dD
deanie D

1 reviews | Active since Aug 2017

01 Aug 2017, 13:50

Aneurysm apparently not life threatening

<p> </p> <p>Hi I'm finding it hard to wrap my head around this.</p> <p>I want an explanation as to why One Plan does not see my sickness as death defying? I was told ONLY do they see a stroke as life threatening, yet after my ruptured cerebral aneurysm I'm sitting with all the after affects of stroke. My right side is disabled, i have to learn everything From scratch. My aneurysm burst in September last year and still dont have any use to my arm. I had to have speach therapy, and still dont talk properly. My leg has had extensive physio and able to walk short distances with the assistance of a walk aid.</p> <p>One Plan paid for me the Monday to Thursday in ICU I was still in ICU till the Monday and then another 2 weeks in hospital. And then a week in rehab. The only reason I was there so short was cause we couldnt afford it... we maxed out our credit cards and maxed all personal loans. I know it is an insurance not a medical aid but 240K would have made a huge difference to the mere 96k we were given.</p> <p> </p> <p><br />I have read up on the condition since and it is a life threatening disease</p> <p>You can read up http://www.medicalnewstoday.com and www.bafound.org </p> <p><br /> </p> <p>Burst aneurysms are dangerous<br />When a brain aneurysm bursts, there is a brain bleed known as a subarachnoid hemorrhage.</p> <p>This medical emergency needs urgent treatment. The chances of survival are worse when treatment is delayed.</p> <p>The National Institute of Neurological Disorders and Stroke say that about 40 percent of people who have a burst brain aneurysm die within the first 24 hours. A quarter will die within 6 months.</p> <p>Survival depends on a number of factors, including age, general health, and how quickly medical care is received.</p> <p>For people who do survive a burst brain aneurysm, the outlook remains serious. It increases the chances of another burst, and there are likely to be complications such as long-term brain damage and nervous disorders.</p> <p>Later on I was given feedback that ICD10 codes were not matching up..... it is not my job to give the ICD10 codes to the medical, could they not have phoned and said something doesnt make sense. Im very upset about the entire thing.</p>

0
Replies (2)
Oneplan Insurance
Oneplan Insurance's reply22 Aug 2017, 16:14
Official

Hi Bernadine,

Please accept our deepest sympathies for all that you have experienced. No individual deserves to go through what you have been through.

We do understand that aneurysms are dangerous to one's health, but unfortunately, your condition was said to be non-life-threatening as per the ICD10 codes that we had received from the referring doctor. The codes do not match the diagnosis of an aneurysm. Aneurysms are covered under dread disease with a cover limit of R300 000. Your condition was classified as an illness in hospital where your cover limit was R102 000. A 5% excess was payable to Oneplan.

We once again apologize for all that you have been through.

Regards,

The Oneplan Team

dD
deanie D's update06 Oct 2017, 11:40
Reviewer Update
Can I please get proof of all the paper work that was sent to you in my case. Then i will know who i can take on in the matter. Thank you