Discovery Health has filed its contempt of court application against the Road Accident Fund (RAF) and CEO Collins Letsoalo for failing to comply with a judgment ordering the fund to resume paying medical schemes – but the matter is expected to be heard only in 2024.
Business Day reports that the parties have agreed the matter will not be put on the urgent roll this week, as originally requested by Discovery Health, and will jointly approach the Deputy Judge President of the Gauteng High Court (Pretoria) for a special allocation for it to be heard as soon as possible in 2024.
The RAF and Discovery Health have been locked in legal battle for more than a year after the fund directed its staff to stop processing claims from medical schemes in August 2022. For decades, the RAF, charged with compensating victims of road traffic accidents, had reimbursed medical schemes after they had covered the health costs of their members’ traffic accidents.
Discovery won an urgent High Court application in October 2022 to have the RAF’s directive declared unlawful and set aside. The RAF sought to appeal, taking its fight to the Constitutional Court, which declined to hear the matter.
Discovery has now asked the High Court to declare that the RAF and Letsoalo are in contempt of court because they have continued to implement the August 2022 directive by rejecting claims for compensation filed by medical schemes if the claimant’s scheme has already paid for the claim, including for prescribed minimum benefits and emergency conditions.
It also wants the court to declare that respondents have attempted to circumvent the judgment and made contemptuous public statements.
Discovery Health has asked the court to stop the RAF and Letsoalo from implementing a further directive issued to staff in April that instructed them not to reimburse claims from medical schemes, arguing that it undermined the August 2022 judgment.
RAF chief governance officer Mampe Kumalo said in court papers that the RAF’s two new internal directives about medical schemes, issued in April and November, are different from the one reviewed and set aside in 2022.
It denied being in contempt of court because it was applying these new directives, not the old one, Kumalo said.
She described the RAF as a “financially ailing and inadequately funded” social welfare fund that had been “plundered by unscrupulous and greedy intermediaries who deprived the very people meant for it”.
Medical schemes are obliged by the Medical Schemes Act to cover prescribed minimum benefits, which include emergency care arising from road traffic accidents, she added, and the RAF should not be paying for private healthcare for “privileged citizens” who belong to medical schemes.
In papers, Letsoalo said the RAF has limited resources. Almost 100 000 claims are lodged with the fund each year, and it is confronted almost daily with fraudulent and overinflated claims, he said.
Business Day PressReader article – Discovery files for RAF to be declared in contempt (Open access)
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Discovery setback in tussle with RAF
Discovery appeals dismissal of application for RAF to resume payments