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MVA investigates 59 fraud cases

Fri, 15 April 2016 16:40
by Rodney Pienaar
News Flash

The Motor Vehicle Accident Fund investigated 59 cases of fraudulent claims in last five years where individuals try to claim for accident related injuries that are either none existent or unauthenticated.
The Fund also forked out N$191.3 million for medical bills, to cater for accident related injuries and funeral claims.
MVA Chief Corporate Affairs’ Kapena Tjombonde, fraudulent claims are indicative of the high risks the Fund is exposed to.
“The MVA Fund provides assistance and benefits to all people injured and the dependents of those killed in motor vehicle crashes regardless of who caused the crash, subject to some limitations and exclusions. The payments are done in accordance with administrative law principles. Based on the MVA Fund’s financial records an amount of N$ 191.3 million has been paid out to claimants for the injury and funeral grants, and medial benefit for the period 2014/2015 Financial Year”, Tjombonde told The Villager.
In 2013/ 2014 financial year MVA has paid out claims amounting to N$ 28.3 million for injury grant, N$ 4.6 Million for funeral grant and medical benefit N$ 118.0 million and in 2014/2015 financial year Namibians claimed N$ 34.6 million for injury grant, N$ 34.6 million for funeral grant and N$ 118.0 million for medical benefit.
According to MVA fund, injury grant is determine by the number of people injured and the severity of the injuries, funeral grant is determine by the number of people who passed away as a result of road crash and medical benefit is the largest expense for the fund. It involves the cost from evacuate the injured from the accident scene to hospital, the cost within the hospital including x-rays, theater cost more. Rehabilitation after discharged from hospital and home modification. An amount of N$1.5 million is set aside per person for this benefit.
‘’ The MVA fund like any other business faces the risk of fraud. It is however important to point out that we have internal fraud control capacity in place to minimize the exposure. During the period 2014/2015 there were suspected fraudulent cases recorded. These case or matters were referred to the relevant authorities for further investigations and possible prosecution’’, Tjombonde said.
The reported cases include, suspected injury grant, injuries sustained not consistent with medical evidence or claimants temper or forge the medical reports. Suspected loss of support fraud, illegitimate dependents are presented as legal dependents to the deceased by forging birth registration documents. Collusion, claimants who are drivers during the time of crash and in accordance with the fund act on exclusion, limitations would receive limited benefits misrepresented facts about the cause of accident with the intention to defraud the MVA fund so as to gain full benefits from the fund. Medical practitioners colluding with the claimant, medical report reflecting injuries which were in actual fact not sustained or are magnified.