Sun Life is a major force in the employer sponsored life insurance market, especially for mid‑size and large companies. Its plans often include basic life, supplemental life, and accidental death coverage. Because these benefits depend on accurate HR reporting and proper enrollment procedures, many denials arise from administrative mistakes rather than anything the insured did wrong.
When Sun Life denies a claim, families are often left with more questions than answers. The company’s denial letters can be dense and technical, but many of these decisions can be overturned with a structured, evidence based approach.
This page explains why Sun Life denies claims, how beneficiaries can challenge those decisions, and what steps to take immediately.
How Sun Life Handles Life Insurance Claims
Sun Life administers a large portfolio of group life and AD&D plans. These plans rely on employer data, payroll deductions, and enrollment systems that must work together without error. When information is missing or inconsistent, Sun Life often defaults to denial. Understanding how these systems interact is essential to reversing a wrongful decision.
Common Reasons Sun Life Denies Life Insurance Claims
Eligibility and Active Work Disputes
Sun Life frequently denies claims by asserting that the employee was not eligible for coverage at the time of death. These denials often involve medical leave, reduced hours, or job transitions. Many of these decisions rely on incomplete employer information. Payroll records, HR emails, and attendance logs are often critical in challenging these denials.
Evidence of Insurability Failures
For supplemental or voluntary life insurance, Sun Life may claim that the employee never completed the required evidence of insurability. In many cases, the employer failed to notify the employee or failed to submit the form. Courts often hold employers and insurers responsible when the employee reasonably believed they had coverage.
Premium and Payroll Deduction Errors
Sun Life often denies claims by stating that premiums were not paid. These denials frequently involve payroll mistakes, missed remittances, or confusion during medical leave. Many families discover that premiums were deducted or that the employer failed to forward payments. A detailed review of payroll history can reveal that coverage should have remained active.
Contestability Investigations and Alleged Misstatements
If the insured passed away within the first two years of the policy, Sun Life may conduct a detailed investigation. The company may allege that the insured failed to disclose a medical condition, medication, or lifestyle factor. To uphold the denial, Sun Life must prove that the alleged misstatement was material and that the policy would not have been issued if the truth had been known.
AD&D Denials Based on Exclusions
Sun Life is known for aggressively denying accidental death claims. The company often relies on exclusions involving intoxication, illness, drug use, or hazardous activities. These cases require a careful review of medical records, toxicology reports, and the exact policy language. Many AD&D denials collapse under scrutiny.
Beneficiary Disputes and Missing Forms
Sun Life may delay or deny payment if the beneficiary designation is unclear, outdated, or contested. These issues often arise after divorces, handwritten changes, or missing forms. When multiple people claim the benefit, the insurer may delay payment or file an interpleader lawsuit.
What Beneficiaries Should Do After a Sun Life Denial
A denial letter is not the final word. Beneficiaries have strong legal rights, and many Sun Life denials can be reversed with a methodical approach.
Request the Complete Claim File
Sun Life must provide all documents, internal notes, medical reviews, and communications related to the denial. This file often reveals inconsistencies or missing information.
Review the Policy and All Related Documents
Beneficiaries should examine the full policy, including riders, amendments, summary plan descriptions, and employer provided documents. Many denials rely on selective interpretations of policy language.
Investigate Employer or Administrative Errors
Because Sun Life relies heavily on employer provided information, HR mistakes are common. Identifying these issues can be the key to overturning the denial.
Challenge Unsupported Findings
If Sun Life relied on incomplete medical records, incorrect assumptions, or flawed calculations, these findings can be challenged with evidence and expert review.
Prepare a Strong Appeal
A well prepared appeal can reverse a denial and secure full payment. For ERISA governed plans, the appeal is especially important because it becomes the entire record for any future lawsuit.
Why Sun Life Denials Are Often Reversible
Many Sun Life denials are based on administrative errors, incomplete investigations, or misinterpretations of policy language. When beneficiaries challenge these decisions with a structured, evidence based approach, they often succeed. Sun Life must follow strict legal standards, and when they fail to meet those standards, beneficiaries can recover the full benefit.
Get Help With a Sun Life Insurance Denial
If Sun Life has denied or delayed your life insurance claim, you do not have to navigate the process alone. A strategic review of the denial can uncover the path to recovery and protect your rights.