Millions are owed to doctors and other healthcare specialists, with bills stretching to a decade ago in some cases and others forced to retrench staff or downscale their practices as the Road Accident Fund (RAF) dodges payment for services, reports MedicalBrief.
Acccording to witness testimony heard by Parliament’s Standing Committee on Public Accounts last week, millions are still awaiting payment for work done more than a decade ago, said Mariëtte Minnie-Botbijl, owner of a close corporation that helped facilitate payments between the fund and medical experts for several years.
News24 reports that she said the outstanding bill for her clients – industrial psychologists, neurologists, orthopaedic surgeons and occupational therapists – was more than R41m, and that at least 40 of them had downscaled due to non-payment since 2022.
Minnie-Botbijl appeared before the committee as part of its ongoing probe into allegations of fraud, corruption and financial mismanagement at the fund.
“We have tried all avenues from my side. We have tried to engage with RAF branches in different regions; we even tried to write to former Chief Justice Raymond Zondo to say that their medical reports cannot be used in trials with claimants, because they have not been paid. We have gone everywhere and tried everything,” she said.
While some have issued summons, they were equally unsuccessful.
WhatsApp correspondence with other administrators indicated that the total unpaid bills for medical experts were as high as R120m, without interest.
Non-payment of medical experts has been a longstanding issue with the fund, with more than 70 experts writing to Transport Minister Barbara Creecy last year for urgent intervention in their “disastrous situation”, according to Groundup.
In response, the RAF has pushed back against the payments, saying it does not owe experts anything, and that a new issue had been brought up each time there had been a change in leadership with the Department of Transport.
The fund also accused doctors of working with lawyers to launch fraudulent claims against the fund and the Department of Health in the past.
According to Minnie-Botbijl, the RAF had used the services of medical experts as far back as 2007 through its panel of attorneys to assist with assessing road accident victims, writing their medical opinions for claims, and appearing in court as expert witnesses.
The payments for their services were either made through the attorney or directly to the medical expert. Minnie-Botbijl said that the payments to the experts were often short and paid in “dribs and drabs”.
She also said duplicate payments had been issued, and the money had to be refunded to the fund.
According to the law, the RAF is expected to pay experts within 30 days.
The fund appointed a panel of experts in 2015 to assist with victim assessments, with the contract expiring in 2018, but Minnie-Botbijl said the panel – of 82 people – had too few experts to deal with claims and included only two orthopaedic surgeons in Gauteng to service the entire country.
According to her testimony, claimants had to travel hundreds of kilometres for appointments, with the situation quickly becoming chaotic. She said no medical experts had been duly and publicly appointed to the panel since the contract ended in 2018.
“(The) RAF realised that this panel was not working. Appointments were made with non-contracting experts, but the RAF said the bookings needed to be cancelled. Eventually, the RAF issued a directive about the shortage of experts. There was a directive that non-contracted experts needed to agree with tariffs, but eventually, they said they could be used even if they did not agree with the tariff set.”
In an affidavit sent to the committee, Minnie-Botbijl said that 200 medical experts had sent a memorandum to the fund for the non-payment of their services as far back as 2018.
“In November 2018, (the) RAF responded to the memorandum and undertook to deal with unpaid invoices. Nevertheless, the non-payment of my clients’ accounts, and those of other medical experts, persisted.”
Hope for a solution
Minnie-Botbijl said that, over the years, the fund’s leadership, including its former CEO Collins Letsoalo, assured experts they would be paid, with National Treasury approving the outstanding payments and requesting the validating of invoices in 2020.
However, she there was still no concrete plan on how the payments would be made, with experts being forced to turn away accident victims to risk further non-payment by the fund.
The closure of the panel of attorneys in June 2020 had compounded issues for medical experts, with experts who had being paid via attorneys not knowing where their money had gone. The closure of the panel also meant that medical experts had to contact claim handlers directly when dealing with cases of claimants.
“Some of the attorneys were themselves struggling to obtain payment from the RAF and could not pay medical experts. Some of the law firms had closed their doors, leaving clients with no recourse,” Minnie-Botbijl said in the affidavit.
She added that the RAF had also raised the legal defence of prescription not to pay experts in 2021, saying that they had not provided the right documentation with their invoices for the work done years before. The fund had insisted on an authorisation for payments to be made in efforts to “circumvent payment”.
The medical experts had held a meeting with Department of Transport and the chairperson of the new interim board, Kenneth Brown, this year over the non-payment, and, she told EWN, even though they are owed millions, her clients don’t add interest to their bills despite currently waiting between 300 and 400 days to be paid.
Several of her clients have also terminated her services because they can no longer afford to pursue the RAF.
“They love the work, but it is just not sustainable. Too many of them have really lost too much. We cannot continue.”
The inquiry is continuing.
See more from MedicalBrief archives:
More medical experts join battle against RAF CEO over unpaid R150m
RAF revolt: Experts withdraw medico-legal opinions over non-payment
RAF payment problems hit medical experts, endangering practices