Submitting a claim for Personal Health Insurance

Go to my Sun Life to:

  • Submit your claims online for vision, paramedical and dental claims, if applicable
  • Get your claim payments deposited into your bank account
  • Print your claim forms 1
  • View your coverage details and claim history
  • Find out if a drug is eligible (available on Health Coverage Choice) 2

Register online

Not registered yet? Register online at my Sun Life or by phone at 1-877-SUN-LIFE (1-877-786-5433). You will need your policy number (e.g. 037000) and ID number. If you’ve already registered for Customer Access, you don’t need to register again.

Download my Sun Life Mobile

  • You can also submit a medical or dental claim on the go using the my Sun Life Mobile app. Download it for iPhone, BlackBerry and Android 3 devices at sunlife.ca/mobile.

Note: The my Sun Life Mobile app and web services are available to Sun Life group benefits clients. You may see wording related to a group plan that’s not applicable, but the coverage details will be correct.*

*If you are a PHI policy owner, you will not see your or your insured family member’s exclusions. You need to refer to your contract to view specific details and exclusions.

In all provinces except Quebec, you'll receive a pay-direct drug card to be used at the pharmacy when purchasing medications. When you present this card to your pharmacist, the portion that is covered by the plan will be paid automatically. You just pay the remainder of the cost at the pharmacy counter.

For Quebec residents, the pay-direct drug card is not available. If you live in Quebec, you'll need to complete a claims form and submit it after you've applied for reimbursement under your provincial plan or group benefits plan.

To arrange for direct deposit of your claim payments, you'll need to register for web services and provide bank account details.

  • If you submit a claim on a paper claim form and you are registered for web services, we will deposit your payment into your bank account.4
  • If you use the same bank account for premium payments and direct deposit claim payments, you can’t change your banking information online. In that case, you will need to complete a Personal Health Insurance pre-authorized chequing (PAC) or credit card authorization form.
  • If the account is only used for direct deposit claim payments, you may change your banking information online.
  • If you have both health and dental coverage, direct deposit will apply to both benefits; direct deposit is not available for one benefit and not the other.
  • If you and your spouse have separate policies, you will each need to register for web services.

You’ll find an initial supply of paper forms in your welcome package. Mail your completed form, along with your original receipts to the claims office nearest you:

Sun Life Assurance Company of Canada
PO Box 11658 Stn CV
Montreal QC H3C 6C1

Sun Life Assurance Company of Canada
PO Box 2010 Stn Waterloo
Waterloo ON N2J 0A6

Remember to keep a copy for your records. You can also print the forms here:

Dental claim form for personal health insurance

Extended health care claim form for personal health insurance

To ensure payment of these expenses:

  1. Call the 24-hour helpline listed on your Emergency Travel Medical card immediately or have someone call on your behalf.
  2. Our emergency travel assistance provider will verify your health coverage and provincial healthcare coverage so payments can be arranged on behalf of yourself, your insured spouse or your insured dependant.
  3. You'll be required to sign an authorization form allowing the emergency travel assistance provider to recover any amount payable to the provincial healthcare plan.
  4. You're responsible for expenses incurred that are not covered under our plan or your provincial healthcare plan. You'll need to reimburse the emergency travel assistance provider for any excess amount paid on your behalf.
  5. If you receive any subsequent bills for these expenses, please forward them to the emergency travel assistance provider and they will co-ordinate payments with the provincial healthcare plan and Sun Life.
  6. The emergency travel assistance provider may request proof of travel (e.g., plane tickets, gas receipts, car rental receipts) to prove travel dates are within the eligible 60 days. If you don’t provide such proof, your claim may be denied.

More information on Emergency Travel Medical claims is in your welcome package.

Footnote

1 For forms which require changes (such as a termination form), contact the Personal Health Insurance administration team at 1-877-SUN-LIFE (1-877-786-5433) with menu options 1 for English. Changes to the plan such as an address change, adding or removing a dependant or adding or removing a benefit cannot be done on the website.

2 If you have medical (non-drug) exclusions, you can still see these benefits but there is a disclaimer on the website to indicate the contract will determine the level of coverage they have.

Data charges may apply when using this app. my Sun Life Mobile is free for anyone to download, however, you will not be able to access information on the app unless you own Personal Health Insurance or Health Coverage Choice from Sun Life; or if you have benefits through an employer group plan.

4 When the payment is deposited, an email is sent to the owner informing them the claim has been processed and the owner can sign in to see the claims payment details.