nC
naeem C
1 reviews | Active since Apr 2013
03 Jan 2024, 14:49
Last year I called to request and upgrade to my policy thinking that I would provide my cat with the best cover since he has been diagnosed with a fatal kidney disease
Last year I called to request and upgrade to my policy thinking that I would provide my cat with the best cover since he has been diagnosed with a fatal kidney disease. The agent Nicole assured me everything would be okay and that my new cover will start 1 December 2023. Since then all my claims have been declined I've been informed that the upgrade is not a new policy but instead a continuation of the existing policy. Then yesterday I'm told that I have no day to day cover. 2 January the agent tells me that my cat will atheist have hospital cover but today 3 January the department tells me that I have no more cover. I am so disappointed but one plan and l feel like I was treated most unfairly but also dishonestly. Regards Dr Naeem
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Oneplan Insurance's replyOfficial
04 Jan 2024, 11:51Dear Naeem,
Thank you for taking the time to bring this to our attention.
We sincerely apologize for the circumstances under which your Hellopeter posting has reached us and we do apologize 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.
We have attempted to contact you on the listed number; however, it was to no avail.
As per our policy terms and conditions point 7.4.8 states that After an upgrade, should further treatment be required for a previous Hospital Risk Cover claim, the current claim will form part of the previous claim limit and the initial cover limit and claim period will apply.
Records on our system confirm that since the anniversary of your policy when the benefits renewed on the 01st of September 2023, you have already utilized the 4 Casualty claims available on your previous plan, the Classic plan, hence the reason we could not load a new Casualty Claim.
Thank you for taking the time to bring this to our attention.
We sincerely apologize for the circumstances under which your Hellopeter posting has reached us and we do apologize 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.
We have attempted to contact you on the listed number; however, it was to no avail.
As per our policy terms and conditions point 7.4.8 states that After an upgrade, should further treatment be required for a previous Hospital Risk Cover claim, the current claim will form part of the previous claim limit and the initial cover limit and claim period will apply.
Records on our system confirm that since the anniversary of your policy when the benefits renewed on the 01st of September 2023, you have already utilized the 4 Casualty claims available on your previous plan, the Classic plan, hence the reason we could not load a new Casualty Claim.
In the event of you still having Casualty funds available on the Classic plan before the upgrade to the Super plan, you would have served the 30-day waiting period for the new cover limit on the Super plan and you would be able to claim the remaining Casualty benefit under the Super plan cover limit, however, due to you exhausting all 4 Casualty Claims on the Classic plan, you will not be able to claim for this benefit under the Super plan since you have already utilized the 4 Casualty claims that you are entitled to in a 12-month cycle.
Kindly note there are annual cover limits on all our cover types. Once the annual cover limit has been exceeded, the cover limit benefit will renew on the anniversary of your policy.
According to the system you chose to add the Pet Med Booster benefit that was effective from the 01st of December together with the upgrade to the Super plan.
The Pet Med Booster carries a 30-day waiting period which has already been served. Currently, you have an amount of R850 to utilize towards preventative claims under the Pet Med Booster benefit, which is under the Super plan cover limit, however, any claims related to the pre-existing in-hospital claim will fall under the in-hospital cover limit for the Classic plan. Kindly note that the cover limit for in-hospital admissions on the Classic plan is R40 000 as you are still within the waiting periods for the Super Plan cover limit.
The waiting periods as per cover type will apply for any additional cover available on the upgraded plan from the effective date of the upgrade which was the 1st of December 2023.
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, please note that this is by no means a ploy to refuse payment of the claim. We do have your fur-babies 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.
Once again, we apologize for any inconvenience caused and we hope the above brings clarity on the matter.
Kind Regards,
Oneplan
Oneplan Insurance's reply04 Jan 2024, 11:51
Official
Dear Naeem,
Thank you for taking the time to bring this to our attention.
We sincerely apologize for the circumstances under which your Hellopeter posting has reached us and we do apologize 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.
We have attempted to contact you on the listed number; however, it was to no avail.
As per our policy terms and conditions point 7.4.8 states that After an upgrade, should further treatment be required for a previous Hospital Risk Cover claim, the current claim will form part of the previous claim limit and the initial cover limit and claim period will apply.
Records on our system confirm that since the anniversary of your policy when the benefits renewed on the 01st of September 2023, you have already utilized the 4 Casualty claims available on your previous plan, the Classic plan, hence the reason we could not load a new Casualty Claim.
Thank you for taking the time to bring this to our attention.
We sincerely apologize for the circumstances under which your Hellopeter posting has reached us and we do apologize 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.
We have attempted to contact you on the listed number; however, it was to no avail.
As per our policy terms and conditions point 7.4.8 states that After an upgrade, should further treatment be required for a previous Hospital Risk Cover claim, the current claim will form part of the previous claim limit and the initial cover limit and claim period will apply.
Records on our system confirm that since the anniversary of your policy when the benefits renewed on the 01st of September 2023, you have already utilized the 4 Casualty claims available on your previous plan, the Classic plan, hence the reason we could not load a new Casualty Claim.
In the event of you still having Casualty funds available on the Classic plan before the upgrade to the Super plan, you would have served the 30-day waiting period for the new cover limit on the Super plan and you would be able to claim the remaining Casualty benefit under the Super plan cover limit, however, due to you exhausting all 4 Casualty Claims on the Classic plan, you will not be able to claim for this benefit under the Super plan since you have already utilized the 4 Casualty claims that you are entitled to in a 12-month cycle.
Kindly note there are annual cover limits on all our cover types. Once the annual cover limit has been exceeded, the cover limit benefit will renew on the anniversary of your policy.
According to the system you chose to add the Pet Med Booster benefit that was effective from the 01st of December together with the upgrade to the Super plan.
The Pet Med Booster carries a 30-day waiting period which has already been served. Currently, you have an amount of R850 to utilize towards preventative claims under the Pet Med Booster benefit, which is under the Super plan cover limit, however, any claims related to the pre-existing in-hospital claim will fall under the in-hospital cover limit for the Classic plan. Kindly note that the cover limit for in-hospital admissions on the Classic plan is R40 000 as you are still within the waiting periods for the Super Plan cover limit.
The waiting periods as per cover type will apply for any additional cover available on the upgraded plan from the effective date of the upgrade which was the 1st of December 2023.
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, please note that this is by no means a ploy to refuse payment of the claim. We do have your fur-babies 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.
Once again, we apologize for any inconvenience caused and we hope the above brings clarity on the matter.
Kind Regards,
Oneplan