The Motor Vehicle Accident Fund (MVA) paid out N$218 million in medical service provider claims in 2022, a 30% increase compared to 2021, latest data reveals.
According to the Funds Road Crash & Claims report for 2022, September had the highest number of claims amounting to N$36 million, while December had the least claims at N$8 million.
“The number of medical service provider claims increased slightly by 5% between 2019 and 2018, marginally increased by 24% between 2020 and 2019, and increased by 23% during 2022 compared to 2021,” the report said.
This comes as a total of 26 424 Medical Service Provider Claims (MSPC) were filled during the year under review.
Notably, the Fund received 15% and 12% more claims from medical service providers in September and October than in any other month.
At the launch of the report, MVA’s Chief Executive Officer Rosalia Martins-Hausiku shared that over the past 5 years, the Fund has detected 9 suspected fraudulent claims valued at N$3.6 million, and however, actual loss amounts to N $847,406.65.
“Of the 9 cases, 4 have been reported to the Namibian police and the other 5, are now also ready to be reported after preliminary internal investigations. It is important to note that the majority are related to medical treatment of persons who would otherwise not qualify as beneficiaries,” she said.
In terms of recovery, she noted that of the N$3.6 million exposure, through the Fund’s internal fraud detection mechanisms, “the Fund was able to save N$2.7 million that would otherwise be paid if these cases had not been detected.”
As a result, of the actual loss the Fund further recovered N$48,000.
The CEO noted that the claims environment that the Fund operates in deals with monetary pay-outs is always susceptible to fraud.
She said historically, fraudsters were specifically attracted to the cash grants, especially the injury grant as well as payments towards loss of income and loss of support.
“However, due to the Fund’s resolve to treat people in the shortest possible time (which is the golden hour, to save lives), we have seen a surge in medical related fraud due to facts that have been tempered with from the scene of the crash,” she said.
For the last financial year, Injury grants accounted for the majority of benefits filled over the two year period, accounting for 74% of claims in 2022 and 73 in 2021.
“Injury grants are cash payments made to people who have been physically injured as a result of a car crash.”
Funeral Grant accounted for 18% of all benefit claims and loss of support accounted for 4%, closely followed by medical reimbursement and loss of income benefit claims both accounting for 2% respectively.
MVA notes that in 2022 alone, an average of 439 persons were injured in crashes every month with about 60% of people injured and 73% of people killed in road crashes being male.
