The Special Investigating Unit (SIU) has revealed how dodgy lawyers have brazenly looted state funds with bogus medico-legal claims amounting to billions of rand.
Among the cases uncovered was one in which two different lawyers simultaneously claimed damages for the same case in two different courts, one claiming R7.5m and the other R25m.
In another case, a R70m claim was submitted for a supposed botched circumcision at a hospital in Limpopo. An investigation revealed no such procedure was ever performed, but that the patient had been treated for a serious genital infection and that “the hospital actually saved his life”.
In another instance in the Northern Cape, a lawyer won his client R18.7m but was paying it over at a rate of R6,000 a month. Had this continued, it would have taken more than two centuries for the claimant to receive the full amount.
At a media briefing on Saturday, health minister Aaron Motsoaledi and SIU head Andy Mothibi outlined the “explosion” of medical malpractice litigation against provincial health departments and individual health practitioners.
They said the surge coincided with moves by the Road Accident Fund (RAF) to tighten its systems to prevent the unfounded claims that were draining its coffers. This, Motsoaledi and Mothibi said, appeared to have led to the dodgy lawyers involved switching their focus to the health-care sector.
An investigation into possible fraudulent medico-legal claims was launched in the Eastern Cape following a dramatic surge in malpractice claims in the province between 2010 and 2016 — they rose from 46 to 529 in the Mthatha high court alone.
Motsoaledi said Johannesburg-based Nonxuba Attorneys Inc — which submitted 44 claims totalling R497m against the Eastern Cape department of health in the five years up to 2017 — was now facing criminal charges.
The firm targeted obstetrician/gynaecologists involved in births where babies were born with cerebral palsy — a condition that can be caused by brain damage resulting from lack of oxygen.
The SIU investigation found that lawyers or their agents were conning elderly people who were in charge of caring for their grandchildren as part of their schemes. The lawyers, posing as social workers from the South African Social Services Agency, told their victims they were signing to receive child support grants, when they were in fact signing over their power of attorney. The lawyers then sued in their name.
One attorney was found to have submitted a claim valued at R16m after the death of a child. Yet the lawyer was claiming for future medical care based on private hospital rates and loss of amenities of life
— Aaron Motsoaledi
The SIU found that 15 letters of demand claiming a total of R271.8m were fraudulent — the people on behalf of whom they were written said they had never visited any of the health facilities being litigated against. No records of such patients were found at the health facilities.
Motsoaledi said these 15 cases were among 197 dating from the period 2015 to 2021 that the SIU had identified for scrutiny. In that period 2,500 claims valued at R22.3bn were submitted to the department of health in the Eastern Cape.
“Notably, all of these letters were submitted by a single law firm, but we are unable to mention the name because they have not yet been charged in a court of law,” Motsoaledi said.
“There are 35 additional matters valued at about R600m, currently under investigation, initiated by Nonxuba Attorneys, in which no trusts were registered as per the court orders,” the minister said.
He said there had been collusion involving officials in the office of the state attorney, whereby out-of-court settlements for hefty sums were entered into without the mandate or even the knowledge of the health department.
In some instances in the Free State, nurses stole medical records and handed them over to attorneys, meaning that the court involved would rule in favour of the claimant as there was no longer evidence to dispute the case. Lawyers were also found to have withheld funds intended for claimants.
In KwaZulu-Natal, the SIU had completed probes into 107 matters valued at R2.42bn and found them to be fraudulent.
Of these, also from 2015-2021, “76 relate to instances where the claimants are actually deceased”, the minister said.
“One attorney was found to have submitted a claim valued at R16m after the death of a child. Yet the lawyer was claiming for future medical care based on private hospital rates and loss of amenities of life. This one will be referred for criminal prosecution.”
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