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Hester B

1 reviews | Active since Apr 2012

26 Feb 2024, 09:55

Oneplan is not honoring their own policy

I took pet insurance, but low and behold, you only approve what you think you want to approve. You are not sticking to your own rules. Even after I sent throught the paperwork more than twice, you ignored my emails as I needed clarification on fees and benefit and why certain things were not paid for. Yet, typical Oneplan, you ignored my emails. Now in an emergency situation, you are still not willing to help me although I have paid for months on end on my part. What goes for the goose, goes for the gander. You can't expect me to pay but then when push comes to shove you look at the sky and say, aha, today we won't pay. Please, readers, do not waste your money on Oneplan. They promise and say they specify this and the other. But they don't keep to their own rules.

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Replies (3)
Oneplan Insurance
Oneplan Insurance's reply26 Feb 2024, 15:27
Official
Dear  Hester,

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 we have 4 different plan types on our pet product, which include the Accident plan, Hospital plan, Classic plan, and Super plan. Our pet plans are specially designed to cater for our clients’ individual needs. 

The Classic and Super Plans offer comprehensive cover for day-to-day benefits as well as in-hospital benefits and funds are loaded onto the Onecard for your day-to-day benefits, whereas the Accident Plan only covers in-hospital corrective procedures that is related to an Accident. 

Records on our system confirm that you have 1 fur-baby covered on the Classic plan and 2 fur-babies covered on the Accident plan. Kindly note that your fur-babies will receive cover based on the plan type that he/she is covered on.
 
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 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 any inconvenience caused and we hope to restore the experience. 
                   
Kind Regards,
Oneplan 
HB
Hester B's update27 Feb 2024, 14:45
Reviewer Update
Interesting that the call I received from your office today was the first time I ever heard that these words "corrective procedure" MUST BE on the invoice when submitting a claim otherwise you wont pay. Why was this never mentioned when I took out the policy? You dont seem to understand that the customer is king. If there are fewer customers, your income is less, and that means you would have to fire people. But again, you never cared about your own words, just the stats. I remember how forceful the agent was when I spoke with him back then. Please, I really never ever want to do business with you again. Never.
Oneplan Insurance
Oneplan Insurance's reply28 Feb 2024, 12:32
Official
Dear Hester,
 
Thank you for reaching out to us.
 
Please take note that all of our terms and conditions are listed in the policy schedule that is sent to all our clients upon sign-up. 

Kindly note that admission according to the policy schedule is the admittance of an Insured Pet to a veterinary facility as an inpatient for medically justifiable corrective treatments, procedures, surgery, sedation, anesthesia, or specialist observation of an Illness or Injury based on the Admission Matrix set-out under the Hospital Cover section of your policy. 
According to our policy schedule under the heading "What is Not Covered" on the Oneplan Pet Hospital Admission Cover Section (point 2) it states that 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. We have a Diagnostic Booster available as an add-on benefit on our Classic and Super plan which caters specifically to diagnostic tests up to the respective cover limits.  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 to 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