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Fraud

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Reporting Fraud

Find out how to report Fraud

× Healthcare fraud costs the South African healthcare system billions of rands each year. Medical schemes are among the biggest victims. This makes healthcare fraud one of the largest taxpayer rip-offs.
About Fraud
The definition of fraud is the intentional misrepresentation of fact, which causes prejudice or potential prejudice of someone.

This relates to medical scheme fraud in the following way: The deliberate misrepresentation of fact or claim with the intention of letting the medical scheme pay and lose money, or potentially lose money, to the detriment of all medical scheme members.

By this definition it follows that medical aid fraud is a criminal offence in terms of criminal law. The industry is said to be losing 15% of all claims to fraud.