Fraud Management

Sun Life takes a hard stand against group benefits fraud. We continually make significant investments in new technologies, enhanced tools and resources to help combat this growing problem. Estimates have put losses due to fraud as high as 10 per cent of annual health care spending1, which potentially represents over 2.5 billion dollars in losses2. It’s important to know what you can do to help protect your organization and your employees/plan members from the risk of fraud.


Fraud Newsletter – The F Files

Our new semi-annual newsletter covering relevant issues related to group benefits fraud, including information about how to protect from and report group benefits fraud, and to learn about how Sun Life is combating this growing problem through new technologies, tools and resources.

Bright Paper – Group Benefits Fraud: A Leading Edge Perspective

This Bright Paper covers the increasing sophistication of the threats that plans face today, explores Sun Life’s intelligence-led anti-fraud approach and the skilled fraud team who work hard to reduce risk every day.


Helpful tips to be #fraudsmart

Get anti-fraud tips for both plan sponsors and plan members. And read this article on how to protect yourself from benefits fraud.


How to be a responsible plan member

Make sure you’re using your plan the right way to avoid and protect from fraud through your benefits plan. Get information on how to be a responsible plan member when it comes to your drugs, orthotics, physiotherapy, paramedical, medical equipment and/or devices, extended health care and dental plan benefits.


Quiz: How Fraud Savvy Are you?

Take the challenge to see how you rate on our fraud prevention scale.


1 Canadian Life and Health Insurance Association (CLHIA), 2016 (https://www.clhia.ca/antifraud)
2 Based on fraud estimates reported by the Canadian Life and Health Insurance Association (CLHIA), 2016 (https://www.clhia.ca/antifraud) and the Canadian Institute for Health Information (CIHI) forecasted 2015 spending of private health insurers in Canada (https://www.cihi.ca/sites/default/files/document/nhex_trends_narrative_report_2015_en.pdf)