Sun Life Health Insurance Reviews

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.

The worst insurance company to ever deal with. Don't ever get your insurance with this company. They will never pay you. They will keep asking you to submit all kind of your medical information. Then take awhile to review it and get back to you. And then they will ask you to submit more medical information. So, your claim will be on hold for months and months. Until you get frustrated and don't want to deal with them anymore. And that’s their goal so that they don't have to pay you. Warning: do not consider to get insurance with this company.

Don't bother calling them if you have a group benefits question. They are not helpful and they are always screwing up.

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!

I have health plan coverage through the Public Service Health Care Plan (Canada) and will say it's the worst customer service I have ever experienced with any professional service company ever. It's as if they deliberatly attempt to frustrate the customer to make you give up. The phone advisors are more often condescending and rude than they are helpful, and the online secure messaging and inability to communicate by email makes the whole system as slow as molasses. I have come to despise Sun Life and will never, ever willingly use them for anything ever again as long as I live.

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 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!