Sun Life Health Insurance Reviews

I used to be able to submit claims online through their terrible website. Now the website is even worse, as they have taken away that ability. The only option now it to submit a freaking paper claim. What century is this again???

Sun Life is absolutely horrible.
I am submitting claims very fast, with the proof of payment and they intentionally delay the payment.
I have been audited this year on December 29, 2016 for a claim submitted on Dec. 19, 2016. The e-mail sent to me was again, delayed, and sent on Fridaym Dec. 30, 2016 asking for the proof of payment. They claim they did not receive my envelope. How untruthful! I've send tons of envelopes and the only one that did not reach destination was the one sent to Sun Life? In 10 days?!
It is possible to get under control this intentional delay practice?

My health insurance plan with Sun Life says 80% coverage for Orthodics which I have to wear in all my shoes and have to re-order every year since my condition worsens.
This year I ordered custom made orthodics that cost 500$. After submitting my first health claim of the year Sun Life rejected it with the classic excuse that somewhere in the contract buried with very small characters there is a limit of one orthodics every 24 months.
However, they never considered to post the same information on the website with my health plan.
Fact that I did not have any claims over the year was not an argument. Also, could not use any of the 100$/month I pay into my plan or to use the very advertised 'flex dollars'.
So now, just before Christmas I have to thank them for the 500$ debt in my account.
I feel like I was miserably robbed with no intend for help from anybody in this institution.
Unfortunately I cannot not choose my health insurance at work but I can witness how low this insurance company can go and how quick is to screw their customers.
I wanted to choose 0 stars value for money since this is what I got but unfortunately that doesn't work.

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

It took them a month and a half to make a decision on my claim. Every time I would call I had a different answer - claim still being reviewed, sent to medical team, they would call me back, etc.... I had open heart surgery due to birth defect. Surgery was done mid Jan 2017. Before I was scheduled to go back to work I developed some complications with fluid going to my heart and lungs. After sending in about 40 pages of medical records, doctor, surgeon and cardiologist notes, their final decision was to deny the claim because " I was not completely immobile the entire time." - I "Started to get better....." This is what their medical team THE SUN LIFE DOCTOR??? decided. God help anyone that needs to go on disability if they are insured with this company. Horrible company and service. Don't know where they find their doctors. - But again their doctors are being paid by Sun Life. A month and a half to make a decision. Something is seriously wrong with that. If you are insured with Sun Life my advise is to change insurers. Lobby to your company and union (as I will do) to make a change. If you are looking for insurance DO NOT GO HERE!!!

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.

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!