JH
Juane H
1 reviews | Active since Mar 2024
03 Dec 2025, 04:13
Poor show
I have been with the pet insurance for approximately 2 years now and was wondering how they were going to be should the need for the cover came up. The experience turned out to be disappointing just as I expected. This is the second time in 2 years I have claimed. The first time was for day to day vaccinations. Don't waste your money insuring your pet with them as you pay in for 2 years and the one time you claim R3500 because your pet gets hospitalized it gets rated as casualty. Therefore you are are left to pay more than half the hospital bill. As for all the reviews on your yes the staff are friendly and helpful however the cover is not what is expected
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Replies (2)
Oneplan Insurance's replyOfficial
03 Dec 2025, 08:02Dear Juane,
Thank you for bringing this to matter our attention.
We sincerely regret the circumstances that led to your Hellopeter complaint and apologize for any inconvenience you have experienced.
Upon a thorough investigation into the matter, we would like to clarify that the claim in question has been reviewed fairly, subject to the stated terms and conditions as outlined in the policy schedule. Based on the invoice submitted for the claim, the services rendered fall under the Casualty benefit and do not meet the admission matrix as outlined on your policy document. It is important to note the following as per the policy schedule; The below conditions under the Admission Matrix must be met for a claim to be considered under either Illness or Accident Hospital cover, subject to the terms and conditions of the policy. On receipt of the claim documentation and invoice the criteria stipulated in the Matrix will be considered for approval of these claims and will include – but is not limited to – the following:
Thank you for bringing this to matter our attention.
We sincerely regret the circumstances that led to your Hellopeter complaint and apologize for any inconvenience you have experienced.
Upon a thorough investigation into the matter, we would like to clarify that the claim in question has been reviewed fairly, subject to the stated terms and conditions as outlined in the policy schedule. Based on the invoice submitted for the claim, the services rendered fall under the Casualty benefit and do not meet the admission matrix as outlined on your policy document. It is important to note the following as per the policy schedule; The below conditions under the Admission Matrix must be met for a claim to be considered under either Illness or Accident Hospital cover, subject to the terms and conditions of the policy. On receipt of the claim documentation and invoice the criteria stipulated in the Matrix will be considered for approval of these claims and will include – but is not limited to – the following:
- Hospitalisation (the act of admission)
- Procedure (corrective not diagnostic)
- Drip setup
- Surgery, professional fee
- Sedation and anaesthesia
- Severity (Based on the below Triage Categories)
- Treatment plan
- Duration of admittance and/or procedure.
For this reason, the claim cannot be reviewed under the In-Hospital benefit.
A Casualty claim has been processed and the funds have been loaded into your Oneplan claims card. You may swipe or tap the card at the service provider to make payment and submit the proof of payment to us for the claim to be finalised.
We understand that this may not be the outcome you were hoping for, but we trust that the above clarity helps explain how the benefits apply. Please be assured that one declined claim does not mean that future claims will not be covered. Each claim is assessed on its own merits and in accordance with the policy schedule. Should you need any further assistance, we are here to help.
Kind regards,
Oneplan.
Oneplan Insurance's reply03 Dec 2025, 08:02
Official
Dear Juane,
Thank you for bringing this to matter our attention.
We sincerely regret the circumstances that led to your Hellopeter complaint and apologize for any inconvenience you have experienced.
Upon a thorough investigation into the matter, we would like to clarify that the claim in question has been reviewed fairly, subject to the stated terms and conditions as outlined in the policy schedule. Based on the invoice submitted for the claim, the services rendered fall under the Casualty benefit and do not meet the admission matrix as outlined on your policy document. It is important to note the following as per the policy schedule; The below conditions under the Admission Matrix must be met for a claim to be considered under either Illness or Accident Hospital cover, subject to the terms and conditions of the policy. On receipt of the claim documentation and invoice the criteria stipulated in the Matrix will be considered for approval of these claims and will include – but is not limited to – the following:
Thank you for bringing this to matter our attention.
We sincerely regret the circumstances that led to your Hellopeter complaint and apologize for any inconvenience you have experienced.
Upon a thorough investigation into the matter, we would like to clarify that the claim in question has been reviewed fairly, subject to the stated terms and conditions as outlined in the policy schedule. Based on the invoice submitted for the claim, the services rendered fall under the Casualty benefit and do not meet the admission matrix as outlined on your policy document. It is important to note the following as per the policy schedule; The below conditions under the Admission Matrix must be met for a claim to be considered under either Illness or Accident Hospital cover, subject to the terms and conditions of the policy. On receipt of the claim documentation and invoice the criteria stipulated in the Matrix will be considered for approval of these claims and will include – but is not limited to – the following:
- Hospitalisation (the act of admission)
- Procedure (corrective not diagnostic)
- Drip setup
- Surgery, professional fee
- Sedation and anaesthesia
- Severity (Based on the below Triage Categories)
- Treatment plan
- Duration of admittance and/or procedure.
For this reason, the claim cannot be reviewed under the In-Hospital benefit.
A Casualty claim has been processed and the funds have been loaded into your Oneplan claims card. You may swipe or tap the card at the service provider to make payment and submit the proof of payment to us for the claim to be finalised.
We understand that this may not be the outcome you were hoping for, but we trust that the above clarity helps explain how the benefits apply. Please be assured that one declined claim does not mean that future claims will not be covered. Each claim is assessed on its own merits and in accordance with the policy schedule. Should you need any further assistance, we are here to help.
Kind regards,
Oneplan.
JH
Juane H's updateReviewer Update
03 Dec 2025, 11:17Thank you for the response however I still don't feel the cover is worth it
JH
Juane H's update03 Dec 2025, 11:17
Reviewer Update
Thank you for the response however I still don't feel the cover is worth it