MR
Michelle R

1 reviews | Active since Apr 2012

14 Jul 2023, 15:32

No reply from management

I have always received excellent service from Oneplan and I recommend them to many People, BUT I am deeply disappointed in my last interaction with them.

The reason I changed from Dotsure to Oneplan was because my dog developed epilepsy just before her 2nd birthday. Dotsure didn't want to change my plan from an accidental plan to a comprehensive plan. I phoned Oneplan and they were willing to offer me the comprehensive plan for my dog (Biscuit), but there was a waiting period of 12 months on the epilepsy. After the waiting time passed, it was time for her 6 month check up at the vet for her epilepsy. I contacted Oneplan and they loaded R1300 on my card and I asked for the R750 over the counter money to also be paid in so that I could purchased Biscuit's medication. Everything went well and I asked if they would pay the Pathcare account as well and they said yes. So I swiped for the consultation and the meds and I could swipe for the over the counter meds too. I submitted my invoice and this is when the problems started. My invoice for the R750 meds was not completely accepted due to the fact that I bought calming tablet and calming drops for Biscuit. The agent explained to me that according to their formulary, those things are not covered. So I asked him if he understands epilepsy and what causes the fits? He clearly didn't, because stress and anxiety causes epilepsy. The calming tablets and drops are vital to keep Biscuit calm so that I can try and prevent fits. With every fit, there is a chance that she might die OR have brain damage. So the agent just sticked to his guns and said that they wont pay the Pathcare account if I dont pay the money back for the calming products. I understand he is just an agent doing his job, so I requested to speak to a well informed senior person who have read up on epilepsy and could phone me back. More than a week and no feedback. Very disappointed as you actually qualify for a discount at Pathcare if you pay within 7 days.

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Replies (1)
Oneplan Insurance
Oneplan Insurance's reply14 Jul 2023, 16:21
Official
Good day Michelle,
 
Thank you for taking the time to bring this to our attention.
 
We sincerely apologize for any inconvenience caused and the circumstances under which your Hello Peter posting has reached. 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 our clients and fur-babies.  Kindly note as per policy terms and conditions behavioural conditions benefit one of our general exclusions which are things not funded for by the Insurer. 
 
Stress and anxiety are deemed as a behavioural condition. Unfortunately, due to this, the medication that was purchased to treat stress and anxiety is excluded from the cover as this falls within the bounds of our very few excluded conditions under Section 6.4 of your policy schedule (General Exclusions) which states that we will not be liable for expenses, hospitalization, injury, sickness, or disease directly or indirectly caused by or related to, Obesity and behavioural conditions (e.g. dogs that have a history of aggression)  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. 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. Oneplan subscribes to its TCF principles and will take all reasonable steps to ensure fair and equal treatment of all our clients.
  
We have acknowledged your complaint and we have escalated the matter to the relevant department. One of our consultants will be in contact with you to further discuss the matter at hand.
      
Once again, we apologize for the inconvenience caused and we hope to restore the experience. 
               
Kind Regards,
Oneplan