1 reviews | Active since Jun 2015
Terrible Servicle
On Tuesday the 16th June i experienced a terrible pain i then rushed to Waterfall City Hospital and when i arrived all the nessacery observations were done and the Dr confirmed it was gastro.I then had to be admitted the hospital contacted Oneplan and given a authorisation number for my admittance.Suddenly on the 19th of June when i'm about to be discharged i recieve a bill from the hospital stating i need to pay the invoice because Oneplan declined because its pregnancy related.As far as i understand my policy covers emergency related admissions of upto 135k.I refuse to be liable to pay this invoice and why did they authorise my stay at the hospital? I'm very dissapointed and i will never refer anyone to Oneplan after this painful incident.I sent Oneplan an email on the 22nd of June requesting that they resolve this matter and i still have'nt heard from them.<br> <br> Shocking service.<br> <br> Palesa
Thank you for bringing the above to our attention.
Based on the terms and conditions of the policy, pregnancy, complications of pregnancy and delivery are excluded for 12 months. On the 10/06/2015 an email was sent with an updated schedule indicating the pregnancy exclusion. The diagnosis received from the service provider is deemed as related to pregnancy and complications in pregnancy and therefore the claim was repudiated.
However with the initial request for the casualty the information received was that the client was 5 weeks pregnant. With admission the hospital was informed that the admission will not be covered as well as with the update. The Emergency authorisation was declined as we were waiting for confirmation of the diagnosis. The account will be reprocessed and paid up to the amount of R4 000.00.
Trust that you will find the above in order.
Kind Regards,
Shanice Maistry
Customer Care Department
Thank you for bringing the above to our attention.
Based on the terms and conditions of the policy, pregnancy, complications of pregnancy and delivery are excluded for 12 months. On the 10/06/2015 an email was sent with an updated schedule indicating the pregnancy exclusion. The diagnosis received from the service provider is deemed as related to pregnancy and complications in pregnancy and therefore the claim was repudiated.
However with the initial request for the casualty the information received was that the client was 5 weeks pregnant. With admission the hospital was informed that the admission will not be covered as well as with the update. The Emergency authorisation was declined as we were waiting for confirmation of the diagnosis. The account will be reprocessed and paid up to the amount of R4 000.00.
Trust that you will find the above in order.
Kind Regards,
Shanice Maistry
Customer Care Department