Road Accident Fund's medical experts launch campaign to recoup millions owed to them

The medical experts once employed by the Road Accident Fund (RAF) to guard against false claims and ensure fair treatment of valid claims, and who are owed millions by the same fund, have opted for a new course of action to retrieve what is legally owed to them. 

According to Mariette Minnie, the accounting representative for a number of the experts, after “exhausting all reasonable means”, they are now launching a media campaign to retrieve more than R63-million. Another grouping of experts, not represented by Minnie but supporting the campaign, say it is owed R100-million.

This week, the experts wrote to Deputy Chief Justice Raymond Zondo as part of their campaign, as per example below, seeking his intervention in the debacle. 

“Dear Honourable Deputy Chief Justice Raymond Zondo,

I am a qualified clinical and neuropsychologist and over the last few years I have provided expert medico legal services to the Road Accident Fund through its (former) panel of attorneys. My services included consultations and assessment of claimants’ injuries, preparation of expert witness reports, attending expert witness meetings and preparing joint minutes of expert meetings and presenting expert evidence in court.”

That describes the function of a typical medico-legal expert involved in assessing the patient in a third-party road accident claim. Minnie says working with the RAF has become unsustainable for herself and the clients she represents, describing it as a legal minefield under RAF CEO Collins Letsoalo. The letter continues:

“The RAF has recently informed all medical experts who rendered these services to them, that we were not authorised to perform such medico-legal services and that we will not be paid for them… feels like blatant theft to me… At no point, when we undertook to perform these assessments… were we informed or did we understand that we did not have the authorisation to provide such work.”

The result is that the experts have withdrawn their expert evidence, meaning that whatever cases are still to be heard in court – and the RAF has large, Covid-hangover backlogs – will have to be postponed. This forces the RAF to obtain new evidence, which means hiring new experts, which in itself raises the question: Where will they find experts if they do not intend paying them? 

How dare you

Less than two hours after the above letter was published, Letsoalo penned a response to the financial manager of one of the medical experts who had written to Zondo. 

“This is clearly a concerted effort to try and distort facts and bombard the judiciary with unnecessary emails and not state facts that you are well aware of and choose to ignore.

“I also take strong exception to you involving the judiciary on matters of dispute in this unethical manner…

“We will be responding to these attacks and will clarify this matter but I think this missive of your needs [sic] to be responded to directly but I won’t burden the judiciary with this… Kindly be informed that this conduct of your is unethical and potentially unlawful.”

Business Maverick has a copy of the letter penned to Zondo, as well as the response from Letsoalo.

This senior financial manager, who wishes to remain anonymous, claims experience of healthcare and medico-legal matters in more than 70 countries, saying that this almost immediate response to the experts’ “Zondo letter” suggests that the RAF CEO seems to be “unwilling to listen”.

“He’s found a loophole that makes him think he doesn’t have to pay the experts, and he won’t hear otherwise. I pointed out the errors, and he responded with a threat of legal action.” 

The issues described above have come to define Minnie’s career in recent years. While she admits her job was created by nothing other than the sheer inefficiencies of the RAF, it has led to an activist-type role, culminating in her facilitation role in the experts’ media campaign.

Minnie squares up

“The RAF has simply been reneging on its legal requirements to pay professionals for services rendered,” says the Heidelberg, Gauteng accounts administrator. Those services, stretching back to 2015, are as varied as the motor vehicle accidents that caused them, ranging from psychologists, occupational therapists and surgeons to everything in between. 

Dr Percy Miller, an experienced neurosurgeon interviewed by Daily Maverick almost a year ago in “The hazard lights are flashing for the Road Accident Fund”, is fully behind the campaign, as he says he is still battling to get money owed to him by the RAF for work done on previous contracts. 

Lies, damned lies and million-rand mistakes

Minnie says experts like Miller are in the “ludicrous” position of being asked to prove that they were requested to perform the work they did. Although in Miller’s case, he says he was approached by the RAF to do work for the fund. 

“Ignatius Briel and Mollica Maharaj [from the RAF] came to my office,” says Miller. “They said they had a lot of work, and asked if I could help them. I said yes, and was confirmed on a list of experts.” Miller is not the only one; the sheer number of medical colleagues affected by the RAF’s seeming duplicity, many with similar tales, have resulted in this campaign, and the experts withdrawing their evidence.

Psychologist Dr Senathi Fisha operates what some refer to as a “one-stop shop” in Pretoria, offering the services of a range of medical specialists to the RAF. She says she too was appointed by the RAF directly, and that she is owed at least R5-million in her personal capacity. “SARS is now threatening to take my house to recoup monies owed, it’s wrong,” says Fisha. 

Miller describes it as “criminal behaviour”, referring to Letsoalo as “a bare-faced liar, and you can quote me”.

Woodmead psychologist Dr Puseletso Dlukulu, who has been doing work for the fund since 2010, says it does not pay invoices. Dlukulu, while detailing the intricacies of the work produced for the RAF, sounds exasperated at the other end of the phone line.  

“You try to be nice, to understand. The left hand [at the RAF] doesn’t know what the right is doing. Despite having a contract with the RAF, they pay our money to the former panel of attorneys. Sometimes they pay the wrong people.”

Further highlighting the meltdown in what she calls the basic working of the RAF, a Centurion psychologist says she too has been wrongfully paid, and that Minnie is championing her efforts to retrieve substantial amounts. 

“She [Minnnie] knows the workings of the fund better than anyone, including those who work there. For instance, over the past 15 years that she has handled my accounts, she has always had to point out [to them] the RAF’s [multiple] double payments to me. They themselves never pick up on this.” 

The RAF: A land of smoke and mirrors

Minnie says the RAF will, by its (in)actions, go to any length to obstruct and dodge its obligations. She says the RAF is now claiming that the contracts according to which the medical experts produced work for the organisation, are between the attorneys and medical experts – however, these attorneys are the very same panel of attorneys who had their contracts summarily ended by Letsoalo in 2020. 

This means that experts are expected to find attorneys no longer in practice and ask them to provide proof that they instructed these same experts with files and documents that they (panel of attorneys) were instructed to return to the RAF after their dismissal. “It’s insane.” 

The insanity continues, says Minnie, with the RAF staff she deals with “clearly not understanding the importance of attention to detail when communicating with professionals”, especially around legal documents. On 10 February, Minnie wrote to the RAF to inform it of serious inaccuracies on its letterheads: 

“Kindly be advised that your attached letterhead for remittances still states Dr Eugene Watson as your CEO as well as previous board members from about 5 years ago.”

Yet, “Letsoalo keeps saying people like myself are benefiting from the RAF’s inefficiencies, and that he’s ‘fixed’ the organisation, as he said on eNCA recently. He loves appearing on TV,” says Minnie, “where he pronounces on his wonderful changes at the RAF. But where are they?

https://www.youtube.com/watch?v=3ISN-DEOiYM

 

Monty Python takes a desk at the RAF

Certainly the lack of change and attention to detail was all too evident in the debacle surrounding the fund’s bungled 2021 December tender document process to appoint candidates to the next expert panel.  

The bungling at the RAF reached alarming proportions between 15 December 2021 and 10 February 2022. It published three different service level agreement (SLA) versions in the latest tender for a new panel of medical experts, in response to Minnie pointing out material errors in the first two.

One of the errors shown to Daily Maverick was that the SLA was dated 2018, another was that all the RAF contact staff mentioned had left RAF employment more than two years ago. In the third version of the SLA published, the RAF states that the experts have already been awarded the contract based on a “request for information procurement process”. 

“But ‘the process’ hasn’t even happened,” says Minnie, who adds that despite asking numerous times for the documents supporting the process, she has received no response. 

“The very first paragraph of the SLA states that the contract was awarded in terms of the fund’s request for information process of procurement with number RAF2021/00018, when the only time this process was ever followed was in 2018 under reference number 2018/00034. I am no attorney but it seems this contract’s very first paragraph starts with a lie.”

The table below is one of a number produced by Minnie, detailing, among others things, incorrect and wrongful payments and how long experts have been waiting for payment for services rendered. She says she submitted them to the relevant staff at the RAF, asking why, among other salient questions, there was no correction of experts’ accounts being paid to “wrong attorneys”.



 “These are just a fraction of the examples I have found”, says Minnie, “from what I have access to. How many more wrong payments have been made?” 

The RAF’s William Maphutha responded to questions put by Daily Maverick to Letsoalo about the above duplicate payments highlighted by Minnie. “We can confirm that there was not duplicate payment to the Expert. However, there is a delay in the implementation part where the Attorney on file would have changed [sic]... we can also confirm that there no misappropriation of RAF Funds.”

Minnie says she tried to engage Letsoalo in October 2021 with queries about the clean audit the RAF received in 2020, in light of the fact that she was having to point out these double and incorrect payments the RAF was making. She says his answer was telling: “I simply owe you no explanation.”

The CEO, in further response to Daily Maverick, refers to “historical issues” that have plagued the RAF. “It is for this reason that the RAF has embarked on a Claims Transformation journey that will address People and System issues. The 1st being a Structural review, and the latter being the introduction of the Integrated Claims Management System.”

Heading for the iceberg on a slippery road?

Transport Minister Fikile Mbalula was evidently confident in his choice when making Letsoalo’s appointment permanent in 2020, saying the former Passenger Rail Agency of South Africa COO would assist in placing the RAF on a stable footing. “Mr Letsoalo joins the RAF at a time when it is facing daunting challenges, and requires a steady hand to guide it through the change into the Road Accident Benefit Scheme.” 

Minnie says this “steady hand” has, in contrast, set about rocking the boat that serves as a life raft for innocent road accident victims, doing away with the services of attorneys experienced in defending against sometimes fraudulent or exorbitant plaintiff claims, not paying experts and not understanding his own organisation. 

“Letsoalo seems confused. He confuses experts with ‘treating’ doctors,” she says, referring to a claim he made a year ago: “I am taking away overpayments; the RAF was being charged five times by medical experts what medical aids were being paid.” Medical aids have nothing to do with medico-legal cases.

“From this wording it is so clear that he doesn’t understand the difference between the services provided by his ‘experts’ and the ‘doctors’ treating the claimants.”

Minnie likens the debacle to the restaurant manager who bears responsibility for the under- or non-performance of the establishment’s waitrons. “So too should the RAF CEO be responsible for the absurd inefficiencies reigning at the RAF.”

Nevertheless, when Letsoalo and Mbalula appeared on national TV on Friday, 4 March, they spoke of confidence and success with the RAF’s apparent “new model”. 

Confusion and the way forward

“If they stop making double and incorrect payments alone,” says Minnie, “they [the RAF] will save millions.” 

Letsoalo has previously told Daily Maverick that he was rooting out the “bad apples” at the fund. Minnie will be hoping that both the experts’ media campaign and the investigation into the RAF recently started by the Special Investigations Unit – at President Ramaphosa’s request – will go some way towards assisting in that regard, clearing up the mess she has exposed at the RAF in the process. BM