Illustrative Image: Money | Broken glass. (Images: Istock) | Medical equipment. (Image: Magnific) | (By Daniella Lee Ming Yesca) 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.
Payment and procurement problems
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 nationally, including just two orthopaedic surgeons. Because the panel could not meet demand, RAF attorneys were allowed to use non-panel experts, subject to tariff guidelines.
Interim directive
When the 2015 panel expired in 2018, the RAF did not immediately put a new formal panel in place. Instead, it issued an interim directive allowing attorneys to appoint experts with RAF approval. The RAF later issued a Request for Information in July 2018, but the report notes that a Request for Information is not a tender and should not be used to award contracts.
Minnie’s evidence was that no formal tender followed until 2021, leaving a gap of about three-and-a-half years. Former RAF procurement manager John Modise told the committee that the RAF treated the Request for Information process as part of procurement and that the National Treasury had supported a portal-based expression of interest process.
The committee was not satisfied. It found poor planning, procurement irregularities and weak internal controls in the appointment of experts. It also raised concern over service level agreements that were, according to evidence, riddled with errors, including wrong tariff references, blank sections, outdated dates and references to officials or structures that were no longer in place.
The money trail was worse.
By November 2018, more than 200 experts had formally complained to the RAF about unpaid invoices and unclear payment processes. The situation deteriorated after the RAF abruptly terminated its panel of attorneys in June 2020.
No proper system
Experts who had completed work through RAF attorneys were left uncertain about where to send reports, how to invoice and how to access the case information needed to finalise their assessments. A March 2020 directive instructed experts to send reports directly to the RAF, but evidence before the committee suggested there was no proper system to support this.
Minnie testified that experts often had to track down claims handlers themselves. In some cases, patients arrived for assessments without the required vendor rotation system number, forcing experts to turn them away because there was no assurance they would be paid.
The report records that the RAF acknowledged debts owed to experts in meetings during 2020 and promised to consult the National Treasury, clear backlogs and roll out an integrated claims management system. But payment failures persisted.
The RAF later asked experts to resubmit invoices and supporting documents. Minnie said this happened repeatedly, with no reliable system to manage the process. At one point, invoices were allegedly lying “strewn on office floors”.
In July 2021, the RAF raised prescription as a defence, arguing that some invoices older than three years were no longer payable. The committee found this stance disingenuous where experts could show they had submitted invoices but the RAF had failed to process them properly.
The committee also heard evidence of wider distress among experts, including one submission involving the estate of a late orthopaedic surgeon allegedly owed more than R14.5-million.
Members of Parliament did not hide their frustration.
ActionSA MP Alan Beesley described the RAF as a “wrecking ball” and asked whether the committee had any estimate of the total outstanding claims, suggesting the figure could run into billions. He also called for greater transparency so claimants could see which claims had been paid and which remained outstanding.
ANC MP Gijimani Skosana said the RAF appeared to have been run “like a spaza shop”, with poor reconciliation and weak accountability. He said victims, experts and legal practitioners had all been prejudiced by the dysfunction.
Prolonged non-payment
ANC MP Helen Neale-May said it was shocking that medico-legal experts remained unpaid for work already performed, while the RAF continued to rely on their reports in litigation. She said the prolonged non-payment had hurt livelihoods and threatened professional practices.
Committee chairperson Songezo Zibi added two anecdotes. In one, a Gauteng Division of the High Court judge in Pretoria reportedly urged MPs to attend RAF court proceedings to see how claims were being handled, warning that the RAF was often poorly represented and expert evidence went unchallenged. In another, a young medico-legal practitioner told Zibi that RAF work had nearly forced him to close his practice because of payment delays and lost files.
The committee found that the RAF had failed to pay valid invoices within the 30-day period required by the Public Finance Management Act and Treasury regulations. It also found that poor communication between the RAF, attorneys, claimants and experts created room for double payments, payment confusion and possible misappropriation by some attorneys.
The report warns that where expert reports were prepared but not used because the RAF failed to defend matters properly, the spending may amount to fruitless and wasteful expenditure.
At the heart of the mess is a fund meant to compensate road accident victims. Instead, the committee heard, its broken systems had left claimants waiting, experts unpaid and public money exposed to waste.
As Zibi observed, these are not merely historical problems. They are still happening. DM