SS
Scott S

1 reviews | Active since Jul 2018

20 May 2024, 12:41

Disgusting Service from a "team" of "people"

Our family has had Oneplan Pet Insurance for years now with no issue until this. The issue: Our older cat gets attacked by another cat. She then disappears for 3 days and on the evening of the 4th day, she returns. Her face and head is now mangled and swollen to the point that her eyes are squint. Rushed to the Vet. Vet keeps her overnight to find out its an abyss/infection CAUSED by the ATTACK. Cat stay for 3 days getting draining session and high does antibiotics. We pay the vet out of pocket. Comes home. Claim goes in via App, app doesnt work with multiple document uploads. Many calls placed. All is well after an email is sent. 10 days later we call again to check on progress and they have "lost" our claim and will rush it. 3 more days. Claim has been declined due to the attack being an illness.. Legitimately told us that the infection is an illness. How the **** can you say that? Heather was the lady involved in the decision, are you a vet Heather? Were you there? Reason: Infections only happen after 48hrs. Sure, they can. But if our cat is missing and comes back with the infection after witnessing the ******* attack what are we to do, count the hours? Ombudsman has been contacted, this is not morally correct and will not be left here. Cancellation forms will be sent asap.

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Replies (1)
Oneplan Insurance
Oneplan Insurance's reply20 May 2024, 16:05
Official
Dear Scott,
 
Thank you for taking the time to bring this to our attention. We are sorry to hear about the way you feel as we will always have our clients and fur-babies best interests at heart. 
 
Upon reviewing the claims forms that we received, it states that your fur-baby, Meuwkie was diagnosed with an abscess which takes longer than 48 hours to form. Records on our system confirm that your fur-baby is covered under our entry-level, Accident Plan which only covers in-hospital corrective procedures that are due to an Accident only and any illness-related events that occur as a result will not be covered under the Accident plan. 

According to the policy schedule “Accident” means a sudden, unexpected, unforeseen, unusual, unintended event that is diagnosed within 48 hours from the time of the event, causing injury to your Pet, the result of which requires immediate medical attention to your Pet and will be assessed according to the Admission Matrix as listed under Section 4, Oneplan Pet Hospital “Special Conditions”.
 
In this case, the services rendered will fall under the Casualty cover limit which would have been covered on our comprehensive, Primary, Classic, and Super Plans up to their respective cover limits as this is in line with our policy terms and conditions. 
  
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