The Tshiamiso Trust started a process of responding to 12 000 claimants on the outcome of their claims.
This process, which was started in February, addresses a backlog of up to eight months for claims lodged before April 2021.
As the trust matured and continuously improved systems and processes, it can now provide individuals with comprehensive information and reasons on their outcomes, particularly where the claimant was found to be medically ineligible.
In addition, the trust needs to ensure that it verifies all decisions made by the medical certification panel as part of its internal quality assurance process.
Unfortunately, due to high lodgement numbers, the complex processing of claims, as well as the quality and verification checks, the trust experienced delays in informing individuals of the outcome of claims.
“We apologise unreservedly to all claimants for the unusually long wait experienced for notification of the outcome of their claims. We have worked hard to improve our processes and systems so that the trust can give feedback more quickly,” said Daniel Kotton, chief executive officer (CEO) of the Tshiamiso Trust.
“As a result, from November 2021, we have ensured that individuals lodging claims for the first time receive regular updates on the progress of their claims and timeous feedback on the outcome.
“We currently inform 120 to 140 individuals of the results of their claims daily.”
Since it was established, the trust has awarded thousands of compensation payouts.
Out of 153 906 registered claims with the trust, 76 488 lodgements have been made, and 31 564 benefit medical examinations (BMEs) have been conducted. Currently, the trust pays an average of 30 to 40 claims to the value of R3 million per day.
“We understand that the compensation of mineworkers is a sensitive and important issue. Each case is unique; we approach every case with due care and diligence to ensure a fair outcome. As a result of this commitment, the announcement of these ineligible claims was delayed, as many of the claims were reviewed a second time to ensure that the correct outcome had been reached,” said Kotton.
He said it was unfortunate that they could not provide a positive outcome for every claimant, as the trust is mandated to fulfil the requirements set in the trust deed, which details which specific cases are compensatable.
Kotton outlined that the trust was looking at ways to speed up access to the record of services held by the qualifying mines to improve the claims compensation system and fully automate all possible scenarios, improving turnaround times.
Claimants can contact the call centre to find out why their claims were found to be ineligible. Contact the Tshiamiso Trust on:
- 080-100-0240 (South Africa);
- 0027-10-500-6186 (outside South Africa); or
- info@tshiamisotrust.com.
Claimants who are dissatisfied with the outcome of their claim have access to a process through which they can appeal the decision. The appeal can be initiated by contacting the call centre.
