Question

Can SunLife refuse to provide me with their review information? Is my claim worth appealing?

Asked on December 22nd 2016 by Frustrated Star
So Sunlife paid my short term claim, but with my long term they denied but really have no reason. They said they were missing notes from a doctors visit. I filed my social security claim the same time and it was approved the first submission in less than two months. Sunlife has sent me in circles for 3 months saying info was never recieved etc. Now they say for my long term that i am only approved for six weeks from when I filed which is insane because their short term policy covered me for three months. They wanted a copy of my social security file and if i did not provide then I would be denied for not complying with providing information. I asked to see the review information and was told they would only supply a full copy of my policy. Obviously my experience matches many others. Is it even worth appealing? Do they ever pay long term claims?

Answer

Answered on December 19th 2016 by Attorney Stephen Jessup

Frustrated Star, if your claim was formally denied in writing and advising you of rights to file an appeal they would have to provide you the complete file. It sounds like they are conducting their review and are only providing temporary benefits. Please correct me if I am wrong. If you are unable to work (which it appears you certainly are unable) and there is a portion of the benefit they would have to pay I would say it is definitely worth pursuing. Please feel free to contact our office to discuss any questions you may have.