AM
Alice M

1 reviews | Active since May 2018

04 Jan 2022, 12:21

Horrible service when it comes to paying back money they owe you

I have been struggling with my hospital claim being paid for over a month now, I had to pay the doctor out of my own pocket before the procedure on the 25th of November, I phoned the Wednesday 29th of November after phoning Oneplan for weeks on end and being told I will be paid back the money I paid in 30 days and on this day I am being told they first need the statement from the hospital and there is another 30 day waiting period so this is a total of 60 days I need to wait for my money to be paid back, my money, not the doctors nor oneplans money, this is money I used from my credit card so this money will run interest a total of R 6393.26, so basically the interest being accumulated on this amount won`t be oneplans problem, but mine. What makes m so furious is if I have been told this the first time I phoned I would have contacted the hospital long ago. I am also being told the hospital will be paid first, then doctors and then only my money which is total nonsense as I have never used the policy for the hospital so there are enough funds and when you do your authorisation for hospital admissions you need 20 thousand different quoted from the hospital, doctors etc before it will be authorised, so why do you need that if you want to check if you will have enough money on your policy if you knew beforehand what the operation will cost???? I am highly disappointed and I will never recommend oneplan to anyone and I will never take out any policy from oneplan again, oneplan is quick to deduct their funds each month and if you take one day to submit a statement from the doctor after being at a GP they immediately freeze your policy, they are quick to do that, but when it comes to payments they take their time to do it, so please tell me why are quotes needed before admissions and authorisation if you will take your holy grail time to process a claim?????

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Replies (1)
Oneplan Insurance
Oneplan Insurance's reply04 Jan 2022, 14:33
Official
Good day Alice,

Thank you for taking the time to bring this to our attention. 
    
We would like to offer our sincerest apologies for any inconvenience caused. 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.

Kindly note that for day-to-day claims, the initial claim must be processed first, before another claim is loaded since the funds are loaded onto the Onecard, the reason for this is for auditing purposes and to prevent *****. 
 
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. Please note that this is by no means a ploy to refuse payment of the claim, and we will assist with all we can in line with our terms and conditions. 

We have acknowledged your complaint and we have escalated the matter to the relevant department. This matter has been dealt as a priority; one of our consultants will be in contact with you.
           
Once again, we apologize for any inconvenience caused, and we hope to resolve the matter as soon as possible. 
             
Kind Regards,
Oneplan