SvdW
Sandra van der Westhuizen
1 reviews | Active since Aug 2018
06 Mar 2025, 12:25
Oneplan Health Insurance
Oneplan medical insurance is the most *********** insurance I have ever come across. They will find any excuse not to pay claims. They require statements from doctors etc and then still won't process it. Then ask for detailed statements. What do they want? A whole history or essay with reasons why you were at the doctor? And please don't even think that you can be admitted to hospital even if it is urgent. I know there is a waiting period of a year. But if you need hospitilisation urgently? Surely they can make an exception to the rule! I asked to speak to a manager, but they are too holy to be spoken to. They will call you back, but they don't.
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Oneplan Insurance's replyOfficial
06 Mar 2025, 12:47Dear Sandra,
Thank you for bringing this matter to our attention.
We sincerely apologize for the circumstances surrounding your Hellopeter posting and the inconvenience this has caused. Please be assured that we take customer feedback seriously, using it to continually improve our services and processes to ensure we meet our clients' expectations. Your satisfaction is important to us, and we value you as our client.
We have reviewed your complaint and would like to clarify that for day-to-day claims to be assessed, a computer-generated detailed invoice is required. Kindly note that in your updated policy schedule, under section 3, a link worded "click here" includes an example of a detailed invoice that is required for claims to be assessed. You may submit invoices and proof of payments via email to *** with your policy number in the subject line. Alternatively, you may submit them on WhatsApp at *** and our team will happily assist.
We certainly understand your concerns with regards to the stated waiting periods, however, kindly note that all applicable waiting periods have to be served in full before you are able to utilize the benefit as per our terms and conditions.
For hospital admission claims, you can request authorization by sending a motivational letter, ICD 10 codes, and procedure codes to: *** and include your policy number as a subject matter. The underwriters will review the claim and provide feedback. Should the claim be an urgent operation, please kindly contact our in-hospital authorization department for authorization on ***.
We certainly understand your concerns with regards to the stated waiting periods, however, kindly note that all applicable waiting periods have to be served in full before you are able to utilize the benefit as per our terms and conditions.
For hospital admission claims, you can request authorization by sending a motivational letter, ICD 10 codes, and procedure codes to: *** and include your policy number as a subject matter. The underwriters will review the claim and provide feedback. Should the claim be an urgent operation, please kindly contact our in-hospital authorization department for authorization on ***.
Oneplan is committed to adhering to its TCF principles, taking all reasonable steps to ensure fair and equal treatment for all our clients.
Once again, we sincerely apologize for any inconvenience and confusion caused and appreciate your understanding.
Kind regards,
Oneplan.
Oneplan.
Oneplan Insurance's reply06 Mar 2025, 12:47
Official
Dear Sandra,
Thank you for bringing this matter to our attention.
We sincerely apologize for the circumstances surrounding your Hellopeter posting and the inconvenience this has caused. Please be assured that we take customer feedback seriously, using it to continually improve our services and processes to ensure we meet our clients' expectations. Your satisfaction is important to us, and we value you as our client.
We have reviewed your complaint and would like to clarify that for day-to-day claims to be assessed, a computer-generated detailed invoice is required. Kindly note that in your updated policy schedule, under section 3, a link worded "click here" includes an example of a detailed invoice that is required for claims to be assessed. You may submit invoices and proof of payments via email to *** with your policy number in the subject line. Alternatively, you may submit them on WhatsApp at *** and our team will happily assist.
We certainly understand your concerns with regards to the stated waiting periods, however, kindly note that all applicable waiting periods have to be served in full before you are able to utilize the benefit as per our terms and conditions.
For hospital admission claims, you can request authorization by sending a motivational letter, ICD 10 codes, and procedure codes to: *** and include your policy number as a subject matter. The underwriters will review the claim and provide feedback. Should the claim be an urgent operation, please kindly contact our in-hospital authorization department for authorization on ***.
We certainly understand your concerns with regards to the stated waiting periods, however, kindly note that all applicable waiting periods have to be served in full before you are able to utilize the benefit as per our terms and conditions.
For hospital admission claims, you can request authorization by sending a motivational letter, ICD 10 codes, and procedure codes to: *** and include your policy number as a subject matter. The underwriters will review the claim and provide feedback. Should the claim be an urgent operation, please kindly contact our in-hospital authorization department for authorization on ***.
Oneplan is committed to adhering to its TCF principles, taking all reasonable steps to ensure fair and equal treatment for all our clients.
Once again, we sincerely apologize for any inconvenience and confusion caused and appreciate your understanding.
Kind regards,
Oneplan.
Oneplan.