Sun Life Health Insurance Reviews

Money is erroneously being taken from my chequing account by Sun Life so I called them to fix the problem. I got passed from person to person, department to department. They are sure that a mistake is occurring, but can't figure out how to stop stealing my money. I've spoken to at least 15 different, useless people and have to explain my story every. single. time. "Write us a letter and we'll get back to you." No, they didn't get back to me. "Send a fax to Attention Ryan and I'll look into it". He hasn't gotten back to me and the next person I spoke to had the nerve to laugh and point out that they have dozens of Ryans. "I'll get back to you tomorrow afternoon or the day after." Nope, Beverley never, ever calls. Just stop stealing my money!!! Seriously, losers, how hard can it be. I finally went to the bank today and put a stop payment on it. This has been happening since March 2011. Yep. They owe me $6000 and I'm seeing a lawyer tomorrow. I'm tired of being polite. I guess 78 months is my limit, LOL. They never, ever, ever call back and rarely answer the phone.

My employer uses Sun Life, so I'm stuck with them. I've even considered other jobs just so I do not have to deal with them. If I could give zero stars I would. Their interface is convoluted and their customer service is atrocious! No one wants to take any accountability and pass you around until you've literally spoken with a dozen unhelpful individuals only to have you give up in sheer horror and disgust. My partner has blue cross and I thought being treated like subhuman was the norm until I spoke with them once. Wow! What a difference!

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!!!

... Theresa Bertuzzi's doctor has recommended a costly drug called Rituxan, which has already been approved by Health Canada for cancer treatment but is still in the clinical trial stages for the treatment of dermatomyositis.

Because Bertuzzi needs the medicine for dermatomyositis and not for cancer, her insurance companies, Sun Life Financial and Desjardins, have rejected her application.

Without insurance coverage, Bertuzzi will have to pay $10,000 for one dose every six months. She said the companies can easily afford the costs but aren’t covering it because they claim there isn’t enough evidence of this drug being used for dermatomyositis.

“I can go out tomorrow and get a massage and they’ll pay for that, but they won’t pay for the drug that will save my life,” she said.

Both Desjardins and Sun Life Financial both sympathized with Bertuzzi’s situation in statements sent to CTV News but said they were unable to cover the drug because it hasn’t been approved by Health Canada for her specific condition. The insurance companies said they would follow up with her to discuss the policies further. Read the full story at CTV News

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