Sun Life Assurance Company is one of the biggest life insurance companies in Canada. It manages short term and long-term disability plans, and acts as a third-party administrator for self-funded plans. If you have a Sun Life long-term disability plan, or if you are considering purchasing one, the following information will help you understand your plan and what to do if your Sun Life long-term disability is denied.

Sun Life Long-Term Disability Insurance Overview

Sun Life long-term disability policies provide a potential financial safety net in the event a policyholder becomes injured, sick or disabled to the extent that they are unable to work for an extended period of time. In most cases, Sun Life Insurance will pay a percentage of the claimant’s monthly earnings until they are no longer considered to have a “total disability” according to Sun Life long-term disability rules.

If a claim is approved, long-term disability Sun Life will typically kick in once the policyholder’s short-term disability coverage has been exhausted.

What are the Sun Life Long-Term Disability Rules?

Sun Life long-term disability rules govern the process by which policyholders submit claims for benefits and how they can submit an appeal if their claim is denied.

When submitting a long-term disability Sun Life claim, a policyholder must provide relevant medical information, a description of how their condition affects their ability to perform daily activities, their job functions, and how their condition affects their ability to work.

The policyholder’s employer and physician will also need to submit forms to Sun Life.

Once a policyholder submits the proper Sun Life long-term disability forms, their case manager will review the information and contact the claimant by phone to discuss the claim. The case manager may also contact the policyholder’s physician and/or employer for further information.

According to Sun Life, this claims assessment process typically takes about 10 business days once all of the claimant’s information is received. A case manager will inform the claimant about the status of their claim by phone and in writing. If the claim is denied, Sun Life will provide the reasons for the denial.

Why Was Your Sun Life Long-Term Disability Denied?

If your claim is denied, you should receive a letter letting you know the reasons why your Sun Life long-term disability was denied. Unfortunately, many providers of long-term disability coverage may initially deny legitimate claims to avoid paying benefits. They may also use confusing language that leads people to believe they don’t meet the definition of total disability when they should actually qualify for Sun Life long-term disability benefits.

If you have your Sun Life long-term disability claim is denied, you may want to contact a lawyer to discuss your situation. A long-term disability lawyer who is knowledgeable about long-term disability rules can help you understand your policy terms and what you can do to appeal your denial.

Where Can You File Sun Life Long-Term Disability Complaints?

There are two ways you can file complaints if your claim is denied. The first step is to file an internal appeal with a Sun Life representative. Be prepared to act quickly if you receive a denial letter because you will only have a limited time in which to file an internal appeal. The specific deadline depends on the specific Sun Life long-term disability rules set forth in your policy, but they typically can be anywhere from 30 to 90 days after your claim is denied.

If that step is unsuccessful, you can file a legal appeal against Sun Life and have a judge make a final decision on your case. If you decide to file a legal appeal, contact a long-term disability lawyer to help you build your case.

Can You File a Sun Life Long-Term Disability Appeal?

Although you can file a Sun Life long-term disability appeal on your own, it is a good idea to consult with a lawyer to help you build your case and get the benefits you deserve. Long-term disability lawyers are knowledgeable about the tactics many insurance companies use to deny legitimate claims, and they can make sure you gather all of the documentation and other evidence necessary to put together a strong appeal.

If you decide to take your Sun Life long-term disability appeal to court, a lawyer will help you navigate the legal system and make the necessary arrangements to gather evidence to support your long-term disability claim. Having a long-term disability lawyer on your side will increase the chances that your Sun Life insurance claim will be approved.