NM
Ntlantla M
1 reviews | Active since Nov 2023
18 Nov 2023, 18:54
Medical insurance ****
Took my wife to netcare Alberton and she was in pain, the surgeon couldn’t admit her because he wantedR30 000 in cash because Oneplan doesn’t pay them. I spoke to an agent called Letu. Who justified I must pay the hospital because they don’t pay cash. Had to leave with my wife in pain. This company ****s people and will never recommend them to anyone ever
Helpful (0)
Replies (7)0
Replies (7)NM
Ntlantla M's updateReviewer Update
18 Nov 2023, 19:12Oh this Let told me if I’m not happy I can go elsewhere
NM
Ntlantla M's update18 Nov 2023, 19:12
Reviewer Update
Oh this Let told me if I’m not happy I can go elsewhere
Oneplan Insurance's replyOfficial
20 Nov 2023, 15:41Dear Ntlantla,
Thank you for taking the time to bring this to our attention.
We are sorry to hear of the circumstances under which your Hellopeter posting has reached us and we do apologize for the inconvenience caused. We do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Please note that 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 as we do have your wife's best interests at heart.
Upon investigation, we discovered that we did not deny an admission. A casualty authorization was granted and approved up to the respective cover limit. Your request for an upfront payment of R30 000 could not be granted in terms of our policy terms and conditions.
Our Hospital Authorization does not do upfront payments instead we issue a guarantee of payment (GOP) however should there be any shortfalls or co-payments the hospital may require that the client pay these funds upfront. We have relationships with the 3 major hospital groups that accept our guarantee of payment (GOP).
A guarantee of payment (GOP) is issued with a cover limit based on the selected cover type. Should the claim amount exceed the cover limit, unfortunately, the remaining amount will be for the client’s account.
It is important to note that we do not have any control over the requirements set by Medical Service Providers for their clients.
Insurance or indemnity insurance covers up to a respective cover limit. We inform all our clients that this product is not a Medical Aid product but a Health Insurance product. Our products are marketed and disclosed that we cover up to certain cover limits as the cover is not unlimited and there is an annual cover limit on all benefits offered which will renew on the anniversary of the policy.
We encourage all our clients and potential clients to ensure that they do understand all products available in the market and perhaps approach their Financial Advisor for a factual comparison of products as hearsay may cause a consumer to make a decision based on inaccurate information.
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 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 hope the above brings clarity to the matter.
Once again, we apologize for any inconvenience caused and hope the above brings clarity to the matter.
Kind Regards,
Oneplan
Oneplan
Oneplan Insurance's reply20 Nov 2023, 15:41
Official
Dear Ntlantla,
Thank you for taking the time to bring this to our attention.
We are sorry to hear of the circumstances under which your Hellopeter posting has reached us and we do apologize for the inconvenience caused. We do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Please note that 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 as we do have your wife's best interests at heart.
Upon investigation, we discovered that we did not deny an admission. A casualty authorization was granted and approved up to the respective cover limit. Your request for an upfront payment of R30 000 could not be granted in terms of our policy terms and conditions.
Our Hospital Authorization does not do upfront payments instead we issue a guarantee of payment (GOP) however should there be any shortfalls or co-payments the hospital may require that the client pay these funds upfront. We have relationships with the 3 major hospital groups that accept our guarantee of payment (GOP).
A guarantee of payment (GOP) is issued with a cover limit based on the selected cover type. Should the claim amount exceed the cover limit, unfortunately, the remaining amount will be for the client’s account.
It is important to note that we do not have any control over the requirements set by Medical Service Providers for their clients.
Insurance or indemnity insurance covers up to a respective cover limit. We inform all our clients that this product is not a Medical Aid product but a Health Insurance product. Our products are marketed and disclosed that we cover up to certain cover limits as the cover is not unlimited and there is an annual cover limit on all benefits offered which will renew on the anniversary of the policy.
We encourage all our clients and potential clients to ensure that they do understand all products available in the market and perhaps approach their Financial Advisor for a factual comparison of products as hearsay may cause a consumer to make a decision based on inaccurate information.
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 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 hope the above brings clarity to the matter.
Once again, we apologize for any inconvenience caused and hope the above brings clarity to the matter.
Kind Regards,
Oneplan
Oneplan
NM
Ntlantla M's updateReviewer Update
21 Nov 2023, 04:18This is so sad that none of you want to take responsibility! The doctors argument was that Oneplan doesn’t pay right hence he wanted the cash and I asked Millicent who happens to be the hospital staff. The quote was not exceeding the policy limit of my R53 000 policy limit. But this was because he lacked confidence in Oneplan and how they pay. This I can attest as I still receive calls from a hospital for a bill that wasn’t paid in May 2023, if the doctors experience with payments was good I don’t think he would have refused. As a result we had to suffer. I have the quote in record will take it up at mean time this policy serves me no purpose.
NM
Ntlantla M's update21 Nov 2023, 04:18
Reviewer Update
This is so sad that none of you want to take responsibility! The doctors argument was that Oneplan doesn’t pay right hence he wanted the cash and I asked Millicent who happens to be the hospital staff. The quote was not exceeding the policy limit of my R53 000 policy limit. But this was because he lacked confidence in Oneplan and how they pay. This I can attest as I still receive calls from a hospital for a bill that wasn’t paid in May 2023, if the doctors experience with payments was good I don’t think he would have refused. As a result we had to suffer. I have the quote in record will take it up at mean time this policy serves me no purpose.
NM
Ntlantla M's updateReviewer Update
21 Nov 2023, 04:21If doctor said arguments was the difference then it would make sense but that was not the case. It was the fact that they experience problems with payments am sure that I was still within my policy limit.
NM
Ntlantla M's update21 Nov 2023, 04:21
Reviewer Update
If doctor said arguments was the difference then it would make sense but that was not the case. It was the fact that they experience problems with payments am sure that I was still within my policy limit.
NM
Ntlantla M's updateReviewer Update
21 Nov 2023, 04:22To make it worse none of you called me to discuss the matter but quick to protect your image on the public platform, a clear sign of misleading people with interest of heart
NM
Ntlantla M's update21 Nov 2023, 04:22
Reviewer Update
To make it worse none of you called me to discuss the matter but quick to protect your image on the public platform, a clear sign of misleading people with interest of heart
Oneplan Insurance's replyOfficial
21 Nov 2023, 14:36Dear Ntlantla,
Thank you for contacting us.
We acknowledge the concerns you have raised and we apologize for any dissatisfaction you may have experienced.
To address your concerns and provide further clarification, one of our consultants will contact you soon.
Kind regards,
Oneplan
Thank you for contacting us.
We acknowledge the concerns you have raised and we apologize for any dissatisfaction you may have experienced.
To address your concerns and provide further clarification, one of our consultants will contact you soon.
Kind regards,
Oneplan
Oneplan Insurance's reply21 Nov 2023, 14:36
Official
Dear Ntlantla,
Thank you for contacting us.
We acknowledge the concerns you have raised and we apologize for any dissatisfaction you may have experienced.
To address your concerns and provide further clarification, one of our consultants will contact you soon.
Kind regards,
Oneplan
Thank you for contacting us.
We acknowledge the concerns you have raised and we apologize for any dissatisfaction you may have experienced.
To address your concerns and provide further clarification, one of our consultants will contact you soon.
Kind regards,
Oneplan
Oneplan Insurance's replyOfficial
29 Nov 2023, 09:49Dear Ntlantla,
Kindly note that we have attempted to contact you on the listed number; however, it was to no avail.
Please provide us with a suitable time or alternative contact number to contact you to further discuss the matter at hand.
Thank you and we look forward to hearing from you soon.
Kind Regards,
Oneplan
Kindly note that we have attempted to contact you on the listed number; however, it was to no avail.
Please provide us with a suitable time or alternative contact number to contact you to further discuss the matter at hand.
Thank you and we look forward to hearing from you soon.
Kind Regards,
Oneplan
Oneplan Insurance's reply29 Nov 2023, 09:49
Official
Dear Ntlantla,
Kindly note that we have attempted to contact you on the listed number; however, it was to no avail.
Please provide us with a suitable time or alternative contact number to contact you to further discuss the matter at hand.
Thank you and we look forward to hearing from you soon.
Kind Regards,
Oneplan
Kindly note that we have attempted to contact you on the listed number; however, it was to no avail.
Please provide us with a suitable time or alternative contact number to contact you to further discuss the matter at hand.
Thank you and we look forward to hearing from you soon.
Kind Regards,
Oneplan