Third party injuries are incidents where a third party was responsible for the injury and therefore may be liable for medical expenses, such as a motor vehicle accident. Any amount recovered from a third party or from the Road Accident Fund for hospital and medical expenses must be refunded to Momentum Medical Scheme, if these expenses were paid on your behalf by the Scheme.
Please remember to report the accident or incident to the police and obtain a case number.
If the motor vehicle accident or incident has resulted in injuries which require hospital admission, follow the below process:
- Contact us via the web chat facility on momentummedicalscheme.co.za, email us at [email protected] send us a WhatsApp message or call us on 0860 11 78 59 to obtain an authorisation within 24 hours of the event. Information needed when contacting us:
- your membership number;
- the principal member’s surname, initials and first name;
- the full name(s) of the person(s) involved in the accident;
- the date of the accident or incident; and
- the case number for the police report, if available.
- In the case of a motor vehicle accident, you will be asked to sign an undertaking whether or not you will be claiming from the Road Accident Fund. The signed undertaking is required to finalise the processing of your claim.
- If you acknowledge that you will be claiming from the Road Accident Fund, details of this are sent to our appointed Road Accident Fund attorney.
- If you have your own attorney, then Momentum Medical Scheme’s attorney would liaise with your appointed attorney. If you need an attorney, you can use Momentum Medical Scheme’s attorney.
- Your attorney will liaise with the Road Accident Fund and settlement will be made to your attorney, who will in turn liaise with us to pay the refund of any medical expenses that the Scheme covered.
This process applies to claims for yourself and any of your dependants who are registered on your membership.