Insurance Coverage
What to expect
when you apply for
In Association & Affinity Business
at Sun Life Assurance Company
of Canada (Sun Life), we believe that
an
informed customer is a smart
customer. When you purchase
insurance, the application and
underwriting processes can be
confusing. This brochure is designed
to help you understand what you
need to do and what to expect
when you apply for cover
age.
THE APPLICATION PROCESS
Once you have made a decision to buy insurance, the first step in applying for coverage involves completing an application form. It contains questions that identify your coverage needs and your personal history. Depending on the product(s) you apply for, the application can include medical, occupational, avocational and financial questions pertaining to you, as well as questions on your family’s health history.
You are a key player in this process. The more information you provide to us, the better we are able to match our coverage to your needs. And that’s why an application form contains many detailed questions. It is important that you fill out the form completely and accurately, for two main reasons:
An incomplete application will be returned to you for further information and will delay the process.
Your completed application is considered a legal, binding document that forms part of your contract for insurance coverage.
Note that all personal information you provide to us will be kept confidential. Sun Life adheres strictly to applicable federal and provincial privacy legislation. To find out more about our privacy policy and code, please contact us for a copy of Respecting your Privacy or review Sun Life’s
Privacy Policy for Canada on our Web site at www.sunlife.ca.
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THE UNDERWRITING PROCESS
Once we receive your completed application, the underwriting process will begin. As customers are not all alike, underwriting is the process of assessing and classifying the degree of risk that each customer represents. Through this risk-selection process, an insurer can determine the eligibility and insurability of the customer for coverage. It also ensures that the customer is charged an appropriate premium rate; for instance, a non-smoker should not pay the same premium rate as a smoker.
Initial Screening
An underwriter will conduct an initial review of your application to ensure that it contains all the required information and decide what additional information is necessary for risk evaluation. If it is determined that you need to complete medical requirements, such as a blood chemistry profile, urinalysis or medical exam, we will
i n f o r m yo u w i t h i n a n ave r a g e o f five business days. These medical requirements will be obtained, at no cost to you, by reputable service providers contracted by us.
Within an average of five business days thereafter, a nurse will call you to arrange a convenient time and location for an appointment. You may also be contacted directly by a Sun Life group representative for additional medical information. As well, we may need to obtain a medical report from your family physician (which will be undertaken by our service provider at our request), and financial information, such as copies of your personal tax returns or business financial statements.
Monitoring
We actively track your application during the underwriting process and follow-up on outstanding requirements. We liaise with our service providers regularly to ensure that we receive information promptly. We have dedicated support staff that keep you up-to-date and send follow-up letters to you on a bi-weekly b a s i s . O u r C u s t o m e r S e r v i c e Representatives are also available to answer any questions you may have about your application.
The Underwriting Decision
It may take up to 20 business days to receive all the necessary medical and/or financial information from the various sources. Once we have all the information, the underwriter will render a decision within an average of five business days and you will be notified. Your application will be either:
approved standard, which means it is approved as applied for – this is the most common result.
approved substandard, which can mean that it is approved with an exclusion – for example, a pre-existing condition will not be covered – this outcome occurs occasionally.
declined, which means that coverage cannot be provided – this is the least common decision. Whenever possible, the underwriter will invite you to re-apply some time in the future.
Appeals
If you do not agree with our underwriting decision, you have the right to appeal. Simply notify us in writing and provide additional information that you believe will help us re-assess your application. In reviewing your appeal, the underwriter will consult other members of the Underwriting team who have specialized expertise. Note that the majority of appeals are resolved after more information is provided, which can either support the original underwriting decision or reverse it.
OUR UNDERWRITING TEAM
Underwriting is a core competency in Association and Affinity Business. Our Underwriting team includes qualified underwriters, medical doctors, accountants, and professional support staff who have decades of underwriting experience. Rest assured, we exercise sound, objective, fair, and consistent judgement in making underwriting decisions. We have an enviable track record and are highly respected in the industry for our impeccable underwriting standards and practices.
NEED MORE INFORMATION?
For assistance, please contact our Customer Service unit toll-free at 1-800 669-7921.
Sun Life Assurance Company of Canada is a member of the Sun Life Financial group of companies, a leading international financial services organization providing a diverse range of wealth accumulation and protection products and services to individuals and corporate customers. Tracing its roots back to 1865, Sun Life Financial and its partners today have operations in key markets worldwide, including Canada, the United States, the United Kingdom, Hong Kong, the Philippines, Japan, Indonesia, India, China and Bermuda.
Sun Life Financial Services of Canada Inc. trades on the Toronto (TSX), New York (NYSE) and Philippine (PSE) stock exchanges under ticker symbol “SLF”.
This brochure is intended only as an outline of the Association & Affinity Business insurance program for general guidance, and is not a contract. The insurance policy issued by Sun Life Assurance Company of Canada sets forth in detail the applicable terms, conditions, limitations and exclusions of this program. For a complete and accurate description of all benefits and entitlements under the program, please call your Sun Life Financial representative.
