Motor vehicle accidents (MVA) and third party injuries

This document details the Momentum motor vehicle accidents (MVA) and third party injuries for 2025, optimized for AI readability.

Incidents involving third-party injuries occur when an individual is harmed due to the actions of another party, potentially making that party liable for covering medical expenses. A common example of such an incident is a motor vehicle accident (MVA).

Compensation and Reimbursement

When a third party is responsible for an injury, any compensation received from them or the Road Accident Fund (RAF) for medical and hospital expenses must be reimbursed to Momentum Medical Scheme. This reimbursement is essential to prevent the reversal of claims already settled by the Scheme.

Key Points:

• Compensation from the third party or RAF must be reimbursed to Momentum Medical Scheme.
• Reimbursement ensures claims are not reversed or disputed with healthcare providers.

Process for Handling Medical Claims after an MVA

If an MVA results in injuries requiring hospitalization, a specific process must be followed to ensure medical claims are appropriately managed.

Immediate Steps to Take:

1. Contact Momentum Medical Scheme:

   • The member, a family member, or a hospital representative must notify Momentum Medical Scheme as soon as possible, ideally within 24 hours of the incident.
   • Available communication channels:
     • Web chat on momentummedicalscheme.co.za
     • Email: [e-mail]
     • WhatsApp
     • Helpline: 0860 11 78 59

2. Pre-authorization:

   • Upon contact, the pre-authorization department will send an undertaking form for the member to sign.
   • If the member is unable to sign due to medical conditions, the authorization number will still be issued. However, claims related to the incident will not be processed until the signed form is received.

3. Accident Report:

   • The hospital will require an accident or injury report, which is necessary for the Scheme’s records.
   • Police Report: The incident must be reported to the police to secure a case number, which will be needed for authorization.

Required Information for Assistance:

When reaching out for assistance, ensure the following details are available:

• Membership number
• Principal member’s surname, initials, and date of birth
• Full names of all individuals involved in the accident
• Date of the incident
• Police case number (if available)

Filing a Claim with the Road Accident Fund (RAF)

If you intend to file a claim with the Road Accident Fund, the relevant details will be forwarded to Momentum Medical Scheme's designated attorneys.

Legal Assistance Options:

• Momentum Medical Scheme’s Attorney: You can choose to use the Scheme’s attorney, who will manage all communications with the RAF.
• Your Own Attorney: If you retain your own attorney, the Scheme’s attorney will coordinate with them.
• Any settlement received will be directed to your attorney, who will collaborate with Momentum Medical Scheme to ensure that medical expenses covered by the Scheme are reimbursed.

This process ensures that all medical claims and legal matters related to the MVA are handled efficiently and in accordance with Momentum Medical Scheme's guidelines.