One Plan Medical Insurance (South Africa)Medical aid claim declined

F Dec 09, 2020
This review was posted by
a verified customer
Verified customer
Review updated:

Disgusting!! If you knows whats good for your health and looking for peace of mind do not sign up with this pathetic excuse of a health insurance!!!
four months into the policy, My wife was suddenly going blind in one eye on late Saturday afternoon 05/12/2020, called in to notify One plan and seek hospital authorization. Had to deal with a consultant named Denzil (whom hasn't a stitch of empathy). Was then told "if at my own discretion" I want to take her to the nearest hospital and the situation isn't "life threatening" I will have to fit the bill. How the hell must I know I am not a doctor and all private GPs are closed on saturday afternoons where I live.
Basically we where lefty in the dark.
We then had to spend the balance of saturday and sunday sitting at a Government hospital with limited facilities and access due to covid, they were unable to properly diagnose the cause or reason due to it being a weekend however the situation was getting worse and not better.
I then had to book an urgent private specialist appointment on Monday morning, after checking my wife the Dr immediately rule this out as a hospital emergency as she is in danger of going totally blind with a list of possible causes unknown and proper test need to be run to establish the cause!!
Again I tried to reach out to One plan for hospital assistance as we apparently have R50000 hospital cover according to the plan my wife is on and again had to deal with the same Robot Denzel to seek hospital authorization and guess what they declined us!!
My wife never had a pre-exsisting eye condition yet Apparently we now not covered for it, I am currently awaiting for the MRI scan which is the only way to tell whats is actually wrong and good luck!, One life if its ruled out as a life threatening condition to do with her brain etc. Expect a law suite coming your way for gross negligence and not honoring your word.
I will using all media platforms available to me to let people know of all the dishonesty your selling to honest hard working people, so they what to expect from a useless ONE PLAN medical insurance. im moving across to a proper medical aid that will cost slightly more but there when you need them.
Further more I had sent you a formal cancellation letter with immediate effect via email, do not attempt to put your grubby hands into my account and debt my account for December. I will reverse it!!

Responses

  • Pe
    Petunia Naiddo Jul 19, 2021
    This comment was posted by
    a verified customer
    Verified customer

    Bad experience with ONE PLAN HEALTH INSURANCE

    It is easier said than done . One Plan Health insurance is very disgusting, human lives does not matter to them only money that matters . On the 12th of July 2021 I went to see a doctor and I told them about it and they upload the funds . They said I must upload the invoice from the doctor . I told them the doctor I consulted did not gave me an invoice but the sick note instead, via whatsapp and they did not show any compassion instead it looked like I was the one who owe them something and they said I should pay the amount of R360 to their account or else they will suspend my plan. My question was who should take the responsibility I was very upset about their conduct . Lastly One plan should stop taking the advantage of good citizens and do the right thing . Business is about trust once it lacks it, it becomes difficult to work together .

    0 Votes

Post your comment

    By clicking Submit you are agreeing to the Complaints Board’s Terms and Conditions

    Submit

    IN THE NEWS

    Unhappy consumers gather online at Complaintsboard.com and have already logged thousands of complaints.
    If you see dozens of complaints about a certain company on ComplaintsBoard, walk away.
    One of the largest consumer sites online. Posting here your concerns means good exposure for your issues.
    A consumer site aimed at exposing unethical companies and business practices.
    ComplaintsBoard is a good source for product and company gripes from especially dissatisfied people.
    You'll definitely get some directions on how customer service can best solve your problem.
    Do a little research on the seller. Visit consumer complaint websites like ComplaintsBoard.