudden. First, they never send you the health plan information packet, second, the out of pocket expense % is not mentioned anywhere. So you're basically lost, and they decide how much they pay for each claim. God knows how they calculate these percentages. Their customer reps can't even explain this. Poor service, and misleading info!

I have group benefits through my hospital..In Toronto/ Mississauga area. My goodness what a subpar provider Sun Life Insurance is. My wife and I did co-ordinated benefits for a pair of eyeglasses, and (Manulife) which is my wife's provider paid out their portion with no concerns. Not even one question. Sun Life did not pay out a cent.. they keep sending it around in circles to our Human Resources and then them... for eyeglasses.. no paymnet yet after 4 months.. I pay the benefits and they have not paid out one penny ..not one... when you need them.. for eye glasses... I have had Dejardin, Manulife , Equitable life and even Td Insurance.. and have been around 25 years in social services. Sun Life is the bottom of the barrel. If you are a company like a hospital, non profit agency,private or public company.. this should be the last choice you should make.. Do you want your employees to respect you.? Well then, don't choose Sun Life Insurance as your group provider... saving money does not always pay in the long run for your employee loyalty and or lost time for the HR dept in your agency..

Sincerely

Mike

My company use to use Manulife Financial, then they switched to Sun Life, no doubt to save a buck. Sun Life repeatedly seems to find ways to dissuade me from using my benefits. For example, twice now, they have told me that I needed a doctor's note in order to qualify for coverage of certain health services. Not knowing any better, I paid for a prescription. (not covered) I recently found out that my employer's plan with Sun Life does not require me to get a prescription. Now that I'm trying to get Sun Life to compensate me for the costs that I've incurred due to their misinformation, or should I call it "intentional dissuasion", they give me the run around. It's like they're trying to make it harder for me to use my health benefits. Furthermore, everytime I call them, I'm on hold for at least 15 minutes it seems. I'm not exaggerating. You can't email them without sending a "secure message" through their site. In order to see their reply, you have to log in to the site and view it.