BE
Byron E

1 reviews | Active since Sept 2013

23 Feb 2023, 21:15

One small Omission for man One giant Leap for Oneplan

These are the facts:

My dog was bitten by another dog. It started breathing funny. I took it to the emergency vet in Hilton, KZN. They X-rayed the dog and kept it in the pet hospital overnight. My pets hospital bill came to approximately R8000. I was shocked and didn't want to be in this situation again. I got hold of Oneplan and explained the situation in detail via their whatsapp chat service including that my dog had just been to hospital and that it cost me R8000 and that is why I was seeking Pet insurance.

I app**** for Pet insurance but in my rush to get the dog on Pet Insurance, I ticked the wrong box and forgot to include that my pet did have a prior visit to the hospital on the application form. My application was accepted and premiums deducted. After one month my dog was ridden over by my wife and since I was under the impression that I had cover for this exact incident we went back to the emergency vet in Hilton and collected him the next day after spending another night in the emergency room and costing me another R8000.

When I put through my claim Oneplan requested a full medical history of the Pet, so I obliged. They noted that my pet had been to the hospital a month before and so they refused to honor the claim. They cancelled my insurance and repaid my premium.

I was not happy with the level of customer care I received during my experience with Oneplan as I could never get hold of them on the phone. The whatsapp service works but is delayed by about 5 hours so you can never speak to anyone in real time. The whatsapp service is also apparently not linked to to the application process as according to Oneplan any disclosures on the whatsapp chat do not constitute an admission of prior incidents as far as they are concerned.

Admittedly Oneplan were within their rights to cancel my insurance policy due to the omission of the prior incident on my application form but since there was no intent to deceive (I voluntarily submitted my pets full medical history as requested) I would have like to have been given the opportunity to pay a higher risk premium and continue under Oneplans Insurance cover.

The hole experience with Oneplan was very tedious and time consuming and in my case it did not have a happy ending. In my opinion there are better Pet insurance options out there who would be more understanding considering my two incidents were totally unrelated (one was a dog bite and the other a car accident) so do your homework before signing up with Oneplan.

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Replies (1)
Oneplan Insurance
Oneplan Insurance's reply24 Feb 2023, 09:27
Official
Good day Byron,
 
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 as we do take customer feedback seriously to improve our service and process to ensure that we meet our client’s expectations.
 
It is important to note that Oneplan as an Administrator of the Insurer does not take non-disclosures lightly. This matter has been reviewed at the highest level and it is unfortunate that the cancellation due to non-disclosure must be upheld as it applies to all clients equally

Kindly note that detailed feedback regarding the reasons for the policy cancelation was sent to your listed email address as it was a result due to the non-disclosure of a pre-existing accident event. 
 
At the time the contract was concluded no disclosure of any previous accidents was mentioned. The agreement is based on the written application which included the following question, “Are you aware of any medical conditions or injuries that your pet suffers from currently or previously had?” Which you marked “No” as the answer on the application form. We are not at liberty to change your application with the information you provided unless it was reduced to writing within the agreement. 
  
Insurance further is based on compensation for when unforeseen events occur, an insurer will consider two accidents in less than 2 months apart as a high risk.
 
The non-disclosure affects the underwriting of the policy and had we been aware of this previous accident which may have been a bite wound, and which the Vet confirmed as their notes being incorrectly documented, the policy would have been underwritten with exclusions and risk adjustments.
  
As per the policy terms and conditions that were sent to your listed email address, it states that we reserve the right to cancel your cover by giving you one (1) calendar month’s written notice thereof. In the event of non-disclosure, misrepresentation of any material facts, or misuse of cover, we will cancel your cover with immediate effect.
 
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 trust the above brings clarity on the matter, once again, we apologize for any inconvenience caused.
 
Kind Regards,
Oneplan