The number – and size – of insurance claims filed with state-owned political risk insurer Sasria (the South African Special Risks Insurance Association) show just how much violent protests are costing South Africa. In 2007, after nearly four years of economic growth of over 5%, Sasria received 540 claims worth R14 million for damage as..
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ANC-regime needs to take notice – The cost of violent protests has spiked 100 fold in a decade
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The Department of Home Affairs faces about R2 billion in claims due to their inability to meet expected services as well as incompetence to maintain law and order in its immigration department
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The Department of Home Affairs already has claims worth about R2 billion that come from civilians because of its inability to meet expected services. The claims are still growing due to the legal costs involved in the construction of cases that had to be resolved in court and of which the Department was apparently ordered..
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The Road Accident Fund disaster – Victims could be left destitute, despite the high fuel levy we pay for accident insurance
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Both the chairman and the chief executive officer of the Road Accident Fund (RAF) admitted in the latest annual report that the fund is insolvent, with liabilities exceeding assets by more than R206 billion at end March 2018. The annual report states that the fund “has been insolvent since 1981”. The total liabilities with regards..
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Disgruntled SAPS members form new union and downed tools on Monday, claims that many experienced officers are being overlooked for promotion in the force
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Disgruntled members of the South African Police Service have formed a new workers union. They’re threatening to down tools on Monday. The group is unhappy about recent promotions and claims that many experienced officers are being overlooked for promotion. These are just some of the issues raised by members of the South African Police service..
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Who is fooling who?: So, according to Eskom there is no coal? Is Eskom deliberately wanting to plunge the country further into darkness and chaos?
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There is no shortage of coal, as Eskom claims. Instead, the coal is piling up at the mines, uncollected by the utility, Anna Marth Ott, CEO of Middelburg Chamber of Commerce and Industry, said yesterday. Middelburg is positioned between three large Eskom power stations, and there are 170 coal mines within a 200 km radius..
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KwaZulu-Natal landowners do not seek land but money – no wonder prosperous farms are ruined as soon as land is transferred to black beneficiaries
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Land allocated to local communities after land claim is now the focus of a dispute between the owners, the state and the Ingonyama Trust of Zwelithini. After several lands claim has been granted, the 30 owners of 11,000 hectares of land, worth R3 billion, want to sell it to the ANC-government for R760 million. This..
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The naked truth about land reform in SA – successful land claimers prefer to take money and not land
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Since 1994, the state has acquired a total of 8.2 million hectares of land in the land reform process during restitution and redistribution. This process has costs the country up to R39,2 billion. Of these, claimants in 93% of all successful land claims chose to take money and not land. This statistic, obtained from government..
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You got to be joking! They are totally in denial -Presidency: ‘We reject the notion that he lied’
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The Presidency is trying to soften the fallout after President Cyril Ramaphosa said there are no farm murders or land grabs in South Africa. “There are no killings of farmers or white farmers in South Africa. There’s no land grab in South Africa. We are involved in a process of discussing land reform‚” Ramaphosa said..
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Mediese selfbetalings styg met skokkende 13,4%
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Die brood het gekrimp, maar ons betaal nou meer daarvoor.
Só het ’n ekonoom die verhoging van meer as 13% in selfbetalings deur mediesefondslede die afgelope jaar beskryf.
Verbruikers wat elke jaar swaar trek aan die premies vir hul mediese fondse het boonop nog verlede jaar R29,7 miljard uit hul eie sak opgedok.
Dit is 13,4%, of ’n hele R2,5 miljard, meer as die vorige jaar, toon die jongste jaarverslag van die Raad op Mediese Skemas (RMS).
Boonop word dié syfer onderskat omdat dit net bereken word op die rekeninge wat lede indien waarvoor hulle self betaal het.
Die selfbetalings is die bedrae waarvoor geëis is wat fondse nie betaal nie.
“Dit kan ’n onderskatting wees van die werklike bedrag wat self betaal word omdat lede nie altyd hul eise aan hul fondse stuur wanneer hul voordele opgedroog het nie,” het die RMS in die verslag gesê.
Johann van Tonder, ’n ekonoom en navorser vir Momentum, het gesê mediese inflasie meet nie die styging in bybetali
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Health Professions Council of SA pursues bogus health practitioners
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A rise in bogus health practitioners has forced the Health Professions Council of SA (HPCSA) and medical schemes to strengthen their forensics units to curb fraud. A team at the HPCSA is conducting about 400 investigations into bogus practitioners. To date, just more than 40 arrests have been made, but prosecutions are slow.
Data from this special investigation unit suggests that about 7% of all medical aid claims in SA are fraudulent and stem from both bogus practitioners and unscrupulous ones.
Estimates are that this type of fraud costs the private sector R22bn a year.
Bogus practitioners include those who had previously been registered with the HPCSA, but were struck off for various infractions, while others had no medical qualifications or experience and used practice numbers belonging to registered healthcare practitioners.
Eric Mphaphuli, a senior inspector at the council, said on Monday that, initially, his team had issues getting the police on board
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Another state institution bites the dust – Government’s RAF has a shortage of money
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A new law will be submitted to replace the current Road Accident Fund. According to proposals, victims of road accidents will receive compensation in installments instead of a one-off payment. Claims can also be instituted directly with the fund administrators. It is currently unclear whether the use of attorneys that sets set claims will be..
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Syndicates and devious health professionals may target National Health Insurance
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Criminal networks are targeting your medical aid rands but could you be part of the problem too?
Criminal syndicates and unscrupulous doctors may be defrauding the private health sector of millions as experts warn that medical schemes may reach a breaking point.
“The health care sector is being targeted by criminal syndicates and even devious practitioners. It is a direct threat to the financial viability of medical schemes in the country, including any National Health Insurance initiative we attempt,” says medical advisor on healthcare forensics at medical aid administrator and risk management service, Medscheme Gregory Pratt. Pratt was speaking at the Board of Healthcare Funders Southern African Conference this week in Cape Town.
“The affordability of medical schemes in the country will soon reach a tipping point.”
In 2013 alone, Discovery Health recovered R300 million in fraudulent claims alone – a number that in 2014 CEO Jonathan Broomberg told
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Skok-voorbeelde van bedrog by mediese fondse aan die lig gekom
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Die gesondheidsorgbedryf is in die visier van misdaadsindikate en onderduimse praktisyns.
Dr. Gregory Pratt, mediese adviseur vir forensiese ondersoeke in die gesondheidsbedryf vir Medscheme, het op die beraad vir gesondheidsorgfinansiers in Kaapstad skokkende voorbeelde genoem van bedrog waarmee hy die afgelope maande te make gehad het.
Mediese bedrog is so algemeen “omdat dit makliker gepleeg kan word as ander finansiële misdade,” sê hy oor die sindikate wat die bedryf teiken.
Voorbeelde van bedrog die afgelope maande:
1. ’n Sielkundige wat in net 102 dae R4,3 miljoen geëis het, het glo 173 pasiënte op een dag gespreek.
2. ’n Dermatoloog het R112 000 vir net 67 minute in die teater geëis.
3. ’n Sindikaat van sielkundiges in KwaZulu-Natal wat in twee jaar R80 miljoen (sien regstelling) geëis het van een mediese fonds. Baie van dié eise was vals of erg oordrewe.
4. ’n Sindikaat van aptekers in Soweto wat in drie jaar meer as R100
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Healtcare Services Delivery need to change in Africa
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Healthcare services delivery in Africa needs to change, but no-one is quite certain how. What is certain is that future trends will be driven by access to big data, to shape new models of care in driving innovative, affordable and accessible services, across this diverse continent.
With 1,2bn people, many enjoying a longer life, and the rise of non-communicable diseases (NCDs) there is a growing recognition of the importance of digital innovation in delivering curative and preventive care.
“The transition to digital healthcare offers opportunities to aggregate patient data from multiple sources – for example, from external healthcare providers and specialists who consult to the patient – to give them a single, accurate patient profile.
“This allows healthcare professionals to quickly connect all the dots in a patient’s care, with a view to focusing on optimum outcomes for the patient.In fact, a study in the Journal of Neurology found that putting a digital
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Genesis wins case on accounting for use of medical savings funds
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On Tuesday, the Constitutional Court ruled that all funds paid by members to their schemes should be considered as assets, regardless of their intended use.
Genesis medical scheme has won its legal battle with the Council of Medical Schemes over how to account for the funds in members’ medical savings accounts (MSAs), a development that has potentially far-reaching implications for both the industry and consumers.
This technical accounting point will make a material difference in the way schemes calculate their solvency ratios that measure gross income against reserves.
Treating MSA balances as assets means schemes’ reported solvency ratios will improve, because funds accumulated in MSAs will now be considered as part of a schemes’ reserves, said Insight Actuaries joint CEO Barry Childs.
This is important because better solvency ratios mean less pressure on schemes to increase premiums.
The judgment overturned a high court ruling that the council has us
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