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Pharmacist sentenced to 10 years for medical aid fraud

Malamulele pharmacy director sentenced to 10 years or a R500 000 fine for defrauding Gems through false claims using members' details without consent.

LIMPOPO – A 41-year-old pharmacist, Tinyiko Gift Mongolele, from Malamulele, has been sentenced to 10 years’ imprisonment or a fine of R500 000 after being convicted on 18 counts of fraud by the Giyani Specialised Commercial Crime Court on Tuesday.

Mongolele, the director of a pharmacy in Malamulele, was arrested following an intensive investigation into fraudulent medical aid claims made between January and September 2018. The fraudulent medical aid claims resulted in the Government Employees’ Medical Scheme (Gems) losing R91 873.07 over a period of nine months.

The fraud was uncovered after Gems detected suspicious claims submitted on behalf of some of its members. The matter was reported to the police, and a fraud case was opened and assigned to Warrant Officer Choene Manaka of the provincial commercial crime unit for further investigation.

Evidence presented in court revealed that Mongolele approached Gems members and requested their medical aid information, offering them cash-back incentives or shoes in return. He then used the information to submit false claims without their knowledge.

He also used the details of two medical doctors without their consent to submit claims for medication that required prescriptions. In some cases, members had never consulted the doctors in question and were unaware that claims had been made in their names.

Following a lengthy investigation that spanned seven years, Mongolele was arrested on May 12 last year. He appeared in the Malamulele Magistrate’s Court on the same day and was granted bail of R5 000.

On Tuesday, February 17, he was found guilty on all 18 counts of fraud by the Giyani Specialised Commercial Crime Court.

During sentencing proceedings, senior state advocate Martin Molokwane argued that the offences were serious, involved a high level of dishonesty, and warranted a severe penalty.

Molokwane submitted that a direct prison sentence of 10 years was appropriate and further argued that, should the court consider a fine, it should be no less than R1 million. The court ultimately sentenced Mongolele to 10 years’ imprisonment, with the option of paying a fine of R500 000.

The director of public prosecutions in Limpopo, Adv Ivy Thenga, welcomed the sentence, stating that the public rightly expects decisive and swift action against fraud and corruption to restore trust in law enforcement.

She emphasised that the continued commitment to the rule of law and accountability is essential in strengthening South Africa’s constitutional democracy, and commended Molokwane and all stakeholders involved in securing the conviction.

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Tanaiya Lees

Tanaiya Lees is the Digital Coordinator for the Polokwane Review-Observer and the Letaba, Phalaborwa, Hoedspruit, Mopani, and Regional Herald. She holds a Diploma in Journalism, and a BA in Communications and Psychology. With an interest in storytelling and a strong commitment to accuracy, her goal is to produce high-quality content that truly connects with readers. She aims to amplify the voices of those who need it most, shine a light on important issues, and inspire meaningful conversations. Tanaiya firmly believes in the power of journalism to effect change and is dedicated to being a part of that change.

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