GN
Graeme N
1 reviews | Active since Sept 2022
20 Jan 2023, 08:47
One Plan Medical Aid - Dissapointing
Dear One Plan Group,
I need to express my utter dissatisfaction with your service delivery.
Your promises have turned out to be nothing but "hot air" and your attitude toward my well being is nothing less than a joke, to say the least.
If you take a look at the claims that I have submitted to you since inception of my cover - EVERY single claim has turned out to be a fight!!! I am now exhausted with the constant battle to get any little help from you.
My latest claim has been rejected already 3 times, to spite handing you THREE types of proof that I visited the dentist. The bill was R1,300.00 of which I had used R630.00 from THIS cover to contribute towards the bill - YET 3 TIME REJECTED. I think the only way that you would have approved this claim, is if one of your employees were sitting next to me in the dentist chair to physically see that I had the procedure done!! This is pathetic!
With this said - I am not going to fight anymore!!!!!
Your Staff are unfriendly and unwilling to help. When questions are asked, the same generic answers are given. What the hell am I paying for - speaking of which, every month my premium is paid, not missing a single payment!!!
That's all I have to say about that!
Helpful (0)
Replies (3)0
Replies (3)
Oneplan Insurance's replyOfficial
20 Jan 2023, 09:29Good day Graeme,
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.
Kindly note that a detailed invoice including the services rendered and the doctors stamp is required when claiming for day-to-day benefits. Once the funds have been utilized, we will require the detailed invoice for the claim to be finalized. We have received the proof of payment; however we are awaiting the detailed invoice in order to finalize the claim. The reason for this is for auditing purposes on our side.
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 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.
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.
Kindly note that a detailed invoice including the services rendered and the doctors stamp is required when claiming for day-to-day benefits. Once the funds have been utilized, we will require the detailed invoice for the claim to be finalized. We have received the proof of payment; however we are awaiting the detailed invoice in order to finalize the claim. The reason for this is for auditing purposes on our side.
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 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 reply20 Jan 2023, 09:29
Official
Good day Graeme,
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.
Kindly note that a detailed invoice including the services rendered and the doctors stamp is required when claiming for day-to-day benefits. Once the funds have been utilized, we will require the detailed invoice for the claim to be finalized. We have received the proof of payment; however we are awaiting the detailed invoice in order to finalize the claim. The reason for this is for auditing purposes on our side.
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 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.
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.
Kindly note that a detailed invoice including the services rendered and the doctors stamp is required when claiming for day-to-day benefits. Once the funds have been utilized, we will require the detailed invoice for the claim to be finalized. We have received the proof of payment; however we are awaiting the detailed invoice in order to finalize the claim. The reason for this is for auditing purposes on our side.
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 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
GN
Graeme N's updateReviewer Update
20 Jan 2023, 09:43I must disagree with your response. Its funny that after my complaint submitted to all and sundry at One Plan and my submission on Hello Peter the claim was approved... WITH THE SAME DOCUMENTATION AS INITIALLY SUBMITTED. This is why I say - every claim has to be a fight. Its worse than a boring tennis match with all the back and forth!!! My claim was approved this morning - hopefully that's the end of it (for now!?). For the record, I am still very, very sceptic about moving forward but we will see...
GN
Graeme N's update20 Jan 2023, 09:43
Reviewer Update
I must disagree with your response. Its funny that after my complaint submitted to all and sundry at One Plan and my submission on Hello Peter the claim was approved... WITH THE SAME DOCUMENTATION AS INITIALLY SUBMITTED. This is why I say - every claim has to be a fight. Its worse than a boring tennis match with all the back and forth!!! My claim was approved this morning - hopefully that's the end of it (for now!?). For the record, I am still very, very sceptic about moving forward but we will see...
Oneplan Insurance's replyOfficial
20 Jan 2023, 14:31Good day Graeme,
Thank you for reaching out to us.
We would like to sincerely apologize about way you feel, and we appreciate the opportunity granted to restore the experience. We hope that you have a pleasant experience going forward. If you need any assistance, please feel free to reach out to us.
Kind Regards,
Oneplan
Thank you for reaching out to us.
We would like to sincerely apologize about way you feel, and we appreciate the opportunity granted to restore the experience. We hope that you have a pleasant experience going forward. If you need any assistance, please feel free to reach out to us.
Kind Regards,
Oneplan
Oneplan Insurance's reply20 Jan 2023, 14:31
Official
Good day Graeme,
Thank you for reaching out to us.
We would like to sincerely apologize about way you feel, and we appreciate the opportunity granted to restore the experience. We hope that you have a pleasant experience going forward. If you need any assistance, please feel free to reach out to us.
Kind Regards,
Oneplan
Thank you for reaching out to us.
We would like to sincerely apologize about way you feel, and we appreciate the opportunity granted to restore the experience. We hope that you have a pleasant experience going forward. If you need any assistance, please feel free to reach out to us.
Kind Regards,
Oneplan