The Road Accident Fund owes the KwaZulu-Natal Health Department R100 million in unpaid fees.
|||Durban - Accident victims are not the only ones facing long waits for payout from the cash-strapped Road Accident Fund (RAF). It owes the KwaZulu-Natal Health Department R100 million in unpaid fees.
This emerged in the department’s third-quarter budget performance report for the 2015/16 financial year tabled in the legislature this week.
Department chief financial officer, Sihle Mkhize, told the health portfolio committee its revenue collection was 35% below the guidelines, partly because of under collection from the RAF, and other debtors.
The fees are for the treatment of road accident victims.
Mkhize told the committee assurances had been given by the fund that outstanding claims would be reimbursed. But when this would happen was not clear.
Committee chairwoman, Lizzie Shabalala, proposed the department report back to the committee at the next sitting on how much has been recouped from the debtors.
Committee member Jomo Sibiya said the fund was, at least, making payments, but questioned if “there was a system that we can use to recoup our funds quickly”.
Dr Mzukisi Grootboom, president of the South African Medical Association, told the Daily News the RAF was critically underfunded. “There were more claims, yet the national Treasury keeps on giving it a minute budget. It is a state agency and another state agency, like the department of health, finds it difficult to force them to pay,” he said
Grootboom said he sympathised with the RAF as road accident claims were growing every year, but funding from the Treasury was not keeping pace.
No details were made available by the department during the portfolio committee as to when the RAF debt was incurred.
Contacted on Wednesday for clarity, Mkhize referred the Daily News to the department’s media office.
Department spokesman, Sam Mkhwanazi, said he did not have the documents with him because he was not at the office, but insisted the matter had been clarified at the meeting.
According to the report, statistics collected from the department’s facilities and information database between December 10, last year and January 15, this year, 3 515 motor vehicle injuries, and 105 fatalities were recorded across the province.
In the same period, the department’s eThekwini District recorded the most injuries (1 017) and 27 fatalities, while Zululand District had the lowest, with 161 and nine fatalities.
A source said the RAF was “crippled” by unscrupulous lawyers who targeted motor vehicle accidents.
The fund relied for income solely on the levy it receives from the sale of petrol and diesel.
The source said the public and private health sectors claimed from the fund for treating road accident victims.
“When there’s a road accident, private ambulances do their best to be at the scene first, and they rush for the passenger/s because they are easily extricated than the drivers who in most accidents are the last to be released from the carnage, if they are alive.”
The sate or other ambulance services were then left to deal with the driver.
“Then come in the lawyers who deploy their agents to convince victims they will get this much if they sued through legal practitioners. Fortunately, now it looks like that will be a thing of the past as provisions are made or about to be made for accident victims to be solely, or with family assistance, involved in claiming for their pain and suffering without having to lose a percentage from their claim to lawyer,” said the source.
The RAF disputed the amount owed to the department, saying the figure was still under discussion.
In a written response to a list of e-mailed questions, RAF spokeswoman, Linda Rulashe, said: “The department could be referring to the value of claims submitted to the Fund and not paid.
“In terms of the RAF Act, the department is required to submit a compliant claim to us within stipulated periods.
“Once the claim is lodged, we are required to assess the claim for compliance with the Act, assess the negligence of the patient and the wrongdoer, assess whether the medical and related treatment provided to the patient is related to the injuries the patient sustained in the road crash, etc.
“Where the claim lodged by the department is not compliant with the Act, or where the patient was solely responsible for the road crash, the department’s claim will not be paid.”
Rulashe said the R1.54/ a litre it gets from the fuel levy, paid to it by the Treasury - which equated to about R3 billion a month - was inadequate when compared with the value of claims settled each month.
“In 2014/15, 173 743 new claims were received and 183 933 claims were finalised, including the overflow from the previous financial year. In the same financial year, the fund paid over R1.2bn for medical services nationally, to ensure that claimants are well taken care of and rehabilitated back to society,” Rulashe said
In the same financial year, the fund received R22.7bn from the fuel levy through the National Treasury.
However, the fund recorded a net deficit of R19.5bn in the period largely because of an increase in the provision for outstanding claims.
Asked about the impact of the lawyers who are alleged to be targeting accident victims, Rulashe said victims were not required to “utilise the services of an attorney” to lodge a claim with the fund because they have a right to do so on their own.
She reminded the public of the adverse consequences of engaging in fraudulent claims.
“Under our impending Road Accident Benefit Scheme, payments will be made directly to claimants and the role of attorneys will be limited, considering the removal of the requirement to prove fault and due to benefits being defined.”
Daily News
