Keeping plans safe and sustainable

Sun Life leads the industry in both the size and capabilities of our Fraud Risk Management team. We take a firm and unwavering approach to reducing and deterring benefits fraud. This commitment has resulted in saving plan sponsors millions of dollars that might otherwise have been spent in fraudulent claims and plan abuse.

Our dedicated team focuses on predicting and preventing fraud before it occurs, using data analytics and artificial intelligence (AI). This results in intelligence-led strategies that focus on prevention, preparedness, response and recovery.

We've invested heavily in fraud risk management in three key areas:

People

  • Our 100+ investigative team includes:
    • Highly trained investigators, including former law enforcement.
    • Industry and service-specific intelligence analysts and field operators.
    • Data analysts.
    • Fraud-focused auditors.
  • Another 1000+ Sun Life employees are trained in fraud detection and mitigation.  

Technology

  • Industry-leading AI that can quickly detect changes in claiming patterns.
  • Sophisticated research and analysis software.
  • Comprehensive screening programs.

Education

  • Plan sponsor and plan member resources and materials.
  • In depth client engagement.
  • Onsite training and educational presentations.
  • Dedicated hotline and email address to report suspicious activity.