New on the anti-fraud front

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Sun Life continues to effectively fight benefits fraud and abuse to ensure your benefits plan is well protected. We have developed some communications that may be helpful and informative to you and your plan members.

For plan sponsorsa new flyer/brochure

For plan membersa fraud prevention tip sheet/poster.   Feel free to distribute fraud tips to your plan members electronically or print off the tip sheets in handout size or in poster size for placing in common areas of your organization.

Changes in e-claims audit process

As of August 30st, plan members submitting claims online will experience some changes.  Key changes coming into effect are:

  • If a plan member’s claim is selected for audit, they may not be asked to send in their receipts.  Sun Life will attempt to contact the member’s service provider to confirm the service.  If we are unsuccessful in our attempts, the member will be prompted to send in their receipts.
  • E-claims audits will now occur before a claim is paid, rather than the audit occurring immediately after the claim has been processed.  This means that members will be notified that their claim is in progress and will receive payment once the verification has been completed.
  • If plan members are required to submit their receipts, they will have a shorter window to mail/fax/e-mail their receipts before e-claim service is suspended.

If you would like to let your plan members know about these changes to the e-claim audit process, here is a brief description of the changes for them.

Other fraud-related events

Sun Life has an advertisement in the September issue of Benefits Canada and in the counterpart French publication, Avantages.

We also have benefits fraud content posted on our microsite hosted by Benefits Canada at:  www.benefitscanada.com/microsites/sunlife and on the French Avantages site at:  www.conseiller.ca/avantages/microsite/sunlife. The fraud content will be updated again in early September, so please check back.

Fraud – Recognize it. Report it. Stop it.

Should you or your plan members suspect fraud may be occurring, please contact our toll free line at: 1 888 882-2221. Your confidentiality will be protected.

Questions?

For more information, please contact your Sun Life Financial group benefits representative.