GM
Godfrey M

1 reviews | Active since Aug 2020

08 Aug 2020, 19:06

Disappointed soon to be former member

So yesterday my dr referred me to casualty for assessment and hospitalisation, I called one plan twice and was given all the runaround, first i am not well and need urgent hospitalisation and have the doctors referal letter, the first consultant (a Brave Nyirenda) ask what the condition I have, I tell him and he says there are a "few things" that are needed before they can assist, they sent me this email.

With regards to your recent enquiry, please note that, for admission letter of motivation is needed ,treatment plan,icd 10 code ,procedure codes together with the quotations for clinical review

I then call back and find a Simphiwe who tells me that for any authorisation to be entertained they are also emailing a medical history form which needs to be completed by all the doctors which I have visited the past two years, image my shock, this they are telling to a very ill person who this was never disclosed to before nor can I find in any of the Documents sent to me before.

I ended up giving up as I did not want to agrivate my condition and was taken to a public hospital where I had to wait for hours before being given a panado and told to come back on Tuesday for treatment and was sent home still not well.

I am typing this while lying sick in my bed and asking myself why I even joined you guys as it looks like you look for any excuse not to pay.

I am left with no choice but to look for medical cover elsewhere.

0
Replies (2)
Oneplan Insurance
Oneplan Insurance's reply12 Aug 2020, 22:03
Official
Hi Godfrey,
 
Thank you for taking time out to elaborate on your query, and are truly empathetic on your current health status. 

In keeping with our treating customers fairly, we would like the opportunity to investigate this matter thoroughly and establish professional and mutual grounds. Regrettably we are not at liberty to discuss in-depth on public platforms but would like the opportunity to schedule a conversation between yourself and the relevant department for an urgent comprehensive intervention. A document containing history of medical records has been requested to facilitate review for final funding decision with our underwriters, this is key as it will allow our clinical team to apply the terms and conditions of the contract Oneplan Health insurance has with yourself.
 
We have requested one of the Underwriters to get in touch with you urgently so, looking forward to serving you fairly.

Kind Regards
Oneplan
GM
Godfrey M's update13 Aug 2020, 08:12
Reviewer Update
Thanks for finally responding, but I have since sent an email to your Cancelation department cancelling my membership and my decision to cancel is irreversible.