Sun Life eClaims

1. Throughout the application there will be mandatory fields required to ensure we are collecting enough information to identify the claim requirements. Before you start your claim, review the insured’s policy and be able to answer this key question:
   • Has the insured been diagnosed with an illness that is covered by their policy?
   • This information can be found in the policy contract, under “covered illnesses”
2. If you indicate that your claim is not for a covered illness under the contract terms, you will be provided with the following alert message:
   "This policy does not cover all illnesses. To submit a claim, you must confirm that the diagnosed condition is covered under this policy. Please delete this claim and contact disable@sunlife.com, if you require assistance."
3. Save your claim and continue completion later. At any point throughout the claim process, you can save and come back later if you are missing any information. You can do this by selecting cancel and select Save for later. You can pick your claim in progress by selecting the deceased’s name on the dashboard.

1. Advisors can find the eClaims portal on the Suncentral sign-in page.
2. Once you select Launch Sun Life eClaims, you will be asked to enter the Contract number for the claim or name.
3. Once you select Search, you will be taken to the Client search results screen, where you will select the name of the Client associated with the claim.
4. From the Contract column, select your contract number. This will bring you to the dashboard to Start a new claim.  You can select Life eClaim or Critical Illness.
5. Once you have entered the eClaims Application, the Client and contract number will be displayed. You will need to complete the claim using the insured person’s contract number.

The eClaims process consists of three (3) main pages that must be completed and reviewed prior to submitting your critical illness claim:

1. Insured person, 
2. Requirements, and 
3. Summary

1. Once you enter in the Client’s policy number, it will prefill their name, contract number, Client number and date of birth.
2. You will need to select who is receiving the benefits.  Note: If the individual receiving the benefits is not the insured person, you will be prompted to select Other and you will be guided to choose:
   • Named Individual
   • Estate
   • Company
3. We ask you to confirm if the policy has been continuously in force for more than 5 years as this will help us identify if this is an early claim.  Additional documents will be needed on all early claims.
   If you select no, the below information box will appear:
   "This is an early claim. Additional documents are required. We will review your submission and contact you with the next steps."
4. You will need to confirm if the insured person has been diagnosed with a critical illness that is covered by the policy.
   • If you select No, you will not be able to submit an e-claim and you will be prompted to delete the claim.  To ensure a smooth process and avoid potential disappointment, we kindly ask that you carefully review the covered illnesses outlined in the contract before submitting a claim. This will help prevent the submission of claims for conditions that may not be eligible for coverage under the current policy.
   • If you select Yes, you will be guided through the rest of the claims process and need to select the appropriate illness and the date of diagnosis. Note: A reminder will be displayed to ensure that the illness is covered under the Client’s contract.
5. You will be asked to confirm where the illness was diagnosed.  This information is important as it will help us determine if foreign claim requirements are needed.
6. If the Client has coverage under a group critical illness policy, you will have the option to input this information within the eClaim.
7. If you are completing a posthumous claim, you can select yes.  You will be asked if the total claim amount is $150,000 or more, as this will be important to know for requirements.

1. This screen will display the current requirements based on the information provided. We have added in tool tips to provide clarity around some of the requirements.
2. Any Sun Life form will be accessible through the eClaim Application.
3. From the requirements screen you will have the capability to drag and drop/upload the completed requirements prior to submitting the claim.
4. If you don’t have all the requirements needed to submit your claim, use the cancel button to save your claim for later.
5. Once you are ready to submit the claim select Save and continue.

1. You will be able to preview all the information prior to claim submission on the summary screen.
2. If you discover an error, use the radio button to go back and update the information.
3. Once you have made your correction return to the Summary page to submit your form.
4. Review the Summary page to ensure all information is accurate to the best of your knowledge. If so, submit your claim by selecting on the Submit Form button.

1. Upon submitting your claim, you will be brought to the Confirmation page indicating that your claim was submitted successfully.

1. You can view your claims in progress on the dashboard.
2. The claim status will change as the claim moves through the adjudication process from submitted, in queue, in progress and completed.
3. Once the claim has been completed it will move to the claims completed tab on the dashboard.

The documents in an approved or submitted eClaim will remain on Sun Life eClaims for 7 years.

If you do not have access to these Clients, please have the notifier contact the client care center to report the death or send an email to LFCLM@sunlife.com to setup the claim. Please ensure you provide all the required information below:

• Name of deceased
• Maiden name
• Marital status (single, married, divorced, widowed)
• Date of birth of deceased
• Date of death of deceased
• Cause of death
• Place of death (city, province, country)
• Name of executor/beneficiary
• Relationship to deceased
• Daytime phone number
• Mailing address
• Funeral home Name

For express claims, eClaims will offer transferring to an investment account as an option in the payment section of eClaim. If the claim is non-express, a claimant statement will be required and will provide you with the same option.

Once a claim has been submitted, you will need to call Advisor Technology Service (ATS) to support deleting the claim.

All individual life insurance and individual critical illness claims can be submitted via eClaims.

We encourage you to start the submission process using the documents you have on hand. The eClaim platform allows you to save your progress at any point, enabling you to return and complete your claim when it's convenient for you.

Alternatively, you can submit your claim even if you don't have all the required documents yet. You'll be able to upload any missing documents later, through the dashboard.

An adjudicator will contact you regarding any outstanding requirements needed to process your claim.

Yes, anyone with access to your Advisor ID profile can submit claims. This includes assistants or other authorized personnel. Additionally, anyone granted the appropriate permissions will be able to view and access dashboard information associated with your account.

If you're in the middle of submitting a claim and realize you're missing information, you can save it for later.

Here's how:

1. Look for the "Cancel" button at the bottom of your submission form.
2. Select "Cancel" and then select "Save for Later."
3. Your claim will be saved, and you can access it later through your dashboard.

Important note: If you've already reached the review screen of your claim, no additional changes can be made. Make sure to save your claim before reaching this stage if you need to add more information later. You can revisit and complete your saved claim at any time by accessing it through your dashboard.

All claims submitted by you should be visible on the dashboard. 

If this is not the case, please contact the Advisor Technology Support at 1-800-800-4786.

The dashboard is updated in real time as claims are processed.

As part of an effort to adopt a more holistic Client-centric approach rather than focusing solely on individual products/policies. This information helps Sun Life to understand the full scope of the relationship.

The first eClaims link entitled Individual Life and Critical Illness eClaim – new submission will lead you to a page where you can submit new eClaims, while the second link entitled Individual Life and Critical Illness eClaim – status dashboard will lead you directly to your dashboard where you can view all the claims you have submitted.

Requirements are based on claim complexity and vary from policy to policy.

Yes, you can. To add documents to an existing claim:

1. Go to your dashboard
2. Select the Client's name
3. This will take you to the claim submission page
4. From there, you can upload any additional documents to the file

No, it's best not to submit unrequested documents or information. Here's why:

1. Unnecessary submissions can potentially slow down the adjudication process.
2. For express claims, additional documents may disqualify the claim from express processing, leading to longer processing times.
3. The claims department has specific requirements for each type of claim. They request only the information they need to process your claim efficiently.
4. Submitting extra documents may cause confusion or require additional review time, which can delay the overall process.
5. If additional information is needed, the claims department will reach out to you with a specific request.

Cause of death is a mandatory requirement for all life insurance claims in Canada. If you're unsure about the cause, follow these steps:

1. Consult the beneficiary or executor: Ask them about the circumstances surrounding the death. They may provide valuable information to help determine the cause.

2. In cases of multiple illnesses: If the deceased had several health conditions, select the most significant or immediate cause of death.

3. Cause of death is cancer: Select the appropriate cancer from the dropdown list. Only select “All other and unspecified parts cancer” when the specific cancer is unknown or isn’t in the dropdown list.

4. Seek guidance: If you're still uncertain after gathering information, contact the Life Claims team for assistance. We can help you interpret the circumstances and determine the appropriate cause to report.

5. Use "Unknown/Other" as a last resort: If the cause remains unclear or is still under investigation, select "Unknown/Other" on eClaim. Then, send a detailed email to LFCLM describing all known circumstances of the death.

6. Follow-up: An adjudicator will review the information and contact you if any additional details are required to process the claim.

Remember, providing accurate information is crucial for efficient claim processing and ensuring compliance with regulatory requirements.

This is required information to process the claim.  You can save your partially completed claim and submit it once you have the funeral home details.

This is to avoid submitting claims for each policy and duplicate entries for beneficiary information.  If they are different, this will trigger our process to search for all affected beneficiaries.

Only submit a claim for one policy and we will search for additional policies for the deceased.

If you see a claim on your dashboard that you did not submit, this means that we have been notified of the death through another source. The team will locate all policies associated with the deceased and manage them as one claim.  If this happens, you will receive an email from the team stating that we have been notified of a death for your Client. The dashboard will provide access to the policies where you are listed as the advisor of record. You will need to submit any outstanding requirements through LFCLM@sunlife.com.

Yes, once the claim is submitted, we will make sure that all appropriate departments are notified that the Client passed away.

The marital status of the deceased is required for a claim for the following reasons:

1. If the beneficiary on the policy is the Client’s spouse and the marital status is widowed, we will need to determine to whom the death benefit is payable as additional requirements may be necessary.
2. In Quebec, if the beneficiary is the Client’s spouse and the marital status is divorced, we require a copy of the divorce certificate. As per the Civil Code of Quebec, if the divorce takes effect after December 1, 1982, the beneficiary appointment to the spouse is null and void and the policy becomes payable to the estate.

We ask for the main point of contact to respect a claimant's preference for Sun Life to communicate directly with the Client rather than through an advisor.

Please do not submit the claim until you have confirmation of a covered illness. If you have questions, you can contact us at disable@sunlife.com.

As part of an effort to adopt a more holistic Client-centric approach rather than focusing solely on individual products/policies. This will allow us to share this information with the group critical illness team, to avoid having the insured send another notification.

No, currently, the eClaims application is only for individual products. If you would like to submit a claim for group critical illness, please contact them by email grpciclaim.amgcollectif@sunlife.com.

Majority of claims only have one CI policy, and this is why eClaims are submitted at a policy level. Each policy has its own defined covered illnesses, and we need to make sure each claim is based on the specific policy provisions.

The guided experience shows what information we need to process the claim, and you won't be able to submit the claim without this basic required information. 

You can save your claim and come back once you have that required information.  For example, we require date of death and funeral home details.

To resolve this issue, please ensure:

1. Your document does not exceed the maximum file size of 10MB per file.
2. You are using one of the accepted file formats: PDF, JPG, or PNG.
3. You are not uploading more than 10 documents per claim. eClaims only accepts up to 10 documents per claim in the formats mentioned above.

If you are still experiencing issues or need to submit more than 10 documents, please email your documents to LFCLM@sunlife.com. In the email subject line, include the policy number and the deceased's name.

There are instructional videos available to support you, located on the Sun Life eClaims page on Suncentral.

For navigational and technical support, please contact Advisor Technology Support at 1-800-800-4786.