MJRr
Mapula Jeanette Ramalobela ramalobelamapula
1 reviews | Active since Dec 2024
10 Apr 2025, 16:57
"I'm extremely disappointed with the service I've received from your company
"I'm extremely disappointed with the service I've received from your company. The claims process was unnecessarily complicated, and I had to remind you multiple times to process my claim. The request for a handwritten receipt after paying in cash was frustrating, especially since I wasn't informed about this requirement earlier. I expect better communication and a more efficient claims process from my medical aid provider. Unfortunately, my experience has been subpar, which is why I'm giving you 1 star."
Helpful (0)
Replies (1)0
Replies (1)
Oneplan Insurance's replyOfficial
10 Apr 2025, 17:56Dear Mapula,
Thank you for bringing this matter to our attention.
We regret the circumstances under which your complaint has been submitted and apologize for any inconvenience you may have experienced. That said, we would like to take this opportunity to provide clarity regarding the requirements and responsibilities related to your claim.
Please note, the claim in question was loaded on 7 April 2025, and the funds were withdrawn from your Oneplan Claims Card for payment. On 8 April 2025, both an SMS and an email were sent to your registered contact details, clearly stating that a detailed invoice was required in order for your claim to be reviewed. However, the requested invoice was only submitted today via WhatsApp. As communicated to you, because the funds have already been withdrawn, a proof of payment is now required in addition to the detailed invoice for the claim to proceed.
We would also like to remind you that your policy schedule contains an example of what qualifies as a detailed invoice. It is critical for all clients to fami****ise themselves with this document, as it outlines the requirements and limitations of your selected plan.
To further assist our members, Section 3 of your policy schedule (“Oneplan Health Cover”) includes a link to step-by-step videos on how to correctly submit a claim. It also clearly states the following; The required documentation must be submitted to the Oneplan Claims Department within seven (7) days of the event, including but not limited to a valid invoice. Should we not receive A VALID INVOICE, your policy will be suspended until you upload the documentation.
We trust this explanation clarifies the process and highlights the importance of adhering to the policy terms. We will review and finalise your claim upon receipt of the required proof of payment.
Kind regards,
Oneplan.
Oneplan.
Oneplan Insurance's reply10 Apr 2025, 17:56
Official
Dear Mapula,
Thank you for bringing this matter to our attention.
We regret the circumstances under which your complaint has been submitted and apologize for any inconvenience you may have experienced. That said, we would like to take this opportunity to provide clarity regarding the requirements and responsibilities related to your claim.
Please note, the claim in question was loaded on 7 April 2025, and the funds were withdrawn from your Oneplan Claims Card for payment. On 8 April 2025, both an SMS and an email were sent to your registered contact details, clearly stating that a detailed invoice was required in order for your claim to be reviewed. However, the requested invoice was only submitted today via WhatsApp. As communicated to you, because the funds have already been withdrawn, a proof of payment is now required in addition to the detailed invoice for the claim to proceed.
We would also like to remind you that your policy schedule contains an example of what qualifies as a detailed invoice. It is critical for all clients to fami****ise themselves with this document, as it outlines the requirements and limitations of your selected plan.
To further assist our members, Section 3 of your policy schedule (“Oneplan Health Cover”) includes a link to step-by-step videos on how to correctly submit a claim. It also clearly states the following; The required documentation must be submitted to the Oneplan Claims Department within seven (7) days of the event, including but not limited to a valid invoice. Should we not receive A VALID INVOICE, your policy will be suspended until you upload the documentation.
We trust this explanation clarifies the process and highlights the importance of adhering to the policy terms. We will review and finalise your claim upon receipt of the required proof of payment.
Kind regards,
Oneplan.
Oneplan.