Mother Jailed For R400k Medical Aid Fraud Following Daughter’s Death Under Fake Identity

The Bloemfontein Magistrate’s Court convicted and sentenced a mother 48-year-old for defrauding the Government Employees Medical Scheme (GEMS) of more than R400,000.

Mamello Kate Khabo was found guilty of medical aid fraud after admitting her sick daughter to a private hospital using the medical aid details of her other child, who was a legitimate beneficiary of GEMS. The sick child was later transferred to another hospital, where she sadly passed away.

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Fraudulent Medical Claims Uncovered

Free State spokesperson for the Directorate for Priority Crime Investigation, commonly known as the Hawks, Lieutenant Colonel Zweli Mohobeleli, stated that Khabo admitted her daughter to Busamed private hospital in Bloemfontein in August 2022. When the child’s condition worsened, she was moved to MediClinic, where she later died.

“When it was time to register her daughter’s death and obtain a certificate, she had no choice but to confess that she had used her surviving daughter’s medical aid details to admit the deceased child,” Mohobeleli explained.

Hawks detectives gathered enough evidence to obtain a warrant for Khabo’s arrest, leading to her detention on November 12 last year.

Court Sentences Khabo

The Bloemfontein Magistrate’s Court sentenced Khabo to four years in prison, wholly suspended for five years, on condition that she does not commit a similar offence during this period.

Similar Cases of Medical Aid Fraud

Medical aid fraud continues to be a serious issue in South Africa. In a separate case last year, the Hawks arrested a Limpopo-based psychologist, Penelope Homu, for fraudulently claiming funds from the Platinum Health Medical Scheme (PHMS). Homu submitted claims for healthcare services that were never rendered, defrauding the scheme of R747,000.

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Homu pleaded guilty and received a sentence of a R120,000 fine or five years in prison. She was also declared unfit to own a firearm. Investigations revealed that she had submitted multiple fraudulent claims under different beneficiaries and referring practices, leading to her prosecution.

Authorities continue to crack down on medical aid fraud, urging healthcare professionals and beneficiaries to ensure compliance with legal and ethical standards.

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