Sun Life Health Insurance Reviews

Per the rep I talked to, for dental insurance that I have, there's a list of like 200 claims that are automatically “downgraded” to be whatever Sun Life wants them to be. For example, my dentist did vertical bite wing X-rays and billed for that — Sunlife decided to only pay out for regular bite wing X-rays, and I was left with the remaining balance. This list is nowhere in my EoB and isn't on their site. My EoB says bite wing X-rays are covered twice a year during routine appointments. So they, the insurance company, will decide whether or not your dentist is allowed to bill for a certain procedure performed and then if the dentist doesn't agree, Sunlife will simply just say “we don't care” and pay for the procedure they think should've happened instead. It's essentially fraud, members aren't aware of this mystical list of exceptions and is never mentioned during open enrollment period. It exists so they can deny claims and take in more of your money while paying out less to the doctors.

Horrible company. Refuses to pay claims. It costs more to to have them, then what they will pay for. The worst.

Called their suport line, to get a poorly trained rep who gave incorrect information and basically wanted to just get through the call, and not research the issue with the claim rejection. This person advised I needed to fill out a "PDP form" from the pharmacist and then give it back to the pharmacist. I live in BC and no one in BC (Pharmacist or Doctor) knows what a "Provincial Drug Plan form" is.
Called back as this drug was covered previously and asked to discuss with a Supervisor, as the Sun Life first line of call takers are basically useless.
When the supervisor called me back she was not well informed on their protocols as she had no clue what she was talking about but advised that I needed to "Fill out a form" then when I asked her to send me this form, she sent me the approved Special Authority Form they already had on file for me?
In short (In long really, but this is my therapy after a Sun Life call) I sent them the receipt only which was done at the Pharmacist when filling the order a week earlier, and they paid the claim.
Again a frustration and normal experience to be expected by Sun Life benefits group, basically wasted a week and 5 phone calls for no reason.
If I was a senior, likely I would of just not been paid as navigating through Sun Life's maze of deception is not for the light off heart!!!