AE
Amber E
1 reviews | Active since Jun 2025
09 Jun 2025, 19:57
My claim for my pet’s hospital admission was denied because Oneplan claims that my pet wasn’t admitted to the hospital
My claim for my pet’s hospital admission was denied because Oneplan claims that my pet wasn’t admitted to the hospital. This is despite all of the invoice line items referring to hospitalisation. There were no calls made to me to clarify my claim or confirm any details before they went ahead and declined my claim. Now, my complaints process will take weeks to resolve, which leaves me out of pocket for the rest of the month. Beware!!!
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Oneplan Insurance's replyOfficial
10 Jun 2025, 07:30Dear Amber ,
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 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 acknowledged your complaint, and upon investigation have noted that our claims department have been in touch with you to provide feedback regarding the review of the claim which has been rejected under the Hospital Benefit due to the invoice provided reflecting a consultation, medication and diagnostics. For a claim to be considered under the Hospital Admission benefit, the invoice must reflect details that will be assessed according to the Admission Matrix. No treatment that meets Admission Matrix requirements occurred and for this reason, the claim unfortunately cannot be considered under the in-hospital benefit.
The formal repudiation letter regarding this has been sent to your listed email address and includes our Complaints Resolution Policy for your perusal.
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.
Once again, we apologize for any inconvenience caused and we hope to restore your faith in our services.
Kind Regards,
Oneplan.
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 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 acknowledged your complaint, and upon investigation have noted that our claims department have been in touch with you to provide feedback regarding the review of the claim which has been rejected under the Hospital Benefit due to the invoice provided reflecting a consultation, medication and diagnostics. For a claim to be considered under the Hospital Admission benefit, the invoice must reflect details that will be assessed according to the Admission Matrix. No treatment that meets Admission Matrix requirements occurred and for this reason, the claim unfortunately cannot be considered under the in-hospital benefit.
The formal repudiation letter regarding this has been sent to your listed email address and includes our Complaints Resolution Policy for your perusal.
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.
Once again, we apologize for any inconvenience caused and we hope to restore your faith in our services.
Kind Regards,
Oneplan.
Oneplan Insurance's reply10 Jun 2025, 07:30
Official
Dear Amber ,
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 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 acknowledged your complaint, and upon investigation have noted that our claims department have been in touch with you to provide feedback regarding the review of the claim which has been rejected under the Hospital Benefit due to the invoice provided reflecting a consultation, medication and diagnostics. For a claim to be considered under the Hospital Admission benefit, the invoice must reflect details that will be assessed according to the Admission Matrix. No treatment that meets Admission Matrix requirements occurred and for this reason, the claim unfortunately cannot be considered under the in-hospital benefit.
The formal repudiation letter regarding this has been sent to your listed email address and includes our Complaints Resolution Policy for your perusal.
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.
Once again, we apologize for any inconvenience caused and we hope to restore your faith in our services.
Kind Regards,
Oneplan.
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 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 acknowledged your complaint, and upon investigation have noted that our claims department have been in touch with you to provide feedback regarding the review of the claim which has been rejected under the Hospital Benefit due to the invoice provided reflecting a consultation, medication and diagnostics. For a claim to be considered under the Hospital Admission benefit, the invoice must reflect details that will be assessed according to the Admission Matrix. No treatment that meets Admission Matrix requirements occurred and for this reason, the claim unfortunately cannot be considered under the in-hospital benefit.
The formal repudiation letter regarding this has been sent to your listed email address and includes our Complaints Resolution Policy for your perusal.
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.
Once again, we apologize for any inconvenience caused and we hope to restore your faith in our services.
Kind Regards,
Oneplan.