ML
Maphuti L
1 reviews | Active since Mar 2018
13 Oct 2021, 14:28
One plan insurance and the claims.
I took this medical insurance cuz it was affordable but it's actually expensive cuz they need impossible things. Here is the story.i was on another medical insurance and I was happy with them just the only thing that I didn’t like about them was the authorization part especially on the weekend its was impossible to get through.and the lady who sold me this insurance, she told me nice things about this insurance which are not there that's why I took it. Now when you claim it's a big hustle and they just don't care especially the person who is responding on their whatsapp line. And I have been told you can only claim for OTC once a year, I mean once a year just imagine and that time your premium is still the same every month. So I won't advise anyone to take this cover cuz you are gonna end up with health problems. But their stuff are very nice, especially Lufuno she is lovely.but this one plan I hate it, I hate everything about it.im so disappointed 😞 and very angry.
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Replies (1)
Oneplan Insurance's replyOfficial
13 Oct 2021, 15:57Good day Maphuti,
Thank you for taking the time to bring this to our attention.
We have attempted to contact you on the listed number; however, it was to no avail.
We sincerely apologize for the circumstances under which your Hellopeter posting has reached us and for any inconvenience caused as this is certainly not the level of service that we aim to provide our clients with. Please rest assured that this matter will be investigated, and measures will be put in place to ensure that this does not reoccur as we do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Kindly note that the plan type that you are on covers for Scripted Medication and Over the Counter Medication (OTC) which are 2 different benefits with 2 different annual cover limits. For scripted medication claims to be approved we will require to see proof that a medical prescription was provided from a medical practitioner for medication to be dispensed and has been requested by a General Practitioner.
With regards to the Over the Counter Medication benefit (OTC), this is a benefit that was recently added onto our health insurance plans to assist clients to purchase medication at a pharmacy without a prescription, however we will require that the invoice from the pharmacy reflects the clients name as this is due for auditing purposes and to prevent *****. You may claim for all OTC events up to the stated limit every twelve (12) month cycle from inception of the policy, for each insured person. This cover forms part of your Health annual limit.
There are annual cover limits on all our cover types and once the annual cover limit has been exceeded the cover limit benefit will renew on the anniversary of your policy. 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.
Kindly provide us with a suitable time to contact you to further discuss your concerns as we would like to provide you with clarity on the matter at hand.
Once again we apologize for the inconvenience caused and we hope to resolve the matter as soon as possible.
Kind Regards,
Oneplan
Thank you for taking the time to bring this to our attention.
We have attempted to contact you on the listed number; however, it was to no avail.
We sincerely apologize for the circumstances under which your Hellopeter posting has reached us and for any inconvenience caused as this is certainly not the level of service that we aim to provide our clients with. Please rest assured that this matter will be investigated, and measures will be put in place to ensure that this does not reoccur as we do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Kindly note that the plan type that you are on covers for Scripted Medication and Over the Counter Medication (OTC) which are 2 different benefits with 2 different annual cover limits. For scripted medication claims to be approved we will require to see proof that a medical prescription was provided from a medical practitioner for medication to be dispensed and has been requested by a General Practitioner.
With regards to the Over the Counter Medication benefit (OTC), this is a benefit that was recently added onto our health insurance plans to assist clients to purchase medication at a pharmacy without a prescription, however we will require that the invoice from the pharmacy reflects the clients name as this is due for auditing purposes and to prevent *****. You may claim for all OTC events up to the stated limit every twelve (12) month cycle from inception of the policy, for each insured person. This cover forms part of your Health annual limit.
There are annual cover limits on all our cover types and once the annual cover limit has been exceeded the cover limit benefit will renew on the anniversary of your policy. 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.
Kindly provide us with a suitable time to contact you to further discuss your concerns as we would like to provide you with clarity on the matter at hand.
Once again we apologize for the inconvenience caused and we hope to resolve the matter as soon as possible.
Kind Regards,
Oneplan
Oneplan Insurance's reply13 Oct 2021, 15:57
Official
Good day Maphuti,
Thank you for taking the time to bring this to our attention.
We have attempted to contact you on the listed number; however, it was to no avail.
We sincerely apologize for the circumstances under which your Hellopeter posting has reached us and for any inconvenience caused as this is certainly not the level of service that we aim to provide our clients with. Please rest assured that this matter will be investigated, and measures will be put in place to ensure that this does not reoccur as we do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Kindly note that the plan type that you are on covers for Scripted Medication and Over the Counter Medication (OTC) which are 2 different benefits with 2 different annual cover limits. For scripted medication claims to be approved we will require to see proof that a medical prescription was provided from a medical practitioner for medication to be dispensed and has been requested by a General Practitioner.
With regards to the Over the Counter Medication benefit (OTC), this is a benefit that was recently added onto our health insurance plans to assist clients to purchase medication at a pharmacy without a prescription, however we will require that the invoice from the pharmacy reflects the clients name as this is due for auditing purposes and to prevent *****. You may claim for all OTC events up to the stated limit every twelve (12) month cycle from inception of the policy, for each insured person. This cover forms part of your Health annual limit.
There are annual cover limits on all our cover types and once the annual cover limit has been exceeded the cover limit benefit will renew on the anniversary of your policy. 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.
Kindly provide us with a suitable time to contact you to further discuss your concerns as we would like to provide you with clarity on the matter at hand.
Once again we apologize for the inconvenience caused and we hope to resolve the matter as soon as possible.
Kind Regards,
Oneplan
Thank you for taking the time to bring this to our attention.
We have attempted to contact you on the listed number; however, it was to no avail.
We sincerely apologize for the circumstances under which your Hellopeter posting has reached us and for any inconvenience caused as this is certainly not the level of service that we aim to provide our clients with. Please rest assured that this matter will be investigated, and measures will be put in place to ensure that this does not reoccur as we do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
Kindly note that the plan type that you are on covers for Scripted Medication and Over the Counter Medication (OTC) which are 2 different benefits with 2 different annual cover limits. For scripted medication claims to be approved we will require to see proof that a medical prescription was provided from a medical practitioner for medication to be dispensed and has been requested by a General Practitioner.
With regards to the Over the Counter Medication benefit (OTC), this is a benefit that was recently added onto our health insurance plans to assist clients to purchase medication at a pharmacy without a prescription, however we will require that the invoice from the pharmacy reflects the clients name as this is due for auditing purposes and to prevent *****. You may claim for all OTC events up to the stated limit every twelve (12) month cycle from inception of the policy, for each insured person. This cover forms part of your Health annual limit.
There are annual cover limits on all our cover types and once the annual cover limit has been exceeded the cover limit benefit will renew on the anniversary of your policy. 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.
Kindly provide us with a suitable time to contact you to further discuss your concerns as we would like to provide you with clarity on the matter at hand.
Once again we apologize for the inconvenience caused and we hope to resolve the matter as soon as possible.
Kind Regards,
Oneplan