CF
Colleen F
1 reviews | Active since Oct 2016
08 Dec 2022, 09:49
ONE PLAN INSURANCE - DONT GET WHAT YOU PAY FOR
PET OWNERS – PLEASE MAKE SURE WHAT YOU BUY FROM ONE PLAN – The dream they sell you when you sign up and what you actually get when your pets get sick is TOTALLY the opposite. Bella my Little Yorkie fell and lost her rear leg 5 years ago. The vet bill was unplanned and very expensive. I signed up with ONE PLAN HOSPITAL COVER in 2018 for all my pets. I never claimed from the cover until 29.11.22 when Bella’s could not use her only rear leg and had to drag herself she was in so much pain. I took Bella to the vet and he gave me a quote for the IN HOSPITAL PROCEDURE to do Xrays and investigate the reason why Bella can’t use her Leg. I submitted the Hospital Authorization Request to ONE PLAN with the vet quote. It was REJECTED because Xrays and investigations of illness is not covered under the hospital plan. My Argument – Bella is sick and need to be treated in hospital. How can the Vet take Xrays of any animal if they are not sedated in hospital, no pet is going to stand still.
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Replies (3)
Oneplan Insurance's replyOfficial
08 Dec 2022, 11:05Good day Colleen,
Thank you for taking the time to bring this to our attention.
We do sincerely apologize for any inconvenience which has been caused. We do have your fur-baby's best interest at heart and wish that she has a speedy recovery. Kindly note terms and conditions of the policy must be adhered to and app**** fairly for all clients.
Upon investigation we discovered that your fur-baby is covered on the Hospital plan. The services rendered on the invoice fall under the Casualty cover limit which would have been covered on our comprehensive Classic and Super plan up to their respective cover limits. Unfortunately, any diagnostic tests is excluded from the Hospital Plan.
Kindly note according to our policy schedule under the heading "What is Not Covered" on the Oneplan Pet Hospital Admission Cover Section (point 2) it states, Admission and/or hospitalization exclusively for diagnostic procedures, monitoring and/or observing is not covered under the in-hospital benefit, however this will be covered under the day-to-day benefits on the Comprehensive plans.
Should a diagnostic procedure result in a confirmed diagnosis the cost of the in-hospital corrective procedure can be reviewed under the authorized Hospital admission cover limit. Kindly note that all in-hospital claims must meet our admission matrix which is found in your policy schedule.
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. 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 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.
Once again, we apologize for any inconvenience caused.
Kind Regards,
Oneplan
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.
Once again, we apologize for any inconvenience caused.
Kind Regards,
Oneplan
Oneplan Insurance's reply08 Dec 2022, 11:05
Official
Good day Colleen,
Thank you for taking the time to bring this to our attention.
We do sincerely apologize for any inconvenience which has been caused. We do have your fur-baby's best interest at heart and wish that she has a speedy recovery. Kindly note terms and conditions of the policy must be adhered to and app**** fairly for all clients.
Upon investigation we discovered that your fur-baby is covered on the Hospital plan. The services rendered on the invoice fall under the Casualty cover limit which would have been covered on our comprehensive Classic and Super plan up to their respective cover limits. Unfortunately, any diagnostic tests is excluded from the Hospital Plan.
Kindly note according to our policy schedule under the heading "What is Not Covered" on the Oneplan Pet Hospital Admission Cover Section (point 2) it states, Admission and/or hospitalization exclusively for diagnostic procedures, monitoring and/or observing is not covered under the in-hospital benefit, however this will be covered under the day-to-day benefits on the Comprehensive plans.
Should a diagnostic procedure result in a confirmed diagnosis the cost of the in-hospital corrective procedure can be reviewed under the authorized Hospital admission cover limit. Kindly note that all in-hospital claims must meet our admission matrix which is found in your policy schedule.
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. 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 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.
Once again, we apologize for any inconvenience caused.
Kind Regards,
Oneplan
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.
Once again, we apologize for any inconvenience caused.
Kind Regards,
Oneplan
CF
Colleen F's updateReviewer Update
08 Dec 2022, 12:00Excluded from Hospital Plan - diagnostic procedures, monitoring and/or observing
Monitor/Observing - dog cant walk and struggle with leg
Action - help the dog to walk
What to do - Take Xray and Treat dog in Hospital
ONE PLAN HOSPITAL PLAN - Please explain in simple English how we achieve hospital cover to help the dog with the necessary treatment to get better this and how you approve this under the Hospital plan
Monitor/Observing - dog cant walk and struggle with leg
Action - help the dog to walk
What to do - Take Xray and Treat dog in Hospital
ONE PLAN HOSPITAL PLAN - Please explain in simple English how we achieve hospital cover to help the dog with the necessary treatment to get better this and how you approve this under the Hospital plan
CF
Colleen F's update08 Dec 2022, 12:00
Reviewer Update
Excluded from Hospital Plan - diagnostic procedures, monitoring and/or observing
Monitor/Observing - dog cant walk and struggle with leg
Action - help the dog to walk
What to do - Take Xray and Treat dog in Hospital
ONE PLAN HOSPITAL PLAN - Please explain in simple English how we achieve hospital cover to help the dog with the necessary treatment to get better this and how you approve this under the Hospital plan
Monitor/Observing - dog cant walk and struggle with leg
Action - help the dog to walk
What to do - Take Xray and Treat dog in Hospital
ONE PLAN HOSPITAL PLAN - Please explain in simple English how we achieve hospital cover to help the dog with the necessary treatment to get better this and how you approve this under the Hospital plan
Oneplan Insurance's replyOfficial
09 Dec 2022, 13:20Good day Colleen,
Thank you for reaching out to us.
Kindly note that for a claim to be reviewed under the in-hospital benefit, we require a confirmed diagnosis linked to an in-hospital corrective procedure or treatment that meets our admission matrix requirements that is listed in the policy documents.
Thank you for reaching out to us.
Kindly note that for a claim to be reviewed under the in-hospital benefit, we require a confirmed diagnosis linked to an in-hospital corrective procedure or treatment that meets our admission matrix requirements that is listed in the policy documents.
Should the requirements not be met, unfortunately, we will not be able to consider the claim under the in-hospital benefit. We will only be able to review the claim under the Casualty benefit which is available on the Classic or Super plan. Regrettably, Bella is covered on the Hospital Plan which does not offer day-to-day benefits.
One of our consultants will be in contact with you to further discuss the matter at hand, in the hopes to provide clarity on the matter.
Once again, we apologize for any inconvenience caused.
Kind Regards,
Oneplan
One of our consultants will be in contact with you to further discuss the matter at hand, in the hopes to provide clarity on the matter.
Once again, we apologize for any inconvenience caused.
Kind Regards,
Oneplan
Oneplan Insurance's reply09 Dec 2022, 13:20
Official
Good day Colleen,
Thank you for reaching out to us.
Kindly note that for a claim to be reviewed under the in-hospital benefit, we require a confirmed diagnosis linked to an in-hospital corrective procedure or treatment that meets our admission matrix requirements that is listed in the policy documents.
Thank you for reaching out to us.
Kindly note that for a claim to be reviewed under the in-hospital benefit, we require a confirmed diagnosis linked to an in-hospital corrective procedure or treatment that meets our admission matrix requirements that is listed in the policy documents.
Should the requirements not be met, unfortunately, we will not be able to consider the claim under the in-hospital benefit. We will only be able to review the claim under the Casualty benefit which is available on the Classic or Super plan. Regrettably, Bella is covered on the Hospital Plan which does not offer day-to-day benefits.
One of our consultants will be in contact with you to further discuss the matter at hand, in the hopes to provide clarity on the matter.
Once again, we apologize for any inconvenience caused.
Kind Regards,
Oneplan
One of our consultants will be in contact with you to further discuss the matter at hand, in the hopes to provide clarity on the matter.
Once again, we apologize for any inconvenience caused.
Kind Regards,
Oneplan