JO
John O
1 reviews | Active since Jul 2011
07 Apr 2025, 09:03
Useless.
We had a health emergency (poisoning, basically), and were at Milpark emergency ward. We called in to make an emergency claim. DESPITE the cover on the app saying that we were covered for in-hospital, they offered to pay R 400 for doctor consult only, which is R 1100 too little. On top of that, when I tried contacting the automated agent at 17h20, on the Saturday, the human agent only responded/came online at 14h08 the next day and then cancelled the conversation because **I** didn't respond. I decided, when I saw that they were not answering the automated system, to phone. I phoned for pre-authorisation and the 'emergency" help agent declined saying we were only covered for doctor consults at a GP. This was for the case of my partner whose details can be obtained by contacting me.
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Replies (4)0
Replies (4)
Oneplan Insurance's replyOfficial
07 Apr 2025, 09:19Dear John ,
Thank you for bringing this matter to our attention. We take client feedback seriously and are committed to maintaining the highest standards of service.
We sincerely regret any frustration caused by the experience you've had with our services.
Upon review of your complaint, we have escalated your policy to the relevant department for further assistance. A consultant will be in touch with you to discuss the matter.
Oneplan subscribes to its TCF principles and will take all reasonable steps to ensure fair and equal treatment of all our clients.
Upon review of your complaint, we have escalated your policy to the relevant department for further assistance. A consultant will be in touch with you to discuss the matter.
Oneplan subscribes to its TCF principles and will take all reasonable steps to ensure fair and equal treatment of all our clients.
We truly regret any frustration this situation may have caused, and hope to restore your experience with our services.
Kind regards,
Oneplan.
Oneplan.
Oneplan Insurance's reply07 Apr 2025, 09:19
Official
Dear John ,
Thank you for bringing this matter to our attention. We take client feedback seriously and are committed to maintaining the highest standards of service.
We sincerely regret any frustration caused by the experience you've had with our services.
Upon review of your complaint, we have escalated your policy to the relevant department for further assistance. A consultant will be in touch with you to discuss the matter.
Oneplan subscribes to its TCF principles and will take all reasonable steps to ensure fair and equal treatment of all our clients.
Upon review of your complaint, we have escalated your policy to the relevant department for further assistance. A consultant will be in touch with you to discuss the matter.
Oneplan subscribes to its TCF principles and will take all reasonable steps to ensure fair and equal treatment of all our clients.
We truly regret any frustration this situation may have caused, and hope to restore your experience with our services.
Kind regards,
Oneplan.
Oneplan.
JO
John O's updateReviewer Update
07 Apr 2025, 09:44No you guys are not serious. You do not go to casualty emergency if it is not an emergency. It was an emergency. Either pay up or it goes to financial ombudsman. Simple.
JO
John O's update07 Apr 2025, 09:44
Reviewer Update
No you guys are not serious. You do not go to casualty emergency if it is not an emergency. It was an emergency. Either pay up or it goes to financial ombudsman. Simple.
Oneplan Insurance's replyOfficial
07 Apr 2025, 12:37Dear John,
Thank you for getting back to us.
Kindly note that our claims department is currently in the process of gathering all the necessary information from the treating hospital and doctor to review the claim. Once all the information has been received and reviewed, feedback will be provided regarding the claim.
Kind regards,
Oneplan.
Thank you for getting back to us.
Kindly note that our claims department is currently in the process of gathering all the necessary information from the treating hospital and doctor to review the claim. Once all the information has been received and reviewed, feedback will be provided regarding the claim.
Kind regards,
Oneplan.
Oneplan Insurance's reply07 Apr 2025, 12:37
Official
Dear John,
Thank you for getting back to us.
Kindly note that our claims department is currently in the process of gathering all the necessary information from the treating hospital and doctor to review the claim. Once all the information has been received and reviewed, feedback will be provided regarding the claim.
Kind regards,
Oneplan.
Thank you for getting back to us.
Kindly note that our claims department is currently in the process of gathering all the necessary information from the treating hospital and doctor to review the claim. Once all the information has been received and reviewed, feedback will be provided regarding the claim.
Kind regards,
Oneplan.
JO
John O's updateReviewer Update
07 Apr 2025, 13:53Great thanks. Our view is that emergency matters except from contact sports, according to your policy statement which we have on-hand, is catered for, and NOT subject to the period in which no claims may be made due to having recently been onboarded. But we will wait for your decision before modifying or removing this review.
JO
John O's update07 Apr 2025, 13:53
Reviewer Update
Great thanks. Our view is that emergency matters except from contact sports, according to your policy statement which we have on-hand, is catered for, and NOT subject to the period in which no claims may be made due to having recently been onboarded. But we will wait for your decision before modifying or removing this review.