BREAKDOWN: RAF medico-legal experts owed more than R121m as claims system buckles

The Road Accident Fund’s medico-legal system has been described in Parliament as a web of poor planning, unpaid invoices, procurement confusion and broken accountability, with some medical experts waiting years to be paid for work already used in court.

Medico-legal experts, including doctors, specialists, occupational therapists and other health practitioners, play a central role in Road Accident Fund (RAF) claims. Their reports help assess injuries, loss of earnings and the value of compensation due to road accident victims.

But evidence before the Standing Committee on Public Accounts (Scopa) recently suggests the RAF’s handling of this system has left both experts and claimants mired in administrative delays with no payments in sight.

Presenting a section of the committee’s report, parliamentary legal adviser Fatima Ebrahim said the evidence pointed to serious failures in the appointment, contracting and payment of medico-legal experts. These experts are not treating doctors but are appointed to provide independent assessments used in the claims process and, where necessary, in court.

The committee received submissions from experts who had worked for the RAF, either directly or through its former panel of attorneys, as well as experts appointed by claimants’ attorneys. In both cases, the recurring complaint was non-payment.

A key witness was Cecilia Margaretha Minnie, owner of MMB Made Easy, a close corporation that processes accounts on behalf of medico-legal experts. Minnie has worked in the field since 2007 and represented more than 100 clients, giving the committee a long view of the RAF’s payment and procurement problems.

Minnie’s affidavit said 35 of her clients were owed R41.29-million, excluding interest, with some claims dating back to 2014. She said a broader group of 47 medical experts was owed more than R120.75-million, also excluding interest.

According to the report presented to the committee, the RAF historically used a panel of medico-legal experts, often instructed through attorneys appointed to the RAF’s panel of attorneys. The experts would prepare reports and, where needed, testify in court.

However, the system was anything but neat. Some experts invoiced attorneys, who would then claim from the RAF and pay them, while others billed the RAF directly. The report found no clear explanation for these different processes.

In 2015, the RAF appointed a new expert panel for three years, after a tender process that began in 2013. But Minnie testified that the panel was too small for the RAF’s needs, with only 82 experts nationall