Making a Claim

NOTE: This claim process only applies to employees who retired on or after Jan 1, 2010.  Current employees or employees who retired prior to January 1, 2010, will find claim information here. 

You should contact the Plan administrator or access the website at www.coughlin.ca/ncbaa-aannc to get the proper form to make a claim. There are time limits for making claims. These limits are discussed in the appropriate sections of this group benefits e-booklet. All claims must be made in writing on forms approved by Sun Life. No legal action may be brought by you more than one year after the date we must receive your claim forms.

How to claim Hospital room expenses

If you, your spouse, or any of your children are hospitalized, give the admitting clerk your contract number, 150052, and insurance company name, Sun Life Financial. Generally, hospitals bill the Plan directly. If your hospital does not, send a completed claim form with the hospital’s invoice to Sun Life. They will either pay the hospital directly, if the claim was sent directly from the hospital, or reimburse you, up to the value of semi-private accommodation.

Out-of-province hospital and medical expenses

If you have supplementary coverage and have a travel-related emergency, contact Europ Assistance (where possible, before incurring expenses) at:

• 1-800-511-4610 (in Canada or the US), or
• 001-800-368-7888 (in Mexico), or
• *202-296-7493 (from elsewhere, call collect).

* Add the long distance code to contact the US. Europ Assistance will coordinate payments from the provincial Health Care plan and Sun Life for members under the supplementary coverage. You do not need to submit a claim, unless you want to claim for coordination of benefits under another plan. If you do not contact Europ Assistance:

• get detailed receipts,
• submit expenses to your provincial Health Care plan,
• once the province reimburses you, send Sun Life:
  a claim form,
  duplicate receipts (or photocopies), and
  the provincial statement of payment.

Send in your claim as quickly as possible, because provincial plans have very strict time limits. If claims are late, they may not be paid by the province or Sun Life.

Vision Care benefit expenses

For eyeglasses or contact lenses, you can submit your claim electronically. Just go to www.sunnet.sunlife.com/member/signin/index.asp, sign in with your access ID and PIN, click on “My claims” and then click on “Vision Care e-claim” under the “Submit a claim” tab. You can get an access ID and PIN number by calling Sun Life at 1-800-361-6212. If you prefer:

• pay the expense and get a receipt,
• complete a claim form, and
• mail both claim and original receipt to Sun Life.

For laser eye surgery:

• pay the expense and get a receipt,
• complete a claim form, and
• mail both claim and original receipt to Sun Life.

Once the next two-year calendar period begins, submit a claim form with a copy of your original receipt and explanation of benefits from Sun Life. You can continue to resubmit the laser surgery expense claim under the regular Health Care Plan until the balance is paid, as long as the person for whom you are claiming remains continuously covered under the Plan.

Prescription drugs, other medical supplies and paramedical services

For other eligible expenses:

• pay the expense and get a receipt,
• complete a claim form, and
• mail both claim and original receipt to Sun Life.

Dental expenses resulting from accidental injury

• Have your dentist complete the appropriate sections of the dental claim form. Make sure that the claim is not sent electronically to the Dental Care Plan.
• Attach the Dental Care claim form to a Health Care claim form and send both to Sun Life.