- When should I file my claim? What are the time limits to file a claim?
- How do I file my claim?
- If I have both STD and LTD coverage with Sun Life, do I need to complete both claim statements?
- When will I know something about my claim?
- Who will review my claim?
- Should I stay in contact with my employer?
- What happens if I disagree with the claim decision?
- If I am receiving Workers’ Compensation or State Disability should I file a STD or LTD disability claim?
You should file a claim as close as possible to the beginning of your illness, injury or pregnancy. Delays in submitting your claim could result in a reduction of benefits that may be payable to you. Also, it may impact our ability to make a timely decision.
You must complete a disability claim statement for the appropriate coverage, Short-Term Disability (STD) or Long-Term Disability (LTD). The forms can be accessed by clicking on the links and they include portions that need to be completed by you, your employer and your doctor. You can return the completed claim statement to us via fax, mail or e-mail to firstname.lastname@example.org.
No. If you have both coverages with Sun Life, you should submit a STD claim form. If needed, additional information will be requested for consideration of LTD benefits.
We will send you a letter acknowledging our receipt of your claim statement. This letter is mailed the day after your claim has been received. You will continue to receive regular updates regarding the status of your claim until a decision is made.
The review process entails many steps to ensure we make a prompt and fair decision. It involves a thorough review by a Disability Claims Professional (DCP). During the initial review a DCP will call you and your employer. This will provide us with a better understanding of your medical condition, job duties and any financial information that might pertain to your claim.
The DCP will then consult with members of our medical staff (nurses, doctors and/or psychologists). They may contact you or your medical provider(s) to help us clarify any questions we might have regarding your medical condition. Our vocational staff will also review your claim. Their role is to work with you and your employer to help you get back to work.
Ongoing communication with your employer is important to both of you. Workflow adjustments may be necessary while you are away. Keeping your employer updated will help them plan for your absence and recovery.
Our claims review process has been designed to ensure that reviews are thorough and decisions are appropriate according to the terms of the disability policy. Should we determine that benefits are not payable, in part or in whole, you will be notified. The notification will provide you with an explanation of why benefits are not payable and information on how to appeal our decision should you disagree.
If I am receiving Workers’ Compensation or State Disability should I file a STD or LTD disability claim?
Yes, it may be possible for you to receive benefits from us while receiving benefits from other resources such as these. The specific impact of receiving such benefits is dependent upon your Sun Life policy.