Medical aid society loses $290 000 to worker

Bessie Hambury (53), of Number 71 Windermere Road in Morningside, on Wednesday appeared before Bulawayo provincial magistrate Mrs Learnmore Mapiye facing fraud charges and was remanded on $500 to 20 December when she would be given a trial date.

The court ordered her to surrender her passport and title deeds to Number 71 Windermere Road, Morningside, to the Clerk of the Criminal Court.

She was further ordered to report thrice a week, on Mondays, Wednesdays and Fridays between 6am and 6pm to Bulawayo Central Police Station and should not interfere with State witnesses.

The court heard that Masca employed Hambury as a claims adjudicator responsible for checking incoming claims to ensure that only valid claims are processed and paid by the society.

She also attended to members bringing in claims for processing and assisted in ensuring that proper tariff codes were used in the settling of claims.

It was also her duty to authorise the treatment of members and processing claims where members     would have to pay cash to service providers and made sure that refunds were made correctly and promptly.

The State alleges that she hatched a plan to defraud Masca and allegedly approached individuals on 82 occasions requesting to use their bank accounts on the pretext that she was expecting deposits from various sources.

The State alleges that between 28 September 2009 and 19 September this year and on 82 occasions she created false claims and fed them into the system purporting that the claimants had at some stage undergone varying types of treatment for complicated procedures like brain surgery, hip replacements, knee placements and lung placements.

The State will seek to prove that she defrauded her employer of $228 880,53 and after the amounts had been deposited into the accounts, she would contact the people and ask them to make withdrawals on her behalf.

The alleged offence came to light after some discrepancies were discovered among the claims in that in claims involving complicated procedures, there were no hospital or diagnostic claims associated with them.

It was also discovered that in some of the claims, the service providers, who were said to have performed the procedures, were not even in that discipline.

Investigations were then instituted and in October this year, Hambury allegedly disappeared from work and was only arrested on 3 December.

Mr Malvern Nzombe appeared for the State while Mr Mazhar Petkar, of James, Moyo-Majwabu and Nyoni Legal Practitioners defended Hambury.

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