1 reviews | Active since Oct 2013
Worst medical insurance
March 2021 I joined OnePlan. To my misfortune December I fell, upon falling I was okay until afternoon when my abdomen was extremely painful that I was rushed to the doctor.
From the Dr I was rushed to hospital. I was at Unitas, after a couple of tests I'm told I'm pregnant. While still shocked, I'm informed it's ectopic and I'll need surgery urgently.
They call Oneplan for authorization and oneplan declines and their reason is that, I am on a waiting period because I had a similar operation in 2019. 2019 I had a myemoctomy with Gems medical aid, I was not a member of Oneplan. I call them trying to understand why waiting period when I was not their member at the time and I get nowhere.
One plan refused all my claims relating to my abdomen. I was released from private hospital care which I pay Oneplan monthly to have access to and rushed to a public hospital.
I am not happy with the insurance and would advise anyone looking to join them to not even bother. They will let you down when you need them most.
I don't understand why I have to be on a 12 months waiting period for any abdomen care when I was not with the medical insurance during my first operation.
I am certainly not pleased
Thank you for taking our call earlier and allowing us the opportunity to further discuss the matter at hand.
We sincerely apologize about the way you feel and for any inconvenience which has been caused.
As per our telephonic conversation, the inception date of your policy was 01 May 2021 and as per our policy schedule that was sent to your listed email address, there is a 12-month waiting period for Pregnancy, complications of pregnancy and deliveries. Unfortunately, the claim was rejected due to the condition that is excluded for the first twelve months of the policy.
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, please note that this is by no means a ploy to refuse payment of the claim. We do have your 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 once again apologize for all that you have been through.
Thank you for taking our call earlier and allowing us the opportunity to further discuss the matter at hand.
We sincerely apologize about the way you feel and for any inconvenience which has been caused.
As per our telephonic conversation, the inception date of your policy was 01 May 2021 and as per our policy schedule that was sent to your listed email address, there is a 12-month waiting period for Pregnancy, complications of pregnancy and deliveries. Unfortunately, the claim was rejected due to the condition that is excluded for the first twelve months of the policy.
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, please note that this is by no means a ploy to refuse payment of the claim. We do have your 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 once again apologize for all that you have been through.