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Trust clears backlog in responding to claimants

22nd April 2022

     

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From February 2022, the Tshiamiso Trust started a process of responding to 12 000 claimants on the outcome of their claims. This addresses a backlog of up to eight months for claims lodged before April 2021.

Current and former South African gold mining companies Africa Rainbow Minerals, Anglo American South Africa, AngloGold Ashanti, Harmony Gold, Sibanye-Stillwater and Gold Fields are founders of the Trust. The structure was established following a successful class action lawsuit on behalf of former mineworkers and the settlement agreement that was reached on May 3, 2018.

As the Trust has 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.

Additionally, the Trust needs to ensure that it verifies all decisions made by the Medical Certification Panel as part of the Trust’s internal quality assurance process. Unfortunately, owing to high lodgement numbers, the complex processing of claims, and the quality and verification checks, the Trust experienced delays in informing individuals of the outcome of their 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,” Tshiamiso Trust CEO Daniel Kotton said in the March press release.

“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 daily of the results of their claims.”

Since it was established, the Trust has awarded thousands of compensation pay-outs. Out of 153 906 registered claims with the Trust, 76 488 lodgements have been made, and 31 564 Benefit Medical Examinations have been conducted. Currently, the Trust pays an average of 30 to 40 claims to the value of R3-million a 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,” explained Kotton.

“It’s unfortunate that we cannot 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 compensable.”

Kotton outlined that the Trust is 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.

He added that claimants can call its call centre to find out why their claims were found to be ineligible. The Tshiamiso Trust can be contacted on 0801 000240 for South Africa, 00 27 10500 6186 outside South Africa, or email info@tshiamisotrust.com.

Any claimants who are dissatisfied with the outcome of their claim have access to an appeal process. Dissatisfied claimants can initiate the appeal process by calling the call centre.

The Trust has an eight-step claims process. Claimants are required to meet specific criteria to be eligible to lodge a claim. The Trust Deed outlines the requirements that govern the work of the Trust. Once a claim is registered, a claimant must provide their valid South African identity document or South African Development Community (SADC) passport, their Industry Card or similar documentation, service records from the mines they worked at and any available medical records.

The Trust’s team assesses these submissions to determine whether a claimant can proceed to medical examinations for a diagnosis.

Claimants can be found ineligible at three points in the process. They may be found ineligible at the lodgement stage: this means that the claimant may not have done risk work; they did not work during the period covered by the Trust, which is March 12, 1965, to December 10, 2019; or they did not work at one of the six qualifying mining companies or at the 82 qualifying mines.

Claimants can also be found ineligible at the medical certification stage. This means that the claimant is not medically eligible because they do not have a compensable disease, namely silicosis or work-related tuberculosis, or that the individual does not have permanent lung damage resulting from a qualifying disease.

Finally, a claimant can be found to be ineligible at the trust certification stage for reasons such as insufficient cumulative risk work or not working at a qualifying mine for the required period.

Edited by Nadine James
Features Deputy Editor

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