AB
Adele B
1 reviews | Active since Jun 2012
04 Sept 2026, 03:08
Very Bad Service
I am on the standard blue plan for my pets with oneplan. One of my fur babies had to spend the night in hospital for tests to be conducted. Authorisation and Promice to pay was given to Oneplan with quotation and motivational letter from the dr. The procedures were done, and I submitted the claim. Now all of a sudden every excuse in the book is used not to pay the account. The dr wrote a letter, is willing to supply all medical reports and speak to the vet that give the go ahead for payment and they are still declining the payment. I pay a huge amount of money every month and the service is getting worse and worse. Yes my dogs are old (11 and 12) min pinchers, with chronic illnesses, but it still does not justify why the account will be settled after the go ahead was given. I pay their chronic medication out of pocket every month as the don't even want to cover that. I owed them R205 from a previous visit and they haunted me for payment and I told them I will pay at the end of the month and I did. I am very disappointed in oneplan. I have to take them for their yearly check up in October, but how can I trust them to actually pay?? I even have the levy waiver on the policy. I will not recomend oneplan to anyone, if I could I would change, but because they are over 10 years nobody will give full cover only accident cover. Oneplan knows that and now the do what they want. In short.....they are useless and can't be trusted.
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Replies (5)AB
Adele B's updateReviewer Update
04 Sept 2026, 03:34And another "non urgent" matter they refused to pay. The vet had to test my other dog for cushions disease, which is a hospitalized treatment. There are three tests to be done with waiting periods one after the other hence the hospital stay. I don't have the money to pay the vet account to do it privately, that is why I HAVE INSURANCE, We still don't know if she has it, and no treatment plan can be given until we know which one will work as ONEPLAN won't allow us to do the tests. Absolutely pathetic.
AB
Adele B's update04 Sept 2026, 03:34
Reviewer Update
And another "non urgent" matter they refused to pay. The vet had to test my other dog for cushions disease, which is a hospitalized treatment. There are three tests to be done with waiting periods one after the other hence the hospital stay. I don't have the money to pay the vet account to do it privately, that is why I HAVE INSURANCE, We still don't know if she has it, and no treatment plan can be given until we know which one will work as ONEPLAN won't allow us to do the tests. Absolutely pathetic.
Oneplan Insurance's replyOfficial
04 Sept 2026, 07:15Dear Adele,
Thank you for taking the time to share your concerns with us.
Thank you for taking the time to share your concerns with us.
Please note that your claim was reviewed fairly and in accordance with the policy terms and conditions and the clinical information provided. Based on the documentation received, only diagnostic investigations were being performed at the time of the claim, with no admission-related treatment procedure having taken place.
As a result, the claim falls under diagnostic testing and does not qualify for payment under the Hospital Benefit. The Hospital Benefit is applicable when there is a covered hospital admission and qualifying treatment or procedure, subject to the policy terms and conditions.
The admission matrix outlines that, for a claim to be considered under the In-Hospital benefit, the treatment must include one or more of the following:
The admission matrix outlines that, for a claim to be considered under the In-Hospital benefit, the treatment must include one or more of the following:
- Hospitalization (the act of admission)
- Procedure (corrective not diagnostic)
- Drip setup
- Surgery, professional fee
- Sedation and anesthesia
- Severity
- Treatment plan
- Duration of admittance and/or procedure
Kindly note that the formal repudiation letter regarding this has been sent to your listed email address.
We appreciate that this outcome may not be what you expected, however claims are assessed consistently against the policy benefits and cover provisions applicable to the selected plan.
Thank you for your feedback and for bringing your concerns to our attention, and we hope this clarifies the matter.
Kind regards,
Oneplan.
Kind regards,
Oneplan.
Oneplan Insurance's reply04 Sept 2026, 07:15
Official
Dear Adele,
Thank you for taking the time to share your concerns with us.
Thank you for taking the time to share your concerns with us.
Please note that your claim was reviewed fairly and in accordance with the policy terms and conditions and the clinical information provided. Based on the documentation received, only diagnostic investigations were being performed at the time of the claim, with no admission-related treatment procedure having taken place.
As a result, the claim falls under diagnostic testing and does not qualify for payment under the Hospital Benefit. The Hospital Benefit is applicable when there is a covered hospital admission and qualifying treatment or procedure, subject to the policy terms and conditions.
The admission matrix outlines that, for a claim to be considered under the In-Hospital benefit, the treatment must include one or more of the following:
The admission matrix outlines that, for a claim to be considered under the In-Hospital benefit, the treatment must include one or more of the following:
- Hospitalization (the act of admission)
- Procedure (corrective not diagnostic)
- Drip setup
- Surgery, professional fee
- Sedation and anesthesia
- Severity
- Treatment plan
- Duration of admittance and/or procedure
Kindly note that the formal repudiation letter regarding this has been sent to your listed email address.
We appreciate that this outcome may not be what you expected, however claims are assessed consistently against the policy benefits and cover provisions applicable to the selected plan.
Thank you for your feedback and for bringing your concerns to our attention, and we hope this clarifies the matter.
Kind regards,
Oneplan.
Kind regards,
Oneplan.
AB
Adele B's updateReviewer Update
04 Sept 2026, 09:08Exactly what I mean with you that lies to your customers, with authorisation and promise to pay to Vet, you still have excuses. You only care about your bank accoumt. Diagnostics are necessary for further correct care, that you are apparently also trying to dodge. You get my miney EVERY month, but you are not willing to stay true to your word. My next step now is to go to the ombudsman.
AB
Adele B's update04 Sept 2026, 09:08
Reviewer Update
Exactly what I mean with you that lies to your customers, with authorisation and promise to pay to Vet, you still have excuses. You only care about your bank accoumt. Diagnostics are necessary for further correct care, that you are apparently also trying to dodge. You get my miney EVERY month, but you are not willing to stay true to your word. My next step now is to go to the ombudsman.
Oneplan Insurance's replyOfficial
04 Sept 2026, 09:14Dear Adele,
Thank you for taking the time to share your concerns with us.
Thank you for taking the time to share your concerns with us.
Please note that your claim was reviewed fairly and in accordance with the policy terms and conditions and the clinical information provided. Based on the documentation received, only diagnostic investigations were being performed at the time of the claim, with no admission-related treatment procedure having taken place.
As a result, the claim falls under diagnostic testing and does not qualify for payment under the Hospital Benefit and can be reviewed under day-to-day cover, however, the benefits are depleted. The Hospital Benefit is applicable when there is a covered hospital admission and qualifying treatment or procedure, subject to the policy terms and conditions.
The admission matrix outlines that, for a claim to be considered under the In-Hospital benefit, the treatment must include one or more of the following:
The admission matrix outlines that, for a claim to be considered under the In-Hospital benefit, the treatment must include one or more of the following:
- Hospitalization (the act of admission)
- Procedure (corrective not diagnostic)
- Drip setup
- Surgery, professional fee
- Sedation and anesthesia
- Severity
- Treatment plan
- Duration of admittance and/or procedure
Kindly note that the formal repudiation letter regarding this has been sent to your listed email address, which includes the complaints resolution process that you may follow.
Certain terms and conditions are always applicable, and these are included in all policy documents before and during your experience with us. We will assist with all we can in line with our terms and conditions. Oneplan subscribes to its TCF principles and will take all reasonable steps to ensure fair and equal treatment of all our clients.
We appreciate that this outcome may not be what you expected, however claims are assessed consistently against the policy benefits and cover provisions applicable to the selected plan.
Thank you for your feedback and for bringing your concerns to our attention, and we hope this clarifies the matter.
Kind regards,
Oneplan.
Kind regards,
Oneplan.
Oneplan Insurance's reply04 Sept 2026, 09:14
Official
Dear Adele,
Thank you for taking the time to share your concerns with us.
Thank you for taking the time to share your concerns with us.
Please note that your claim was reviewed fairly and in accordance with the policy terms and conditions and the clinical information provided. Based on the documentation received, only diagnostic investigations were being performed at the time of the claim, with no admission-related treatment procedure having taken place.
As a result, the claim falls under diagnostic testing and does not qualify for payment under the Hospital Benefit and can be reviewed under day-to-day cover, however, the benefits are depleted. The Hospital Benefit is applicable when there is a covered hospital admission and qualifying treatment or procedure, subject to the policy terms and conditions.
The admission matrix outlines that, for a claim to be considered under the In-Hospital benefit, the treatment must include one or more of the following:
The admission matrix outlines that, for a claim to be considered under the In-Hospital benefit, the treatment must include one or more of the following:
- Hospitalization (the act of admission)
- Procedure (corrective not diagnostic)
- Drip setup
- Surgery, professional fee
- Sedation and anesthesia
- Severity
- Treatment plan
- Duration of admittance and/or procedure
Kindly note that the formal repudiation letter regarding this has been sent to your listed email address, which includes the complaints resolution process that you may follow.
Certain terms and conditions are always applicable, and these are included in all policy documents before and during your experience with us. We will assist with all we can in line with our terms and conditions. Oneplan subscribes to its TCF principles and will take all reasonable steps to ensure fair and equal treatment of all our clients.
We appreciate that this outcome may not be what you expected, however claims are assessed consistently against the policy benefits and cover provisions applicable to the selected plan.
Thank you for your feedback and for bringing your concerns to our attention, and we hope this clarifies the matter.
Kind regards,
Oneplan.
Kind regards,
Oneplan.
AB
Adele B's updateReviewer Update
04 Sept 2026, 09:26Automated response, can't even speak to a human. My vet is willing to submit all reports and speak to your vet but apparently you still don't care
AB
Adele B's update04 Sept 2026, 09:26
Reviewer Update
Automated response, can't even speak to a human. My vet is willing to submit all reports and speak to your vet but apparently you still don't care