What do I do if my claim is rejected?

Your claim is first processed by a claims adjuster at Sun Life. If the information you give is not sufficient to enable Sun Life to make a decision on the claim, they will request more specific and detailed information. Keep copies of everything you send them. If you give sufficient evidence, the claim is approved. If not, the claim is denied.

If your claim is denied, Sun Life will ask you for more documentation. If, after another review, the claim is still refused and you disagree with that decision, you can ask Sun Life's Disability Management Unit to review your case. This committee, made up of senior claims analysts, may overturn a claims adjuster's earlier decision.

To appeal, send a letter to:

Disability Management Unit
Group Claims Control Department
Sun Life Assurance Company of Canada
PO Box 12500, Station CV
Montreal, Quebec H3C 5T6

Visit their website for phone numbers and other contact information.

You can also give your letter to Human Resources, or ask your PSAC Component or Regional Office to handle your appeal. Don’t forget to show your social insurance number on your letter and on all documents you submit.

After you appeal:

Sun Life will tell you what documents you need to qualify, and will respond on a priority basis to questions from HR about the status of your appeal. In emergency situations, Sun Life will usually answer direct questions from you or your representative.

Have your certificate and control numbers handy.

Topics: 

September 22, 2013
Share/Save