For a plan member whose disability claim has been declined, the new process can help them decide next steps. If they choose to appeal, we’ve made the process easier and more efficient.

Improved plan member communications

  • We’ve enhanced Disability Case Manager training to ensure our verbal and written communications are clear, concise and transparent.
  • We’ve redesigned some letters to plan members in order to:
    • clearly communicate decisions, and
    • offer concrete next steps in the appeal process.
  • We’ve created a new, easy to use appeal form.

New streamlined appeals process

  • Plan members who appeal their disability claims decision will no longer follow three levels of appeal. Instead, the plan member only needs to appeal once. The Disability Appeal team will ensure all required internal levels of review are completed before a decision is final. These changes allow for a more streamlined and efficient approach to decision-making.
  • We’ve also formed a new appeal committee and created quality control programs to support our new process.

There is no need to communicate these changes to plan members. Those plan members who receive a decline letter will simply benefit from a better plan member experience.

We’ll be communicating the above information to plan sponsors on May 13, 2021. You can review this communication here.

Learn more

The enhanced disability appeal process is just one of many enhancements to come. Talk to your Sun Life Group Benefits Representative for more information on how we are shaping the future of disability.