I Don't Know where to Start
by Gerald Sroka on Jul 3, 2024
1 out of 5 stars
I had podiatrist surgery, by a podiatrist who has been practising for the last 30 years. Canada Life denied my claim saying he does not meet the qualifications. However, they covered my initial assessment. After calling several times and giving them the registration number they still denied it.
Worst service EVER! Messages (plural) sent through their online portal not even acknowledged, no response. Submitted a claim - Canada Life has advised me that the garment prescribed by my physician for the treatment of a recently diagnosed condition.
Is not considered a valid treatment by them. Apparently, they know more about me & my condition than my physician. Appalling.
Canada Life rejected my claim and said “Important: Your plan does not cover non-prescription sunglasses.”
My submission is for my sunglasses frame.
f-r-a-m-e. That is part of eyewear.
My previous claim only has a lens. How can I wear only lenses? What does eyewear mean? Only means prescribed lens?
Could you please show me an example of wearing only a lens?
I put the category under Eyewear and Exams. Canada Life first mistakenly put it under Laser eye surgery and later again mistakenly under Lenses: single vision.
Can Canada Life read my notes?
I have been a long-term group member under Great-West Life for more than 40 years and am now with Canada Life due to their 2020 business change. There has never been a problem until this year. The plan covers Prescription glasses every 4 years. This year, we purchased eyeglasses based on an Optometrist's prescription, paid fully upfront (as usual) and then submitted the claim with receipts to Canada Life. DENIED! Reason: "This provider is not eligible for reimbursement". Tried telling them that the provider had not asked for payment, we paid in full and had used the same provider in 2019. We simply wanted the Vision Plan benefit. Well, after several telephone complaint discussions and an appeal that a representative put in, the same response is given. Trying to escalate the complaint to the Ombudsman was another disappointment. We were referred to a vague Customer complaint process. After more than two weeks, the issue is still pending. Our options are limited. We are seniors and this experience has left us emotionally drained. Short of taking legal action, there is no accountability.
Customer service is disgraceful - the average wait time to connect with a representative is 1 hour and beyond!
Example: I called on a workday, Mon, 18-Oct during business hours and had to wait for 1 hour on the line listening to their apologies for the delay. Shame on you Canada Life!
Most importantly - Canada Life is not willing to reimburse the eligible expenses under various excuses!
Example: it took them forever (more than 1 month) to review the claim for a standard Gastroscopy done in a private clinic. In the end, they requested an itemized statement of charges that the clinic cannot provide and refused to pay.
If your future employer provides you with a Group Plan from Canada Life - run!
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This could be great Is. Company for Group Bens. if their agents were actually trained in the aspects of this type of Insurance. Every claim I have sent in has been rejected and then sometimes paid out. It takes an enormous amount of time to continually provide additional information before a claim is paid out. When calling the Call Centre you wait forever to talk to an agent who is usually in a hurry to get off of the phone? Furthermore, they have a committee who approves some drugs that are not always on their list of prescribed drugs. This committee in my case misread all Doctors info and Pharmacy Info. Therefore rejecting my claim. Called in as advised by supervisor who just said Call back to call center they have copies of letters. They did not, and only explained that it takes weeks for decisions to be made? Yet I had a letter of decline in my hand. It speaks volumes when a supervisor manager does not even understand what her Call Centre has as information. As I said, this could be a really good Insurance Company if they just understood what they were selling and actually did due diligence when making decisions.