LTD to age 65 not paid out
by c_jack on Oct 12, 2016
1 out of 5 stars
I had extended healthcare coverage through my professional association which I paid thousands of dollars for over the years. Having had skin cancer 3 times, I decided to have a skin treatment advised by my skin specialist. The treatment was approved by Sun Life ahead of time but my claim was denied when submitted. They requested bogus information and talking with their customer rep didn't help. Having been ripped off by Sun Life I have cancelled my health plan. I would advise not doing business with this company as their conduct is dishonest.
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 am on my father's Sun Life insurance. I am a student under the age of 25, therefore, as of the insurance policy, I am supposed to be insured. Every six months or so ever since I turned 18 I get refused. And my dad has to argue with them every single time, and then he confirms that I am supposed to insured for say another two years, and then a few months later (or a few weeks later on this case) I get refused. Again. It is frustrating when you are a student on a tight budget, thinking your medication will cost 2$ and then it costs over 20$, having to put it on your credit card and then waiting for up to six weeks to get your money back. Not impressed at all.
My spouse was a employee for Ontario Hydro. Unfortunately, they chose Sun Life for their health benefits. We sent in documents for receipts for our glasses. They just ignore us. They do not contact us to tell us why they are not paying. When we phone them, the lie and say they didn't receive any receipts. They keep saying this no matter how many receipts you sent in.
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.
I have been patiently waiting.....and waiting.....and waiting........and......
First you deny my claim ,then when I ask for reason you cannot give me one.
The same claim breezed through on Blue Cross on my wife's coverage where she works part time! Then you asked me to get doctorrs referral and fax it "special to Jen" on the phone after a couple of weeks ,I was notified it was being "processed" the first thing in the morning Over 10 days ago If it takes that long to process one claim some heads need to roll. My health dwindles while I wait. Remember health?? It's supposed to be HEALTH insurance.
Once again it shows the simplicity and superiority of Bue Cross insurance over Sun Life.
Every where I go ....Blue Cross we'll process that no need to do a thing.....Sun Life your on your own, pay up front and see if you can get the money back.
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.
They asked me to submit additional documents, then again for the same case more additional documents. Then just answered that provider delisted and will not be paid anymore. What about claims submitted before the provider was delisted? They answered: now it your problem, we do not care and will never pay. They have stolen several hundreds dollars by delaying before they delisted the provider. I am sure they knew they were going to delist the provider, that is why they delayed asking crazy additional documents.
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.
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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.