Sun Life poor claim processing
by valsan15 on Aug 6, 2015
1 out of 5 stars
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!
8 months now on my new job and still don't have life insurance coverage! They keep calling to tell me I'm missing "something" to finish processing my application but they cant' tell me what's missing. The sub-contractor they sent to do my physical lost some of my paperwork so they denied my coverage. Now I'm being denied due to "non-response". When I call to ask what I'm supposed to respond to, and I quote "Sir, we don't know". They denied coverage for my wife for a "medical condition", but they can't tell me what it is. She has only had a couple surgeries on her feet........ HR is trying to help but there is only so much they can do. I give up. I'm just going to tell HR to cancel my application with Sun Life so I can just go get private life insurance. It'll cost the same but I'll have much better service. Not a grain of intelligence can be claimed by any of the agents working at Sun Life! Anyone that rates better than 1 star obviously hasn't had to deal with them in any capacity yet - but you'll soon find out and be back here re-posting a new review.
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
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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