How to submit a critical illness insurance claim

3 helpful tips

  1. Be timely. We need to know about your illness within one year of your diagnosis.
  2. Be thorough. Give us as much information as you can when you send us your claim. 
  3. Be complete. Please fill out all of the information on the claim form. Remember to sign and date the forms you send us.

The most common missing information is:

  • Physician contact information: the full address, including postal code and phone number of all of the doctors you consulted. This includes regular attending physicians and specialists.
  • Signatures: If you’re unable to sign the claim form due to your illness, make sure it’s signed by your power of attorney for property. Submit the form appointing the power of attorney along with the signed claim form.

Step 1. Contact us

Call us at 1-800-669-7921 as soon as possible after the date of your diagnosis or surgery to let us know about your critical illness. We’re open any business day between 8:30 a.m. and 5 p.m. ET. 

We’ll start by asking you for basic information:

  • Your name
  • Date of birth
  • Phone number
  • Address
  • The type of illness

Please ensure you review the definitions, terms and conditions of your coverage. Depending on your plan, you can find coverage details in your certificate, employee booklet, group contact or benefits administrator.

Step 2.  Complete the Critical Illness claim forms

After we speak with you, we’ll send you a package with these forms:

  • Proof of Claim
  • Confidential Physician’s Report
  • Authorization Form

If your doctor charges a fee to help you complete the forms, you’ll have to pay the cost.

If you’d like help with these forms, please call us at 1-800-669-7921, Monday to Friday from 8:30 a.m. to 5 p.m. ET. 

3. Send us your completed forms

You can send us your information using one of the options below.

Please keep a copy of the documents you send us for your records.

If you need to send medical information for your claim, your doctor can send it to us directly.

Fax: 
1-855-233-9880

Mail:    
Sun Life 
227 King St S 
PO Box 1601 Station 
Waterloo, ON  N2J 4C5 
Sun Code: 300A50

Courier:    
Sun Life 
227 King St S 
Waterloo, ON  N2J 4C5 
Sun Code: 300A50

Email:  
A&Aclaims@sunlife.com 
If you choose to send your information by email, we can’t guarantee the privacy or security of email communications while they’re on their way to us.

4. Our review

Once we have your claim information, we’ll send you a letter with the name and contact of your dedicated case manager. They’ll be your main point of contact for your claim. You can also ask them for an update or send them more information any time while we’re reviewing your claim. 

You can also call us at 1-800-669-7921, Monday to Friday from 8:30 a.m. to 5 p.m. ET.

5. The claim decision 

Once we’ve finished our review, we’ll send you a letter to let you know if your claim is approved.

  • If we approve the claim, we’ll make the payment by cheque. 
  • If you’d prefer your payment by electronic funds transfer (EFT), be sure to give your case manager a copy of a void cheque when you start your claim.
  • Depending on your policy, there may be a waiting period before we can make the payment. This is what your policy calls a survival period.

If we don’t approve the claim:

  • We’ll send you a letter with a detailed explanation about our decision, including any relevant medical information.
  • If you choose to appeal our decision, we’ll give you next steps. 
  • You’ll have 90 days to send us new information. If your doctor charges a fee to send us new medical information, you’ll have to pay the cost.

This information can be sent by: 

  • Fax: 1-855-233-9880
  • Mail:    
    Sun Life 
    227 King St S 
    PO Box 1601 Station 
    Waterloo, ON  N2J 4C5 
    Sun Code: 300A50
  • Courier:    
    Sun Life 
    227 King St S 
    Waterloo, ON  N2J 4C5 
    Sun Code: 300A50
  • Email: A&Aclaims@sunlife.com. If you choose to send your information by email, we can’t guarantee the privacy or security of email communications while they’re on their way to us.

3 helpful tips

  1. Be timely. Contact us as soon as you know about your illness within one year of your diagnosis.
  2. Be thorough. Give us as much information as you can when you send us your claim. 
  3. Be complete. Please fill out all of the information on the claim form. Remember to sign and date the forms you send us.

The most common missing information is:

  • Physician contact information: the full address, including postal code and phone number of all of the doctors you consulted. This includes regular attending physicians and specialists.
  • Signatures: If you’re unable to sign the claim form due to your illness, make sure it’s signed by your power of attorney for property. Submit the form appointing the power of attorney along with the signed claim form.

1. Contact us

Please call us at 1-877-786-5433, Monday to Friday from 8 a.m. to 8 p.m. ET as soon as you find out you’ve been diagnosed with a covered critical illness. 

We’ll start by asking you for basic information: 

  • Your name
  • Policy number
  • Date of birth
  • Telephone number
  • Address
  • The type of illness

2. Send us additional information

Once we’ve confirmed the basic information for your claim, we’ll ask you to complete one or more forms depending on the type of illness. 

An advisor will connect with you to confirm what we need. They’re also happy to answer any questions about your claim.

You can also call us at 1-877-786-5433, Monday to Friday from 8 a.m. to 8 p.m. ET. We’re here to help.

3. Send us your claim information

You can send forms and any other details to us using one of the options below. Please keep a copy of the documents you send us for your records.

If you need to send medical information for your claim, your doctor can send us the information directly.

Fax: 
1-866-487-4745

Mail:    
Sun Life 
227 King St S 
PO Box 1601 Station 
Waterloo, ON  N2J 4C5 
Sun Code: 300A50

Courier:    
Sun Life 
227 King St S 
Waterloo, ON  N2J 4C5 
Sun Code: 300A50

Email:  
disable@sunlife.com 
If you choose to send your information by email, we can’t guarantee the privacy or security of email communications while they’re on their way to us. 

4. Our review 

After we receive the information we need, we’ll start our review of your claim. We may also reach out for further information if we need it.   

You can ask your advisor for an update on your claim or send them more information any time during our review. 

You can call us at 1-877-786-5433, Monday to Friday from 8 a.m. to 8 p.m. ET. We’re here to help.

5. The claim decision 

Once we’ve finished our review, we’ll send you a letter to let you know if your claim is approved.

  • If we approve the claim, we’ll make the payment by cheque. 
  • If you’d prefer your payment by electronic funds transfer (EFT), be sure to give your advisor a copy of a void cheque when you start your claim.
  • Depending on your policy, there may be a waiting period before we can make the payment. This is what your policy calls a survival period. Your advisor can give you more information.

If we don’t approve the claim:

  • We’ll send you a letter with a detailed explanation about our decision, including any relevant medical information.
  • If you choose to appeal our decision, we’ll give you next steps. 
  • You’ll have 90 days to send us new information. If your doctor charges a fee to send us new medical information, you’ll have to pay the cost.

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