Sun Life Financial, US

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Filing a claim

 

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Filing a long-term disability or short-term disability claim

If an insured under a Sun Life Long-Term or Short-Term policy becomes disabled, a claim should be submitted using these forms. Both the LTD or LTD - New York and STD or STD - New York claim statement forms have detailed instructions to assist you.

Visit the Disability Claims Center for additional information.

Filing a life claim

If a person insured under a Sun Life Group Life insurance policy dies, a claim should be submitted using the Life Claim Statement. For life insurance claims, the following is also required: a certified copy of the Death Certificate, the Employee Application and beneficiary changes (if maintained by the policyholder).

There are some situations where additional information might be required:

If the beneficiary is a minor: submit certified letters of guardianship for the minor's estate.

If the beneficiary is the estate, submit certified letters of testamentary appointing the Executor/Administrator of the estate.

If the claim is incurred within the first three months of coverage, payroll records or other proof of active work will be required.

Filing a life disability claim

If a person insured under a Sun Life Group Life insurance policy becomes disabled (and the policy has a life insurance disability benefit), a claim should be submitted using the Life Disability Claim Statement or Life Disability Claim Statement - New York. This benefit is commonly known as a "waiver of premium" benefit.

Filing a dental claim

The Dental Claim Form or Dental Claim Form - New York should be used to file a claim when dental services are rendered on an insured. The claim form is completed by the dentists and mailed to the Benefit Center on the back of the insured's Sun Life Dental ID card. You can also obtain the correct mailing address by calling us at 800.442.7742.

Filing an insured vision claim

If a person insured under the Sun Life Vision Plan receives services from an in-network VSP provider no claim form is needed. If services are received by an out-of-network vision provider, the insured will need to submit their claim for reimbursement using the following process:

  • The insured pays for the services in full at the time of service from the out-of-network provider.
  • The insured completes an open access claim form, which can be accessed by logging into www.vsp.com.
  • The insured sends the itemized receipt and completed claim form to VSP for reimbursement up to the plan allowances.

Filing a group dependent life insurance claim

If a dependent person insured under Sun Life Group Life Insurance policy dies, a claim should be submitted using the Dependent's Life Claim Statement, Dependent's Life Claim Statement - New Jersey or Dependent's Life Claim Statement - New York. The following is also required: a certified copy of the death certificate and a copy of the Employee Application.

Filing an accidental dismemberment claim

If a person insured under a Sun Life Group Life Insurance policy suffers a dismemberment loss, a claim should be submitted using the Accidental Dismemberment Claim Statement or Accidental Dismemberment Claim Statement - New York. The following is also required: a copy of the Employee Application and copies of medical records pertaining to the accidental injury

 

Filing an accident claim

If a person insured under a Sun Life Group Accident Insurance policy becomes injured, dismembered or dies due to a covered accident, a claim should be submitted using the Accident Claim Statement. Appropriate documentation (e.g. medical bills, hospital bills, operative report) is required pertaining to the accident.

Filing a cancer claim

If a person insured under a Sun Life Group Cancer Insurance policy is diagnosed with and receives services or treatment for a covered cancer, a claim should be submitted using the Cancer Claim Statement. Appropriate documentation (e.g. medical bills, hospital bills, operative report) is required pertaining to the cancer treatment.

 

Filing a critical illness claim

If a person insured under a Sun Life Group Critical Illness Insurance policy is diagnosed with a covered critical illness or undergoes a covered procedure, a claim should be submitted using the Critical Illness Claim Statement. Appropriate documentation (e.g. medical records, operative report) is required pertaining to the critical illness.

 

Filing a hospital confinement indemnity "gap" claim

If a person insured under a Group Hospital Confinement Indemnity (GAP) policy administered by Sun Life receives treatment, services or supplies that are covered under that policy, a claim should be submitted using the Gap Claim Statement or Gap Claim Statement Spanish. Appropriate documentation (e.g. an Explanation of Benefits from your Major Medical Plan) is required pertaining to the treatment, services or supplies you received. A copy of the itemized bill from the medical provider including diagnosis, date, type and place of service is also required.

Watch the How to File a Gap Claim Video to learn more.

 

Filing a wellness screening claim

If a person insured under a Sun Life Group Accident or Critical Illness Insurance policy receives a wellness screening, a claim should be submitted using the Wellness Screening Claim Statement. Complete a separate form for each family member and date of service. No supporting documentation is required to submit the claim.

 

Filing a cancer screening claim

If a person insured under a Sun Life Group Cancer Insurance policy receives a cancer screening, a claim should be submitted using the Cancer Screening Claim Statement. Complete a separate form for each family member and date of service. No supporting documentation is required to submit the claim.