Claiming for medical expenses after a road accident
Payment of accident-related medical expenses
If you have been involved in a motor vehicle accident, the Anglo Medical Scheme will pay for your accident-related healthcare expenses in accordance with the Rules of the Scheme and your benefit plan. If you lodge a claim with the Road Accident Fund, you must include your Scheme’s accident-related medical expenses which will be provided to you or your attorney. If the Road Accident Fund consequently pays for medical expenses previously paid by the Scheme, the Scheme must be reimbursed the amounts paid by the Road Accident Fund.
Inform Anglo Medical Scheme about the accident
You need to inform the Scheme about the accident as soon as possible. If you want to use an attorney to assist with your claim against the Road Accident Fund, you may use your own attorney or ask the Call Centre to send you a list of preferred attorneys. The Scheme’s preferred attorneys will assess your accident at no cost to you to determine whether you have a valid claim. If you choose to use your own attorney, please ask your attorney to contact us so we can assist with your accident-related accounts and any fee-related queries they may have.
Additional benefits of claiming from the Road Accident Fund
You may be able to claim from the Road Accident Fund if you or your family member(s) were in an accident as a driver, passenger, cyclist or pedestrian. If your claim against the Road Accident Fund is successful, you may receive a payment that is intended to cover past and future loss of earnings, reimbursement for past and future medical expenses paid by yourself, reimbursement for past and future medical expenses paid by the Scheme (to be refunded to the Scheme), loss of support for your dependants and disability payment for injuries that are classified as ‘serious’ by the Road Accident Fund in terms of the Road Accident Fund Act.
Additional information
If you need any additional information, or if you would like to inform us of a road accident, please send an e-mail to member@angloms.co.za or call us on 0860 222 633.