OnePlan Insurance review: Pet claims

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIMS: [protected], [protected], [protected], [protected]

Yesterday we phoned your call centre seeing that no one ever calls us regarding this matter and it was communicated that, once again, OnePlan is still confused with the fact that there are 2x Milo's on the policy which indicates that NO ONE seems to see the CLEAR fact that each and every claim form SPECIFICALLY states the all these claims are linked to 1x Milo, a MALE DACHSHUND!

It blatantly seems that NO ONE at your claims and investigations department care enough to read the claim forms, invoices and statements and lack the mental capacity to understand what the Vet actually communicated to the consultant.

I had to say goodbye to my dog and now I keep fighting with OnePlan's lackluster call centre and consultant affording me NO closure. Absolutely pathetic!

I have had enough of your lackluster help and constantly having to explain to you what is actually infront of you!

Your sorry and hollow escalation claims mean NOTHING to me! I want someone to pick up the phone, someone clued up with the ENTIRE matter and keep to the promise that was said to my mother (the policy holder) on Friday, 01/03/2024 that the matter has been resolved and someone will phone us - a call we are still waiting for.

I WANT MY REFUND FOR THE BURIAL/CREMATION BY COB TODAY!

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected] — Forwarded message — From: Marcel du Plessis

Date: Tue, Mar 5, 2024 at 4:09 PM

Subject: Re: [protected] - CLAIMS: [protected], [protected], [protected], [protected]

To: Complaints (Oneplan), Oneplan Pet Claim

Cc: Martin Rossouw, Debbie Du Plessis

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIMS: [protected], [protected], [protected], [protected]

There is a reason why the complaints department was CC'd in the mail because it has taken 2 months to settle the above claims because OnePlan keeps giving us the run around and requesting the same invoice over and over. Therefore EACH and EVERY invoice was sent last week with the complaints department CC'd therein where after it seemed like something was being done, although and yet again, it seems that there is no proper feedback regarding the matter as it seems no one actually investigates or reads all the mails below and the ton of emails sent before.

On Friday afternoon, 1 March 2024 a person by the name of Michelle (if I remember correctly) from Oneplan’s “Complaints Department” called my mother (the policy holder) and reassured her that the above matters were being investigated and being attended to.

Furthermore, she assured my mother that she would receive feedback by no later than Monday, 4 March 2024 regarding our complaint. It is almost COB on Tuesday, 5 March 2024 and still no feedback from neither a OnePlan consultant, nor someone at the Complaint's Department.

The lack of urgency, feedback and keeping to your word absolutely disgusts me. if you cared as much as what the tag at the end of each of your mails said, these claims would've been settled months ago.

Kindly provide feedback ASAP!

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected]

image. gif

On Tue, Mar 5, 2024 at 3:55 PM Complaints (Oneplan) wrote:

Gooday Marcel Du Plessis,

We hereby acknowledge receipt of your emails. We have noted that these emails were also addressed to the Claims Department who will handle the claims.

Kindly advise me with whom you spoke with so we can escalate your concerns and expedite your response.

The Complaints Department does not make outbound phone calls.

We will afford them an opportunity to assist, should you wish to lodge a formal complaint after the matter has been finalised, you may do so in line with our Complaints Resolution Policy which is attached for your perusal.

Kind regards,

Mardhiyah Abrahams

Complaints (Oneplan)

E: [protected]@oneplan.co.za

[protected]

2nd Floor, South Tower, Nelson Mandela Square, Corner Maude & 5th Street, Sandton City, Johannesburg, 2196

oneplan.co.za

Oneplan is sold by Oneplan Brokers (Pty) Ltd and administered by Oneplan Underwriting Managers (Pty) Ltd, authorised financial services provider FSP43627 and FSP43628. Oneplan is not a benefit option regulated by the Medical Schemes Act, but a short-term insurance product underwritten by Bryte Insurance Company Limited a licensed insurer and an authorised FSP (17703). No liability is accepted for any consequences arising from this email. Please refer to the Terms of Use.

Should you require further assistance please e-mail [protected]@oneplan.co.za

From: Marcel du Plessis

Sent: Tuesday, March 5, 2024 11:09 AM

To: Claims Pet (Oneplan) ; Complaints (Oneplan)

Cc: Martin Rossouw ; Debbie Du Plessis

Subject: [protected] - CLAIMS: [protected], [protected], [protected], [protected]

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIMS: [protected], [protected], [protected], [protected]

A call was received on Friday, 01/03/2024 from your Complaints Department stating that we (Debbie - the policy holder) would be receiving feedback by Monday, 04/03/2024... It is already almost midday on Tuesday, 05/03/2024 and we still have not received any feedback on any of these claims.

As per your statement on 01/03/2024, we request feedback by close of business today, 05/02/2024 or this matter will be referred to the ombudsman.

We await your urgent response, today.

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected]

Image removed by sender. — Forwarded message — From:

Date: Thu, Feb 29, 2024 at 2:50 PM

Subject: FW: URGENT URGENT URGENT! MILO ROSSOUW DU PLESSIS (POLICY NUMBER: [protected]) - REJECTED CLAIMS?

To:

Cc:,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

“REJECTED” CLAIMS: [protected] & [protected]

CLAIM: [protected] - BURIAL & CREMATION REFUND

Good day,

I have just noticed on the OnePlan App that the above claims have been “rejected” – PLEASE OPEN THE ATTACHMENT.

Kindly refer to the attached explaining that claim [protected] indeed does have an invoice PPCP-2115 which you request on your “claim statement”. Also find a note on the Vet’s statement attached with a very nice explanation how the payment was allocated. If you do not understand the explanation or allocation, please contact the Vet, Dr Marga Joubert directly at Pet Pronto.

Furthermore, claim [protected] forms part of the payment of the R2400 (R1550 + R850 = R2400) on the 25/01/2024 where once again the vet, Dr Marga Joubert explains very nicely how the payments were applied/allocated and where you received all the applicable invoices in my previous email regarding same – refer to those same invoices in my email from earlier today which details the R2400 very nicely to read and understand.

Again I explicitly request that that CLAIM [protected] BURIAL & CREMATION REFUND be refunded within 24 hours.

Hoping you find the above in order.

Regards

Debbie

From: [protected]@advchambers.co.za

Sent: Thursday, February 29, 2024 10:13 AM

To: '[protected]@oneplan.co.za'

Cc: 'duplessis. [protected]@gmail.com' ; '[protected]@gmail.com' ; '[protected]@petpronto.co.za'

Subject: URGENT URGENT URGENT! MILO ROSSOUW DU PLESSIS (POLICY NUMBER: [protected]) - OUTSTANDING CLAIMS

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIM: [protected] & [protected]

CLAIM: [protected] - BURIAL & CREMATION REFUND

With reference to my telephonic conversation on Wednesday, 28 February 2024 with one of your agents.

I attach hereto the statement received from Pet Pronto with all notes specifically indicating the payments allocated to each and every invoice which was outstanding at their clinic/offices. The Vet, Dr Marga Joubert had a problem to consult as her account was in arrears however Milo was very ill at that point and being the caring person that she is was prepared to take care of Milo. In the meantime Oneplan was twiddling their thumbs about approving the invoices and therefore, a plan of action was taken to pay her outstanding invoices and these payments were allocated to the oldest outstanding accounts by using the amount that was available on the One Card = R2400 and R850 respectively.

No feedback has been received pertaining to the hospitalization of Milo on 25/01/2024 - the Pre-Authorisation documentation was sent on a previous time – what is happening about this?

Furthermore to the above, I attach each and every invoice which appears on the statement in order for Oneplan to approve and finalize these claims once and for all.

Please feel free to contact Dr Marga Joubert if you should require any additional information regarding the above.

I also want to state that it is of utmost importance (see attached Invoice PPCR-2261) to obtain the refund for Milo’s burial/cremation as my children paid that account in full. It was very traumatizing for my children and if you care any bit as Oneplan says they care, then you will see to it that we get refunded within 24 hours.

I cannot explain how urgent this matter is and your approval for the above claims would be best before close of business today.

Regards

Debbie

Image removed by sender. Mailtrack

Sender notified by

Mailtrack

03/05/24, 11:06:22 AM

Complaints (Oneplan)

e: [protected]@oneplan.co.za

t: [protected]

2nd Floor, South Tower

Nelson Mandela Square

Cnr Maude & 5th Street

Sandton City

Johannesburg, 2196

Oneplan is sold by Oneplan Brokers (Pty) Ltd and administered by Oneplan Underwriting Managers (Pty) Ltd, authorised financial services providers FSP43627 and FSP43628. Oneplan is not a benefit option regulated by the Medical Schemes Act, but a short-term insurance product underwritten by Bryte Insurance Company Limited a licensed insurer and an authorised FSP (17703). No liability is accepted for any consequences arising from this email. Please refer to the Terms of Use.

Should you require further assistance please e-mail [protected]@oneplan.co.za — Forwarded message — From: Marcel du Plessis

Date: Wed, Feb 28, 2024 at 10:13 AM

Subject: Re: Outstanding claim ONE:[protected] [#Ref: [protected]]

To: Oneplan Pet Claim,

Cc: Martin Rossouw, Debbie Du Plessis

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIMS: [protected] & [protected]

WHAT IS SO DIFFICULT TO UNDERSTAND?

The statement (attached hereto) CLEARLY reflects that an amount was paid to Pet Pronto (the vet) on 25/01/2024 in the amount of R2400 and the R850 was paid on 07/02/2024 (check the cards transactions). It furthermore CLEARLY indicates that the R2400 and the R850 was allocated to the ENTIRE outstanding amount for MILO ROSSOUW DU PLESSIS.

He was further admitted to spend the night at the vet, which hospital admission Pre-Authorisation was ALSO sent - CHECK YOUR MAILS!

OnePlan took 3 months to approve his claim of 18/11/2023, therefore we could not load any additional amount on the OnePlan card. The vet helped on a credit basis as OnePlan could not understand that there were 2x Milo's on the policy. Thus, the account with the vet accumulated and, after the 3 month lackluster service of OnePlan, the claim for 18/11/2023 was approved. We then loaded the card with R2400, which was then used to settle the vet account as much as possible - the current outstanding amount of R551.00 (see statement).

READ THE INVOICES, READ THE STATEMENT, READ THE COUNTLESS EMAILS SENT TO YOU OVER AND OVER AND OVER AGAIN!

OnePlan has again proven another lackluster take on your investigations department as well as your customer service department.

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected]

From: Oneplan Claims Main

Sent: Wednesday, February 28, 2024 7:56 AM

To: [protected]@advchambers.co.za

Subject: Re: RE: Outstanding claim ONE:[protected] [#Ref: [protected]]

Dear Debbie

Hope you are well

Please kindly note that you withdrew an amount of R2400 however the invoices received is for an lesser amount, please note that pet med savings is only for an amount of R900.00, therefore there is an rejected amount /claim on your policy.

Should you need any further assistance please feel free to contact us

Also, note that we have a data-free app that you may download on your smartphone Or you may contact us on our WhatsApp line [protected]

Kindly Regards

Kenley Du Plessis

Your reference number is #[protected]. Please retain this number for future communication. — Forwarded message — From: Marcel du Plessis

Date: Wed, Feb 28, 2024 at 9:56 AM

Subject: Re: [protected]: BURIAL & CREMATION REFUND (MILO ROSSOUW DU PLESSIS) [#Ref: [protected]]

To: Oneplan Pet Claim,

Cc: Martin Rossouw, Debbie Du Plessis

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIM: [protected] - BURIAL & CREMATION REFUND

That is not good enough!

The claim was sent on 22/02/2024 (a week ago) and the same exact answer has been given for the past week.

Yet again, it seems that OnePlan's turnaround time is 3 weeks as that is how long every claim submitted to you over the past 3 months has taken!

Every claim submitted for him has been dragged out because no one seems to go the extra mile. I'm terribly disgusted and disappointed in OnePlan's lackluster performance.

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected]

image. gif

On Wed, Feb 28, 2024 at 9:48 AM Oneplan Pet Claim wrote:

Good day Marcel,

I hope this email finds you well.

Kindly note that your claim has been captured and has been sent to our in-hospital assessors for it to be processed, once your claim has been finalized you will receive an email with the outcome of your claim.

Should you need any further assistance please feel free to contact us.

Kind regards, — In Reply To — From: duplessis. [protected]@gmail.com

Date: Wed 28th February 2024, 9:34am

Subject: Re: [protected]: BURIAL & CREMATION REFUND (MILO ROSSOUW DU PLESSIS) [#Ref: [protected]]

To: [protected]@oneplan.co.za

Cc: [protected]@gmail.com, [protected]@gmail.com

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIM: [protected] - BURIAL & CREMATION REFUND

Any feedback on this or is OnePlan going to take their glorious pathetic time once again with every imaginable excuse?

I want feedback TODAY or my refund in my account TODAY!

I am sick and tired of OnePlan's pathetic service.

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected]

image. gif — Forwarded message — From: Marcel du Plessis

Date: Tue, Feb 27, 2024 at 11:19 AM

Subject: Re: [protected]: EUTHANASIA & CREMATION REFUND (MILO ROSSOUW DU PLESSIS) [#Ref: [protected]]

To: Oneplan Pet Claim

Cc: Martin Rossouw, Debbie Du Plessis

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIM: [protected] - BURIAL & CREMATION

Any feedback on this. It's almost a week or is OnePlan going to take their glorious pathetic time again?

I want feedback TODAY or my refund in my account TODAY!

I am sick and tired of OnePlan's pathetic service.

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected]

On Mon, Feb 26, 2024 at 3:31 PM Oneplan Pet Claim wrote:

Hi Marcel,

Thank you for your email.

We apologize for your service experience. Our in hospital team is in currently working on your claim they will provide you feedback as soon as the claim has been finalized.

Kind Regards,

Beverley Jantjies

Your reference number is #[protected]. Please retain this number for future communication. — Forwarded message — From: Marcel du Plessis

Date: Wed, Feb 28, 2024 at 9:32 AM

Subject: Re: Outstanding claim ONE:[protected] (ABSOLUTE PATHETIC SERVICE)

To: Oneplan Pet Claim,

Cc: Martin Rossouw, Debbie Du Plessis

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIM: [protected]

ONCE AGAIN YOUR SERVICE IS ABSOLUTELY PATHETIC!

Why does the app reflect that the claim has been rejected because you haven't received the invoice/statement if it was sent NUMEROUS times and included herein AGAIN!

READ THE EMAIL AND READ THE STATEMENT ATTACHED wherein it reflects EVERY transaction.

WHAT IS SO DIFFICULT TO UNDERSTAND?

READ AND CHECK THE STATEMENT!

I want feedback TODAY!

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected]

image. gif — Forwarded message — From: Marcel du Plessis

Date: Tue, Feb 27, 2024 at 11:14 AM

Subject: RE: Outstanding claim ONE:[protected] (ABSOLUTE PATHETIC SERVICE)

To: Oneplan Pet Claim,

Cc: Martin Rossouw, Debbie Du Plessis

Good day,

POLICY: [protected]

POLICY HOLDER: DEBBIE DU PLESSIS

CLIENT/PET: MILO ROSSOUW DU PLESSIS (Dachshund)

CLAIM: [protected]

YOUR SERVICE IS ABSOLUTELY PATHETIC!

I see that we're heading down the same route as each and every previous route after submitting documents, you just keep requesting the same thing over and over again. ATTACHED HERETO AGAIN!

READ THE EMAILS, READ THE INVOICES, READ THE STATEMENT, READ THE COUNTLESS EMAILS SENT TO YOU OVER AND OVER AND OVER AGAIN!

The invoice, dated 07/02/2024, was sent per email on 13/02/2024 (check your mails), together with EVERY other invoice requested. The same explanation is given here as the previous time, CHECK THE STATEMENT!

The statement CLEARLY reflects that an amount was paid to Pet Pronto (the vet) on 25/01/2024 in the amount of R2400 and the R850 was paid on 07/02/2024 (check the cards transactions). It furthermore CLEARLY indicates that the R2400 and the R850 was allocated to the ENTIRE outstanding amount for MILO ROSSOUW DU PLESSIS.

OnePlan took 3 months to approve the claim of 18/11/2023, therefore we could not load any additional amount on the OnePlan card. The vet helped on a credit basis as OnePlan could not understand that there were 2x Milo's on the policy. Thus, the account with the vet accumulated and, after the 3 month lackluster service of OnePlan, the claim for 18/11/2023 was approved. We then loaded the card with R850, which was then used to help further settle the vet account as much as possible - the current outstanding amount of R551.00 (see statement).

It can also be noted that the invoice in question has the same date as the statement, as well as the last transaction on the card, namely 07/02/2024.

OnePlan has again proven another lackluster take on your investigations department as well as your customer service department.

CHECK THE STATEMENT!

Sincerely frustrated customer,

Marcel du Plessis obo Debbie du Plessis (policy holder)

duplessis. [protected]@gmail.com

[protected]

image. gif — Forwarded message — From:

Date: Tue, Feb 27, 2024 at 11:01 AM

Subject: RE: Outstanding claim ONE:[protected]

To:, Oneplan Claims Team

Cc:

Good day,

Why do you keep sending me the same irritating emails?!

We have sent the information to you MANY TIME BEFORE AND YOU KEEP REQUESTING THE SAME!

You do not comply with what you say in your email hereinbelow:

We wish to always provide you with superior services. Our clients are our #1 priority. We look forward to establishing a healthy relationship with you.

You do not know what superior service is even if you look it in the eye and nor do you know what #1 priority is to your clients. Furthermore, there is no healthy relationship if you cannot provide us with a decent service.

Regards

Debbie

From: Oneplan Pet Insurance

Sent: Tuesday, February 27, 2024 10:37 AM

To: [protected]@advchambers.co.za

Subject: Outstanding claim ONE:[protected]

Importance: High

Hi Milo Rossouw,

Your Pet Med Booster claim on 2024/02/07, Reference no. [protected] cannot be processed due to the following reason Require detailed invoice/statement. Please provide us with the required info as soon as possible.

You will not be able to load another claim until this claim is finalised. This can also be done using the upload function via our app.

Remember that Onepet is NOT a medical aid but medical insurance. Should you have any questions, please contact us on the numbers provided and our call centre will assist you.

We wish to always provide you with superior services. Our clients are our #1 priority. We look forward to establishing a healthy relationship with you. For any queries, please do not hesitate to contact us on [protected].

Regards,

The Oneplan Team