Doctor in alleged R17m RAF scam

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THE STAR

A KZN doctor is among 579 people who allegedly tried to defraud the Road Accident Fund of over R150m. Photo: Dumisani Dube

Johannesburg - A KwaZulu-Natal doctor facing fraud charges amounting to R17.1 million is among 579 people who allegedly tried to defraud the Road Accident Fund (RAF) of more than R150m.

Dr Fortune Cemane and Faith Rozani - who were arrested in January and face 44 charges of fraud - are some of the people held after an extensive investigation into fraudulent claims.

It is believed that Cemane completed a Statutory Medical Report (SMR), stating that people trying to claim from the RAF were injured as a result of a car accident.

Cemane would allegedly do that even though she had never seen those people.

In some instances, it appeared that she would see patients a year after the accident, then backdate the report as if she had seen them a day after the accident.

Rozani was allegedly the tout that brought the claimants to Cemane. A prison warder was also arrested on charges that he, too, was a tout who convinced people to lodge false claims.

Along with a police reservist, they face 20 charges of fraud totalling R2.2m.

The RAF’s forensic investigation department found that police officers, doctors, lawyers and touts were involved in the scam.

Some RAF employees were also found to have been feeding details of genuine claimants - who had approached the RAF directly - to attorneys, who then later convinced them to become their representatives.

The fund’s chief marketing officer, Nozipho Jafta, said the scam worked in this way: some police officers would sell accident reports of crashes reported at their police stations to touts. They would also commission affidavits for the touts.

The touts would then approach doctors to complete the SMR that forms part of the claims form, stating that the person was involved in a car accident and also listing their injuries.

“The touts then sell the following documents to a law firm: the accident report; the RAF claim form with the completed SMR; the claimant’s affidavit which sets out what transpired; as well as the power of attorney that the tout convinced the claimant to sign for a certain law firm with whom he has an agreement.”

However, the extent of the scam went further than that, said Jafta.

“There are cases where touts convince single mothers to claim they were married to foreign truck drivers who’ve died in vehicle accidents in South Africa.

“The touts supply forged customary marriage certificates and also go so far as to forge proof of salaried employment, resulting in claims that amount to several millions in lieu of future earnings.

“In the last financial year, the RAF paid out R27 396 875 in fraudulent claims.

“However, through the RAF’s effort to smash fraud syndicates, we have managed to save taxpayers over R150m in bogus claims,” Jafta said.

Thinus Grobler, director of the Law Society of the North Provinces, said these cases were very serious and the only next step - if all the facts had been established - was to strike the attorneys off the roll.

Other cases:

* Morokoe Lucky Motloutsi, a former employee of the Road Accident Fund (RAF), was found guilty of corruption in May last year after attempting to defraud the RAF of more than R20 million. He had attempted to reopen files that had already been paid and finalised. Motloutsi then arranged for new payments of about R1 million to be made on each new case.

* In June last year, six Pretoria attorneys and a medical doctor allegedly defrauded the RAF of R6m by submitting 98 claims for an accident which had involved only 30 people. The doctor allegedly provided medical certificates for claimants who he had not physically examined. A tout was also arrested.

* Nalini Atwaru, a Pietermaritzburg lawyer, allegedly defrauded the RAF of about R3.7m by submitting fictitious reports of accidents. She was arrested in February 2012.

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The Star


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