Contradictory clauses
I One Plan in October 2020. My mom was referred to a hospital by a doctor February 2021 and they decided not to acknowledge the claim without a written reason.
How is that possible?
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Replies (1)
Oneplan Insurance's replyOfficial
19 Feb 2021, 15:51Good day Waynie-lee,
We sincerely apologize for the inconvenience caused. We do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Upon investigation we discovered that we have not received any documentation regarding the hospital admission request. Kindly send through the hospital admission forms to *** for our claims department to assess, please add your mom's the policy number in the subject line.
Prior to having authorization given for a claim, Kindly note there is 12 months waiting period for procedures such as gastroscopy and colonoscopy. Terms and conditions of the policy have to be adhered to and app**** fairly for all clients, please note that this is by no means a ploy to refuse payment of the claim.
We will assist with all we can in line with our terms and conditions.
Once we receive confirmation of the hospital admission our claims depart will assess the claim and we will revert to you with the relevant feedback.
Kind Regards,
Oneplan
We sincerely apologize for the inconvenience caused. We do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Upon investigation we discovered that we have not received any documentation regarding the hospital admission request. Kindly send through the hospital admission forms to *** for our claims department to assess, please add your mom's the policy number in the subject line.
Prior to having authorization given for a claim, Kindly note there is 12 months waiting period for procedures such as gastroscopy and colonoscopy. Terms and conditions of the policy have to be adhered to and app**** fairly for all clients, please note that this is by no means a ploy to refuse payment of the claim.
We will assist with all we can in line with our terms and conditions.
Once we receive confirmation of the hospital admission our claims depart will assess the claim and we will revert to you with the relevant feedback.
Kind Regards,
Oneplan
Oneplan Insurance's reply19 Feb 2021, 15:51
Official
Good day Waynie-lee,
We sincerely apologize for the inconvenience caused. We do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Upon investigation we discovered that we have not received any documentation regarding the hospital admission request. Kindly send through the hospital admission forms to *** for our claims department to assess, please add your mom's the policy number in the subject line.
Prior to having authorization given for a claim, Kindly note there is 12 months waiting period for procedures such as gastroscopy and colonoscopy. Terms and conditions of the policy have to be adhered to and app**** fairly for all clients, please note that this is by no means a ploy to refuse payment of the claim.
We will assist with all we can in line with our terms and conditions.
Once we receive confirmation of the hospital admission our claims depart will assess the claim and we will revert to you with the relevant feedback.
Kind Regards,
Oneplan
We sincerely apologize for the inconvenience caused. We do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Upon investigation we discovered that we have not received any documentation regarding the hospital admission request. Kindly send through the hospital admission forms to *** for our claims department to assess, please add your mom's the policy number in the subject line.
Prior to having authorization given for a claim, Kindly note there is 12 months waiting period for procedures such as gastroscopy and colonoscopy. Terms and conditions of the policy have to be adhered to and app**** fairly for all clients, please note that this is by no means a ploy to refuse payment of the claim.
We will assist with all we can in line with our terms and conditions.
Once we receive confirmation of the hospital admission our claims depart will assess the claim and we will revert to you with the relevant feedback.
Kind Regards,
Oneplan