cF
cherine F

1 reviews | Active since Aug 2021

17 Oct 2022, 10:36

the nightmare continues

Leading up from my previous hello peter complaint of the march incident, to date my nightmare continues. I was promised by the claims manager that Mediclinic will send all of the relevant bills directly to them, 7 months down the line I am I suddenly get bills from the hospital that are unpaid, when querying this by oneplan, I was informed that as so much time has passed they will no longer assist with any payment, so then I had to cancel my policy as i cant afford to pay medical bills and a useless medical fund, today again received another bill from the hospital. The problem is, I was promised that the hospital administrator was informed that one plan will assist with the incident but the hospital does not acknowledge oneplans existence. So now the onus falls on me the client to ensure that I am the middle man and I have to act as claims administrator and so all the admin work that oneplan is too lazy to do falls on me, now the issue arises that I am not a doctor I am not a hospital receptionist, I don't know what invoices and procedure and bills must be settled, so now the hospital and the oneplan does not communicate with each other, no bills are being send to me anymore in months, I assume all is well in the world after the hell of an ordeal i can finally move on with my life. Suddenly I am indebted for something that was supposed to be covered for and everyone is shrugging their shoulders not giving a damn. Please can i just understand why I paid +_ R24000.00 in premiums and when I needed you to help me with one event you made my life hell and continue to do so. I would have been better off saving my money and taking my chances in a government hospital. People please be cautious of this place, they paint a pretty picture and I think they have a good package...at face value, but administratively it is a nightmare, every single claim, every singe doctors visit is a fight and an issue and drama, you don't want to deal with that when you are sick and especially if you have a life threatening situation. They don't treat the customer fairly. They will be quick to call you after making a hello peter complaint and try and convince you to change it with empty promises, but again, what they advertise and what they do. Two different things.....just be careful.

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Replies (1)
Oneplan Insurance
Oneplan Insurance's reply17 Oct 2022, 14:29
Official
Good day Cherine,

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 as per our policy terms and conditions, clients have 4 months to submit outstanding claims for processing. Any claims submitted after four (4) months from the Insured Event will not be accepted. Please note that it is the responsibility of the client to ensure that all claim invoices have been received by us.

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 our client's 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 the policy holder to further discuss the matter at hand. 

Kind Regards,
Oneplan