pP
pieter P
1 reviews | Active since Apr 2017
11 Jul 2024, 15:43
Check that you know what you are in for with Oneplan
My dog was hit by a car, and I had to take her to the vet. The vet took x-rays, dressed and cleaned her wounds, and gave her medication. When I submitted the claim from this One Plan didn't even pay out 50%. When asked why I got peppered with all kinds of small print that I still don't understand. Also when she got neutered, One Plan paid out R120, even though when they sold me the plan I was told that it was covered. I'm not on the cheapest plan. I see there is a lot of good reviews here, so not sure if I'm an exception or if I didn't listen properly when the plan was sold to me, but I'm moving to another insurer.
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Oneplan Insurance's replyOfficial
11 Jul 2024, 17:00Dear Pieter,
Thank you for taking the time to bring this to our attention.
Thank you for taking the time to bring this to our attention.
We sincerely apologize for the circumstances under which your posting has reached us and for any inconvenience caused. We do have your fur-babies best interest at heart, and we wish her a speedy recovery.
We have attempted to contact you on the listed number; however, it was to no avail.
Kindly note that for a claim to be considered under In-Hospital Admission, the invoice must reflect details of an in-hospital corrective procedure. Should a diagnostic procedure result in a confirmed diagnosis the cost of the procedure will be reviewed under the authorized Hospital admission cover limit. Kindly note that all in-hospital claims must meet our admission matrix which is found in your policy schedule.
Upon investigation we discovered that your fur-baby is covered on the Classic plan and the services rendered on the invoice fall under the Casualty benefit due to it being diagnostic tests and medication that was dispensed, therefore, the claim was assessed and approved under the Casualty benefit up to the cover limit of R1400.
According to our policy schedule under the heading "What is Not Covered" on the Oneplan Pet Hospital Admission Cover Section (point 2) it states that admission and/or hospitalization exclusively for diagnostic procedures, monitoring, and/or observing is not covered under the in-hospital benefit, however, this will be covered under the day-to-day benefits on the Comprehensive plans.
Kindly note with regards to the sterilization of your fur-baby, this is covered under the Pet Med Savings benefit up to the annual limit of R800. According to the claims history, an amount of R680 was utilized on the 09th of February 2024 which left your fur-baby with a balance of R120 and we could only approve the balance of R120 towards the claim that we received on the 20th of June 2024.
As per the policy terms and conditions, the Pet Med Savings benefit may be used towards preventative care claims for your insured pet. According to our policy schedule under Pet Med Savings (point 3.2), it states Pet Med Savings means access to a savings wallet that may be used towards preventative care claims for your insured pet and includes, voluntary sterilization up to a cover limit of R800 per pet covered on the Classic plan. Should clients request more cover, they can choose to add on the Pet Med Booster which offers an additional R800 towards preventative care claims.
There are annual cover limits on all our cover types which are renewed on the anniversary of your policy.
Certain terms and conditions are always applicable, and these are included in all policy documents before and during your experience with us. The terms and conditions of the policy must be adhered to and app**** fairly for all clients. We do have your fur-babies 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 to have provided clarity on the above matter.
Kind Regards,
Oneplan
Oneplan Insurance's reply11 Jul 2024, 17:00
Official
Dear Pieter,
Thank you for taking the time to bring this to our attention.
Thank you for taking the time to bring this to our attention.
We sincerely apologize for the circumstances under which your posting has reached us and for any inconvenience caused. We do have your fur-babies best interest at heart, and we wish her a speedy recovery.
We have attempted to contact you on the listed number; however, it was to no avail.
Kindly note that for a claim to be considered under In-Hospital Admission, the invoice must reflect details of an in-hospital corrective procedure. Should a diagnostic procedure result in a confirmed diagnosis the cost of the procedure will be reviewed under the authorized Hospital admission cover limit. Kindly note that all in-hospital claims must meet our admission matrix which is found in your policy schedule.
Upon investigation we discovered that your fur-baby is covered on the Classic plan and the services rendered on the invoice fall under the Casualty benefit due to it being diagnostic tests and medication that was dispensed, therefore, the claim was assessed and approved under the Casualty benefit up to the cover limit of R1400.
According to our policy schedule under the heading "What is Not Covered" on the Oneplan Pet Hospital Admission Cover Section (point 2) it states that admission and/or hospitalization exclusively for diagnostic procedures, monitoring, and/or observing is not covered under the in-hospital benefit, however, this will be covered under the day-to-day benefits on the Comprehensive plans.
Kindly note with regards to the sterilization of your fur-baby, this is covered under the Pet Med Savings benefit up to the annual limit of R800. According to the claims history, an amount of R680 was utilized on the 09th of February 2024 which left your fur-baby with a balance of R120 and we could only approve the balance of R120 towards the claim that we received on the 20th of June 2024.
As per the policy terms and conditions, the Pet Med Savings benefit may be used towards preventative care claims for your insured pet. According to our policy schedule under Pet Med Savings (point 3.2), it states Pet Med Savings means access to a savings wallet that may be used towards preventative care claims for your insured pet and includes, voluntary sterilization up to a cover limit of R800 per pet covered on the Classic plan. Should clients request more cover, they can choose to add on the Pet Med Booster which offers an additional R800 towards preventative care claims.
There are annual cover limits on all our cover types which are renewed on the anniversary of your policy.
Certain terms and conditions are always applicable, and these are included in all policy documents before and during your experience with us. The terms and conditions of the policy must be adhered to and app**** fairly for all clients. We do have your fur-babies 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 to have provided clarity on the above matter.
Kind Regards,
Oneplan