COIDA Services
Did you know that more than 220 000 employees suffer from Occupational injuries and Diseases each year. Most of these injuries and diseases result in the need for medical treatment, loss of income, permanent disablement, and death. Unfortunately, most people in South Africa are not aware that they are entitled to all these benefits under Compensation for Occupational Injuries and Diseases Act which is Administered by the Compensation Fund. Sena is a specialist in this regard and buying one of our products or services listed below makes you qualify for our assistance should you or any of your family members get involved in a work-related accident or suffer from an Occupational Disease.
Claims Management
- We assist you and your employer to ensure that your claim is reported to the Compensation Fund, RMA or FEM.
- Arranging for Injured employees to receive medical treatment through our 24-Hour emergency line.
- Ensure that injured employees receive appropriate medical treatment at suitable
- Ensuring that all required documents from the employer and Medical Service Providers are completed and submitted in the required
- Ensuring that employees and employers receive their Temporary Total Disablement payments (Income replacement) from the Compensation Fund, RMA or
- Ensuring that employees and employers receive all the benefits to which they are entitled in terms of the COID
- Ensuring that injured employees, or their dependents receive their correct compensation for permanent disablement i.e., Lump Sum or Monthly
- Tracing, completion, and submission of documents for the spouse/s and children, to ensure that they receive the fatal benefits as dictated by
- Ensuring that employees are properly rehabilitated, reskilled and socially integrated following the Occupational Injury or Disease.
Case Management
At Sena financial services we assist with assessing and adjudicating treatment requested for all injuries and diseases in medical facilities which include:
- Liaising with hospital case managers for updates of treatment, procedures and costs, request, MSP medical reports in hospital.
- Monitoring high risk high-cost acute claims, reviewing treatment plans, assessments, and medical reports.
- Adjudicating requests for medical treatment and authorize with communication to funder/claimant and employer.
- MMI (Maximum medical improvement), support to claims staff; facilitating interdisciplinary approaches; arranging for rehabilitation and re-skilling.
- Reviewing and confirm ICD10 codes from medical reports and update.
- Cost management of medical treatment, procedures, internal, external prosthesis and over servicing.
- Cost management of a claim, benchmarking for hospital cases review and update.
- Assist claims with complicated cases for recommendations and PD confirmations.
- Liaise with MSP’s, employers and employees when required.
Interested? Need more information?
Fill in the form below and click submit, and a Sena representative will be in contact with you.