PBP
Piet Booyens. Pietbooyens
1 reviews | Active since Sept 2023
18 Nov 2023, 08:48
Not so good we wend to the hospitaal they cond help jou one plane do not cover the cost of hospital
Not so good we wend to the hospitaal they cond help jou one plane do not cover the cost of hospital.so less I am not happy.
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Replies (1)
Oneplan Insurance's replyOfficial
19 Nov 2023, 09:39Dear Piet,
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 Hellopeter posting has reached. We take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Kindly note that we grant the authorization for in-hospital claims based on the information that the hospital provides us with which includes the patient's clinical and vital signs, unfortunately, authorization for Admission cannot be granted if the information we receive from the hospital does not fall within the Orange or Red Triage Colour Category. Please note that in-hospital claims can be paid directly to the service provider or a refund can be processed to the client once we receive all the relevant documentation up to the respective cover limits.
Should the hospital confirm the Triage color to be Green, according to our policy schedule the condition will be covered under the day-to-day benefit being a normal GP consultation, medication, radiology, or pathology up to the respective cover limit. A Green Triage is Not covered under the emergency cover. When the patient is informed of the Triage color and benefit that the health insurance will provide, the choice is entirely up to the client as to whether they will continue with treatment at the hospital.
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 our client's 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.
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.
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 Hellopeter posting has reached. We take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Kindly note that we grant the authorization for in-hospital claims based on the information that the hospital provides us with which includes the patient's clinical and vital signs, unfortunately, authorization for Admission cannot be granted if the information we receive from the hospital does not fall within the Orange or Red Triage Colour Category. Please note that in-hospital claims can be paid directly to the service provider or a refund can be processed to the client once we receive all the relevant documentation up to the respective cover limits.
Should the hospital confirm the Triage color to be Green, according to our policy schedule the condition will be covered under the day-to-day benefit being a normal GP consultation, medication, radiology, or pathology up to the respective cover limit. A Green Triage is Not covered under the emergency cover. When the patient is informed of the Triage color and benefit that the health insurance will provide, the choice is entirely up to the client as to whether they will continue with treatment at the hospital.
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 our client's 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.
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
Oneplan Insurance's reply19 Nov 2023, 09:39
Official
Dear Piet,
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 Hellopeter posting has reached. We take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Kindly note that we grant the authorization for in-hospital claims based on the information that the hospital provides us with which includes the patient's clinical and vital signs, unfortunately, authorization for Admission cannot be granted if the information we receive from the hospital does not fall within the Orange or Red Triage Colour Category. Please note that in-hospital claims can be paid directly to the service provider or a refund can be processed to the client once we receive all the relevant documentation up to the respective cover limits.
Should the hospital confirm the Triage color to be Green, according to our policy schedule the condition will be covered under the day-to-day benefit being a normal GP consultation, medication, radiology, or pathology up to the respective cover limit. A Green Triage is Not covered under the emergency cover. When the patient is informed of the Triage color and benefit that the health insurance will provide, the choice is entirely up to the client as to whether they will continue with treatment at the hospital.
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 our client's 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.
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.
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 Hellopeter posting has reached. We take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Kindly note that we grant the authorization for in-hospital claims based on the information that the hospital provides us with which includes the patient's clinical and vital signs, unfortunately, authorization for Admission cannot be granted if the information we receive from the hospital does not fall within the Orange or Red Triage Colour Category. Please note that in-hospital claims can be paid directly to the service provider or a refund can be processed to the client once we receive all the relevant documentation up to the respective cover limits.
Should the hospital confirm the Triage color to be Green, according to our policy schedule the condition will be covered under the day-to-day benefit being a normal GP consultation, medication, radiology, or pathology up to the respective cover limit. A Green Triage is Not covered under the emergency cover. When the patient is informed of the Triage color and benefit that the health insurance will provide, the choice is entirely up to the client as to whether they will continue with treatment at the hospital.
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 our client's 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.
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