VR
Ver R
1 reviews | Active since Mar 2009
14 Apr 2025, 08:28
74yr old claims not paid - Dr of 40yrs must change
My doctor does not have a computer or printer neither swipe facilities.
I have been with Dr Weyers for over 50yrs. What is fair for me as a client is for OnePlan to probe alternative measures for my particular case. Otherwise, what you are asking me to do is go to a new Dr with all these facilities who does not have my history. Is that fair or even realistic?
My health is suffering. I am 74. I currently having severe pain but I cannot go to my GP because of OnePlan's limitation placed on me and my claim will not be refunded. I have been a loyal OnePlan client for years and my premiums started at about R700 and now it's about R2000. I pay this R2000 monthly, diligently without fail, with my pension and money from my children. But I can't enjoy the benefits for this large sum I pay for my GP? Where is the value in that? I am disappointed in OnePlan. I however believe that this is not to get me out of the system.....
I am awaiting a favorable and practical outcome on this matter.
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Replies (2)
Oneplan Insurance's replyOfficial
14 Apr 2025, 08:44Dear Ver,
Thank you for taking the time to bring this to our attention.
From the outset, we sincerely apologize that your experience with Oneplan has not been a pleasant one and apologize for any inconvenience caused. It is deeply concerning the circumstances under which your Hellopeter posting has reached us. Customer service is our number one priority, and this is not the level of service we aim to provide our clients with. Please rest assured that this matter will be investigated.
We have acknowledged your complaint and would like to clarify that in December 2024, a General Practitioner claim was approved as a once-off leniency with a hand-written invoice. We attempted to contact you to inform you of this, however, were unable to reach you. An email was sent to the email address registered on your policy in response and to inform you that the claim was approved as a once-off leniency. Furthermore, in the email, we mentioned that going forward, we will no longer accept hand-written invoices for claims to be assessed.
It is important to note that we have seen an increase in ********** claims, and this has resulted in increased risk. In response to these challenges, we have implemented interim measures to enhance the security and integrity of our claims process. One such measure involves requiring a detailed computerized invoice reflecting the services rendered, including the proof of payment when claiming for any day-to-day benefits.
While we understand that this adjustment may cause an inconvenience, please know that it is necessary to protect the interests of all our clients and ensure the sustainability of our product.
Kindly note that the terms and conditions of the policy must be adhered to and app**** fairly to all clients. We do have our client's best interests at heart, and we will assist with all we can in line with our terms and conditions. Please note we are governed by the FAIS Act and must apply the TCF policy to ensure all our clients receive fair service and cover.
Once again, we apologize for any inconvenience caused and we hope this clarifies the matter.
Kind Regards,
Oneplan.
Kind Regards,
Oneplan.
Oneplan Insurance's reply14 Apr 2025, 08:44
Official
Dear Ver,
Thank you for taking the time to bring this to our attention.
From the outset, we sincerely apologize that your experience with Oneplan has not been a pleasant one and apologize for any inconvenience caused. It is deeply concerning the circumstances under which your Hellopeter posting has reached us. Customer service is our number one priority, and this is not the level of service we aim to provide our clients with. Please rest assured that this matter will be investigated.
We have acknowledged your complaint and would like to clarify that in December 2024, a General Practitioner claim was approved as a once-off leniency with a hand-written invoice. We attempted to contact you to inform you of this, however, were unable to reach you. An email was sent to the email address registered on your policy in response and to inform you that the claim was approved as a once-off leniency. Furthermore, in the email, we mentioned that going forward, we will no longer accept hand-written invoices for claims to be assessed.
It is important to note that we have seen an increase in ********** claims, and this has resulted in increased risk. In response to these challenges, we have implemented interim measures to enhance the security and integrity of our claims process. One such measure involves requiring a detailed computerized invoice reflecting the services rendered, including the proof of payment when claiming for any day-to-day benefits.
While we understand that this adjustment may cause an inconvenience, please know that it is necessary to protect the interests of all our clients and ensure the sustainability of our product.
Kindly note that the terms and conditions of the policy must be adhered to and app**** fairly to all clients. We do have our client's best interests at heart, and we will assist with all we can in line with our terms and conditions. Please note we are governed by the FAIS Act and must apply the TCF policy to ensure all our clients receive fair service and cover.
Once again, we apologize for any inconvenience caused and we hope this clarifies the matter.
Kind Regards,
Oneplan.
Kind Regards,
Oneplan.
VR
Ver R's updateReviewer Update
14 Apr 2025, 09:06You can't generalize under my claims umbrella of *****. I told you that I have been with this Dr for decades, I've been claiming refunds I pay to him for many years, I asked you to help me and you refused based on *****ulent claims, which should not even be a concern based on all the facts of my history with Oneplan, but this is not considered. How do I go to a new Dr with printing facilities who does not know my medical history and who I don't trust, this is the issue here, can you help me or not?
VR
Ver R's update14 Apr 2025, 09:06
Reviewer Update
You can't generalize under my claims umbrella of *****. I told you that I have been with this Dr for decades, I've been claiming refunds I pay to him for many years, I asked you to help me and you refused based on *****ulent claims, which should not even be a concern based on all the facts of my history with Oneplan, but this is not considered. How do I go to a new Dr with printing facilities who does not know my medical history and who I don't trust, this is the issue here, can you help me or not?