Pretoria - The Compensation Fund will soon review its functional model to establish the most effective way of rendering its pensions fund, medical aid and insurance functions.
Acting Commissioner Vuyo Mafata said the intensive exercise is expected to be concluded by early 2017.
He said the outcome of the assessment exercise would give a proper gauge on the efficacy of the business and enable the organisation to efficiently deploy its resources.
“The key purpose of the assessment is to ascertain the core business of the fund. The terms of reference of the exercise are being finalised,” Mafata said.
The Compensation Fund manages the Compensation for Occupational Injuries and Diseases Act (Coida) Act which provides for compensation for disablement caused by occupational injuries or diseases sustained or contracted by employees in the course of their employment, or for death resulting from such injuries or diseases and to provide for matters connected therewith.
Challenges
Mafata said issues of concern on the financial side relate to matters raised by the office of the Auditor General that have resulted in negative audit outcomes over the years.
He said the fund was working at full steam to deal with these financial and performance information matters raised by the Auditor General.
The fund was also addressing the issue of lack of capacity in its financial management division.
While the process of addressing the service delivery bottlenecks is underway, he said: “We are mindful also that we have an organisation to run, that we do not shy away from our obligation as an organisation to pay claims and invoices on time”.
The target is to pay clients within 30 days, and the matter is receiving urgent attention at high level.
Umehluko System
“We have introduced Umehluko to deal with efficiency issues. We are close to 100% electronic-based claims platform. Although we are still getting reports sent manually.
“Indeed, there are also teething problems with Umehluko. However, we are dealing with those issues. One of the benefits of Umehluko is that efficiency is improved and the issue of fraud is being eliminated,” Mafata said.
The Umehluko System, is an integrated claims management system that is internet based. The systems allows for clients – employers and medical practitioners - to submit electronically their medical invoices, reduction in the submission of paper forms and medical invoices, saves costs and time and leads to improved turnaround time for claims processing.
Mafata said going forward the four strategic pillars of focus will be on financial management challenges, service delivery challenges - paying claims on time, administrative challenges - to address operational efficiencies and human resources - to deal with capacity and skills shortage. – SAnews.gov.za
