Compensation fund appeals to employers to provide accurate information for claims to be settled quickly
The Compensation Fund (CF) has appealed to employers to provide as much information as possible to enable it to process claims that have been lodged as a result of disease contracted at work during the COVID-19 period as efficiently and effectively as possible.
“We have been receiving some claims that have incomplete documents as prescribed by the Directive, thus causing delays in adjudicating. Some of the information that is often missing in the claim documents are laboratory results, exposure questionnaires or no first medical report and some critical fields in the claim forms left blank," says the CF Commissioner Vuyo Mafata.
The appeal comes as a total of 8968 claims have been lodged with the Fund. Of that number, 5895 claims have been submitted directly to the Compensation Fund and a further 2813 to Rand Mutual while Federated Employees have received 261 claims.
In respect of the claims that have been paid out, an amount of R5 947 746.03 has since been disbursed towards benefits. The distribution of payments is as follows;
- R 1 037 847.23 paid for temporary total disablement and this constitutes just above 17% of the total amount paid.
- R 51 477.53 paid towards permanent disability lump sum and this constitutes 1% of the total amount paid.
- R 1 582 312.15 paid out in medical aid costs and constitutes above 27% of the total.
- R 18 251.00 paid out in funeral costs and constitutes below 1% of the total amount.
- R3 257 858.12 paid out in dependents benefits costs and constitutes above 55% of the total amount paid.
From the total 8 968 claims received, 59% (5 308) were received from Females and 41% (3 660) from Males. The following is the gender distribution;
Females account for 78% (4 577) while males account for 22% (1 318) of the total 5 895 claims received by the Compensation Fund. The distribution is reversed in relation to the 2 812 claims received by Rand Mutual whereby females account for 24% (686) while males account to 76% (2 126) and the 261 claims received by Federated Employers whereby females account to 17% (45) while males account to 83% (216).
From the total 8 968 claims received, 24% (2 135) were found to be invalid while 76% (6 833) met the validation criteria. The invalidated 2 135 claims were rejected.
Of the total validated 6 833 claims, 74% (5 029) were adjudicated while 26% (1 804) are still to be adjudicated and 69% (3 466) of those had liability accepted while 31% (1 563) had liability repudiated.
The following is the distribution per organisation;
- Of the total 5 895 claims received by the Compensation Fund (no invalidity reported), 81% (4 231) were adjudicated and 19% (1 598) still to be adjudicated. Of the 4 297 claims, liability was accepted for 77% (3 305) and liability repudiated for 23% (992).
- Of the total 2 812 claims received by Rand Mutual, only 24% (677) were found to be valid while 76% (2 135) were deemed invalid and rejected. Of the 677 valid claims, 75% (508) were adjudicated and 25% (169) still to be adjudicated. Liability was accepted for 10% (49) and liability repudiated for 90% (459).
- Of the total 261 claims received by Federated Employers (no invalidity reported), 86% (224) were adjudicated and 14% (37) still to be adjudicated. Liability was accepted for 50% (112) and liability repudiated for 50% (112).
Of the 5895 claims received by the CF, 2897 come from the Western Cape followed by Eastern Cape with 1139, Gauteng with 1052, KwaZulu-Natal with 648, Mpumalanga 110, Northern Cape with 35, North West 29 and Limpopo 3. No cases were reported in the Free State.
Of the 2812 claims received by Rand Mutual, Gauteng has received 2227 claims, 163 in the Eastern Cape, 149 in KZN, 74 in the WC, 56 in the Free State, 35 in NW, 20 in Limpopo and 77 are unallocated.
Federated employers who represent workers mostly in the construction sector has received a total of 219 claims – mostly from Gauteng (151), Western Cape (32), KZN (24), Northern Cape (11), North West (1), Free State (6) and (3) in Mpumalanga.
As the CF Commissioner Mafata has pointed out, the Fund has put systems and measures in place to ensure that all claims are attended to efficiently and effectively.
Media enquiries:
Hlonitshwa Mpaka: CF Director: Communication & Marketing
072 670 5464 Or
Musa Zondi:
Acting Departmental Spokesperson
067 426 4190
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