Good Until they Weren't

On the 1st February 2024, my mother was rushed to Life Fourways Hospital. She had a fall, that fractured her pelvis. We were in contact with One Plan from that date, every question, every query, I contacted them. She was admitted to ICU, and then moved to a general ward. She was receiving in hospital physiotherapy. Prior to her discharge, I called One Plan on the 7th February to query if they covered a Step-Down. My mother required further therapy, in order for her to walk again. I was told by the Authorisations agent that Step-Down was not covered, but if the doctor could write a motivation letter for out of hospital care, then she would be able to go to physio, under the same claim number subject to funds. We understand that there is a limit per accident claim, and we have diligently monitored that at the hospital. I called Authorisations on the 12th February to find out the progress, as the physiothe****** and the doctor had sent through the motivations. I was informed that nothing had been received. I then sent through the motivation from the doctor to One Plan. Now, we have not had any issues with One Plan, the center agents have all been helpful, and given us the way forward, until the 12th February. I sent the details through, and spoke to the same agent morning and afternoon, the more I explained I understood there was a cap to the limit, the more he was telling me that there was a cap to the limit. Explained that they were waiting for anesthetist accounts, and x-rays etc. mentioned that there was no surgery, and we paid the CT scan, they more I was being told about the CAP. Eventually, I was told that the motivation was going to be sent to a manager. The authorisation was rejected, as One Plan do not cover out of hospital physiotherapy. I am confused? You asked us to get the motivation letter, we are aware there is a cap and we will be liable for everything over the cap, we ran around little mad and the questions were asked, and now my mother has been discharge from hospital, still cannot walk. So, you allow your members to recover, then be discharged, with the same issue, and no assistance going forward. My main issue is, every step of the last 2 weeks, I have not done anything prior to speaking to One Plan. The agent yesterday, was rude and treated me like I was a fool. I am well aware of what the process is, well aware of the cap in the claim limit, and I am well aware that invoices are coming through, I have made sure that I am on top of what was required. OnePlan was amazing when this all started, then they just let us down