Sun Life Health Insurance Reviews

I worked & paid in to their contracted plan for 21 yrs, using it for dental, prescriptions & glasses without any problems. A life changing disease made the Canadian Gov't deem me to be "totally & permanently disabled" & the Canadian gov't granted me CPP Dissability till age 65. Sun Life however refused to pay me LTD after only 2 yrs. Their contract said I was to be paid until age 65....but that is just a scam. I am very grateful to our gov't who approved my CPP Dissability claim. The gov't makes their medical evaluation & makes their decision & pays you a dependable amount each month until age 65. Sun Life is just one giant fraud. Sun Life really should be forced to close down since they never honour their contracts. Sun Life is an unreliable scam. Sun Life is a failure, who will never pay out. They harrass you constantly & close your file throughout your 2 yrs of LTD (causing emotional disstress). The gov't is way better than Sun Life.

Oh very nice at first till its time to help you when you need help the most they will find every loop hole to deny your claim they will do there best to avoid paying you and wait for the sorries it's a hollow effort trust me there's no remorse or caring in there voice it's like a machine they do not care about you or your problems please chose the right insurance company if there is one out there do your research just look at the over comments here and there low rating speaks for itself .its a terrible feeling when your life is falling apart and this company you paid into kicks your family and life onto the scrap heap oh yer that sorry makes it all better I guess.

I provide a brief summary, as the various hoops I have had to jump through are many and mundane.

The company I work for transferred from a very solid and professional drug insurance firm to the godawful Sun Life Financial. Even though their presentations promised a smooth transfer, come first trip to the pharmacy after cut over day, find out that medication needs to be pre-approved prior to being filled. My medication is time dependent, so I had no choice but to pay out of pocket for the drugs. Then I had to chase my doctor for them to fill out forms again justifying the use of the drug and send to SLF. Doctor completed, the forms and faxed through. (What a waste of time for the doctor?!) I called SLF to confirm that everything was good and that I could submit my out of pocket claim and also on my next trip to the pharmacy would be without incident. I was promised everything was fine, a letter was received confirming my drug coverage. I arrived at the pharmacy - same thing. Refused by insurer. A call to the SLF resulted in being transferred 3 times over 45 minutes, about half as many times as I was offered to use their website to check my status - an obvious and painful delaying tactic, do they think people will give up and actually try their website? Its BS - does nothing, not customer interaction can be achieved from the site. I was eventually told the drug ID number they had on record was wrong and I would need my doctor to resend the drug approval - also I was told this was my fault? Turns out the drug has a different number in their system and the doctor and I should have known this and provided it. I am now two months out of pocket with my first paper claim rejected and back to square one. A very unsatisfactory company. Medical insurance companies are vampires to the system anyways, but Sun Life Financial are turning it into an art form.

Good reviews for setting up of policy and price comparisons. The bad reviews are those that refer to claims. They don't pay out. I've been arguing for about a year now and I am arguing for my elderly father. It is is strong form of elder abuse. If my father didn't have me there would not be an arguing of the claim. I wonder how many elderly people are not getting what they paid a lifetime for.

What happens if they don't have a daughter or other person who cares? I have over 30 phone calls and countless documents in the mix and have been fighting for a year. I have satisfied every tenet required. I have letters from governmental agencies and doctors that support the claim. They don't phone supporting professionals and it's gotten to the point that if I can't prove what things are, I prove what things are not. It is the secondary insurer and the first insurer, Blue Cross, recognizes the claims.

They do not accept anything online and constantly say they haven't received letters. It goes to a post office box so getting a signature, forget it. They would have to pick it up from the post office. I started sending three copies of every letter sent. That is how bad it is. When I begged someone in the post office to go get a signature, she helped me out. I knew they had the package and when I phoned they said they didn't. I told them what I had done and magically, the package was there.

At the very least they should go online, at least there is a record of what is sent. Antiquated and the policy hadn't been updated in ten years. Don't go there. If you are thinking of getting an insurer....look at the ratings for the claims.

I have never dealt with a company so incompetent and so unwilling to help its customers. I was told that my claim would be paid in 48 hours. After three days, I called to see what the problem was. They said that in fact it would take 5 business days, not 2. When I asked why they sent me an email saying 48 hours, the person on the phone didn't have an answer.

After 6 business days and no deposit into my account, I called again. I verified my banking information, which was correct. They said the best they could do was requisition a direct deposit trace that would take 1-7 days. (One week for a direct deposit trace? That can be done with one phone call to the receiving bank.) After a week and no word from them, I called back. The person on the phone this time told me that a DD trace takes 2-4 weeks. (2-4 WEEKS??? ARE YOU JOKING???) I asked to speak to a manager. The 'manager' didn't have any additional information and wasn't able to help me in the least. I asked if there were any way they could stop payment and issue me a cheque, or if they could please contact their accounting department and have someone call the bank about the DD. No, she said, they can't do any of that...

But you know what the 'manager' WAS able to do? She was able to tell me that in fact a DD trace takes 4-6 weeks. In the same phone call, my wait time went up 2 more weeks. I asked her why the other employees each told me different things (3 people, 3 different stories), and she didn't have an answer.

I still haven't been paid, and still haven't gotten an apology. If you have the luxury of waiting for 6 weeks to get paid, or you're rich and don't care, then by all means you should go with Sun Life. However, if you need medical coverage but you do care about being paid in a timely manner and being treated with courtesy and respect, then Sun Life is definitely not the company for you.

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.

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.

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!!!

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!