S
Sulize

1 reviews | Active since Nov 2021

08 Nov 2022, 07:45

Honestly i shocked.....

Honestly i shocked... Their service really has gone bad.. On Friday i put in a SCRIPTED MEDICATION claim.. It was loaded and i received an sms for the scripted medication claim... From Friday afternoon after submitting my invoice and script from the doctor it keeps saying rejected.. To my surprise yesterday they told me to pay the R175 Over the counter medicine claim or i wouldnt be able to put in another claim.. I didnt even submit an otc claim but they keep telling me i must pay.. Why must i pay if i put it through as scripted and they went and changed it to OTC medicine... Even though if you have exceeded your amount it wouldnt even have loaded . Been trying 2 days for someone to set this right....

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Replies (1)
Oneplan Insurance
Oneplan Insurance's reply08 Nov 2022, 08:44
Official
Good day Sulize,

Thank you for taking the time to bring this to our attention.

We sincerely apologize for any inconvenience caused and the circumstances under which your Hellopeter posting has reached. We do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations as we do value you as our client. 
 
We have attempted to contact you on the listed number; however, it was to no avail. 
 
Kindly note that as per our policy terms and conditions under Scripted medication point 3.2.2 its states that Supplements are not covered. We will require a motivational letter from the Doctor in order for the claim to be reviewed under the Scripted Medication benefit. 

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 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. 

Kindly provide us with a suitable time or an alternate contact number to contact you as we would like to provide you with more clarity on the above matter 
    
Once again we apologize for any inconvenience caused and we hope to restore the experience.
    
Kind Regards,
Oneplan