Cimas in bid to curb fraud

Cimas in bid to curb fraud
Published: 10 July 2014
Cimas Medical Aid Society is currently sending out every week about 9 000 new colour coded membership cards with photographs that are designed to reduce the number of fraudulent claims.

The society estimates that about 30 percent of the claims it receives are fraudulent, with many of them being claims from non-members posing as members by using a friend's or relative's Cimas membership card.

The new card carries the member's photograph, making it more difficult for non members to fraudulently make use of the card.

Cimas has received photographs for inclusion on the new cards from about 90 000 of its 206 000 members. Many other members have visited Cimas offices to have their photographs taken.

Those who have their photographs taken at a Cimas office are able to have their new card processed and issued to them while they wait.

The new card is colour coded according to the package the member is on, with a greyish light blue colour for the basic package, orange for the primary package, green for the general package, blue for the private hospital package and gold for medexec.

The old membership cards expire at the end of this month. From the beginning of next month, service providers will only accept the new card.

Cimas has urged those who have not yet sent in their photograph or been issued with the new card at an instant membership card facility to go to their nearest Cimas office to have their photograph taken and be issued with a new membership card.

Instant membership cards with the member's photo printed on it can be obtained at the Cimas head office and Mount Pleasant office in Harare and at Cimas offices in Bulawayo, Mutare and Gweru.

Cimas group chief executive officer Mac Chaora told members at the society's annual general meeting in May that as much as a third of the claims received by Cimas were suspect, with some members allowing non-members to use their membership card to make claims from Cimas.

Speaking at the Cimas Golf Tournament prize-giving last Saturday, Cimas chairman Mordecai Mahlangu also raised the issue of some members "being liberal with their card".

He said that while they might feel this was an act of generosity on their part, it undermined the ability of the society to enhance benefits and maintain membership subscriptions at an affordable level.

Mr Mahlangu also mentioned the society's concern over the recently gazetted increased doctors' tariffs, which he pointed out came at a time when most other prices were going down.

"We at Cimas recognise that, if we allow any of our costs to go up, our contributions will have to go up," he said, adding that many members and member firms were already finding it difficult to pay existing subscriptions.

Appealing today to members who have not yet either been issued with a new membership card or sent a photograph of themselves to Cimas to go to one of Cimas's offices to obtain the new card, Mr Chaora pointed out that the old Cimas card would not be accepted after the end of this month.

 "The old Cimas card will no longer be accepted after 31 July so we encourage all those who have not yet obtained the new card or sent us their photo to take advantage of the instant membership card facility at all our offices  to ensure they have a new card before then," the Cimas group chief executive said.

"The decision to issue a new type of membership card with the member's photograph on it was necessitated by the amount of abuse there has been of the services we provide, largely through members allowing non-members to use their medical aid card to pay for medical services.

 "We believe the new card with the member's photo on it will make it more difficult for non members to make use of the card.

"Unfortunately some of our members don't seem to realise that the society is their society. Its resources are limited. If non-members, who are not paying anything to Cimas, make use of the services for which members are paying, that leaves less for the members themselves.

"Inevitably, if this trend continues, members will have to pay more. However, it clearly would not be fair for members to have to pay more to subsidise fraudulent claims from non members.

"While we continue to appeal to our members, therefore, to see the logic of this and to refrain from allowing non-members to use their membership cards, we have at the same time decided to make it more difficult for membership cards to be used by non-members by including the member's photograph on the membership card," he said. 
- Byo24News
Tags: Cimas, Fraud,


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