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faizel F

1 reviews | Active since Dec 2020

09 Dec 2020, 08:43

Disgusting Values!! Pathetic service!! Useless!!

Disgusting!! If you knows whats good for your health and looking for peace of mind do not sign up with this pathetic excuse of a health insurance!!!! four months into the policy, My wife was suddenly going blind in one eye on late Saturday afternoon 05/12/2020, called in to notify One plan and seek hospital authorization. Had to deal with a consultant named Denzil (whom hasn't a stitch of empathy). Was then told "if at my own discretion" i want to take her to the nearest hospital and the situation isn't "life threatening" i will have to fit the bill. How the hell must i know i am not a doctor and all private GPs are closed on Saturday afternoons where i live. Basically we where lefty in the dark. We then had to spend the balance of Saturday and Sunday sitting at a Government hospital with limited facilities and access due to covid, they were unable to properly diagnose the cause or reason due to it being a weekend however the situation was getting worse and not better. I then had to book an urgent private specialist appointment on Monday morning , after checking my wife the Dr immediately rule this out as a hospital emergency as she is in danger of going totally blind with a list of possible causes unknown and proper test need to be run to establish the cause!! Again i tried to reach out to One plan for hospital assistance as we apparently have R50000 hospital cover according to the plan my wife is on and again had to deal with the same Robot Denzel to seek hospital authorization and guess what they declined us !! My wife never had a pre-existing eye condition yet Apparently we now not covered for it, i am currently awaiting for the MRI scan which is the only way to tell whats is actually wrong and good luck!, One life if its ruled out as a life threatening condition to do with her brain etc. Expect a law suite coming your way for gross negligence and not honoring your word. I will using all media platforms available to me to let people know of all the dishonesty your selling to honest hard working people, so they what to expect from a useless ONE PLAN medical insurance. I am moving across to a proper medical aid that will cost slightly more but there when you need them. Further i had sent you a formal cancellation letter with immediate effect via email, do not attempt to put your grubby hands into my account and debt my account for December. i will reverse it!!

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Replies (1)
Oneplan Insurance
Oneplan Insurance's reply09 Dec 2020, 16:19
Official
Good day Faizel, Thank you for taking the time to bring this to our attention. We tried contacting you to no avail. 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.  Regrettably, the requested admission/procedure benefits one of our general exclusions, which are things not funded for by the Insurer. As per your request, this was a request to mitigate vision, which unfortunately falls within the bounds of our very few excluded conditions. Certain terms and conditions are always applicable, and these are included in all policy documents before and during your experience with us. We will assist with all we can in line with our terms and conditions.  Should you be open to any level of clarity with our Authorization’s Manager, please provide a suitable time for contact. We once again apologize for the inconvenience caused.  Kind Regards,Oneplan