Sounds too good to be true?....because it is.

I am incredibly frustrated with the service and negligence from Oneplan medical insurance. At sign up it sounds like a wonderful plan, full of promises, call backs, communication, good customer services and client care, your mind is put to rest thinking that you have the type of cover that you need and then it turns into a nightmare.

On Sunday 13.03.2022 – Date of incident – My partner fell and hurt his ankle. I immediately called Oneplan and spoke to someone in the emergency department, explained what happened and she advised that as it was an accident, we do have cover and we can go to the nearest Mediclinic, OneLife hospital and some other hospital I cannot recall the name of. I explicitly asked her what will happen with the payment at the hospital and she advised that the hospital will send the bills to Oneplan to settle.

My partner decided to rather go home as he thought maybe the ankle was just sprained, after a rough night he concluded that it is something more serious.

Monday 14.03.2022- I took my partner to Durbanville Mediclinic, upon arrival I was informed by the hospital that they do not in fact work with Oneplan and that they wait too long for their money from them so I would need to pay this cash up front. I immediately called oneplan again and was advised that they will cover the bill, I asked them what I must do now as they referred me to this hospital and he has already been taken in, then I was advised that I must pay the bill and send it to Claim. This already is a disgusting practice, What would I have done in if did not have the cash on hand?.

Monday afternoon I sent the claim to the claim department received no feedback, I was on the WhatsApp group as well as the online chat app to query the situation and when I will be getting the funds back that I did not have to spend in the first place. The one consultants told me that if that if the hospitals term then there is nothing they can do about it, yet nobody actually answered my questions, I just got there very robotic answers. My question since Monday was what do I do the coming Friday as my partner needs to go for the cast and we don’t have money to pay upfront. By Thursday I was informed that the claim for Monday was not even lodged yet. Eventually I spoke to refilwe in claims, again upon asking her what I must do about Friday she initially said she does not know…really? How am I supposed to accept an answer like this from my service provider, obviously I did not accept this answer. She eventually called me back and said that she spoke to someone at the hospital and arranged a payment guarantee from that with on Friday. I arrived there on Friday and nobody at the hospital has any clue what I am talking about but they said that they will try and put it through. This morning I got an account from the hospital for Friday. I was also told that now I have to wait 30 days to get my money back which I was not even suppose to spend in the first place.

I am in disbelief regarding the lack of service and lack of care I have received, I really though I had peace of mind with this cover but having to deal with a traumatic event and then still having to fight with your service provider to give you the service that they charge you for every month.. its utterly disgusting. And my battle is yet not done, This cast needs to be removed in 5 weeks? Am I to cover that as well?

To sum it up. – you sent me to a hospital that you are not recognized by • You say you will pay the hospital then I must pay. • I have to wait a ridiculous amount of time to get my own money back • After communicating with agent every single day for 4 days in a row none of them could see that the claim was not even lodged yet. • You falsely state again that I can go to the same hospital and not to worry about payment just for me to again get a statement from them.

I want your resolution department to audit every single call, whatsapp, app conversation and email since Sunday. This is not treating the customer fairly.

I want this resolved, I want my money back and this last invoice sorted so that I can take my business elsewhere and I want it done before my next debit order goes off. Why should I pay you another premium if this is the level of service I get from you?