The Road Accident Fund (RAF), which still steadfastly refuses to settle medical aid claims, says it will approach the Constitutional Court after its application against Discovery Health was thrown out by the Supreme Court of Appeal (SCA).
Medical schemes usually submit claims to the RAF after footing the bill for members who had suffered injuries in road accidents.
The RAF was recently dragged to the courts, however, by Discovery Health over non-payment of medical aid costs, because according to the transport entity, it has no duty to reimburse a medical scheme if an accident victim’s expenses have already been paid.
“The Road Accident Fund will be petitioning the Constitutional Court for leave to appeal and will not comment further,” said spokesperson Linda Rulashe.
‘No compelling reasons for an appeal’
The RAF first lost the medical scheme case before Judge Mandla Mbongwe in the North Gauteng High Court last year.
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The high court declared its internal directive to stop reimbursing medical schemes illegal. An appeal against the court’s judgment, which also restrained the RAF from implementing its policy, also failed in January.
On 20 February, the fund filed papers directly to the SCA.
In a three-line judgement sent via email, SCA Judges Zamani Mhlangulela and Christiaan Van Der Merwe said there was nothing compelling the court to hear the RAF appeal.
“The application for leave to appeal is dismissed with costs on the ground that there are no reasonable prospects of success in an appeal, and there is no other compelling reason why an appeal should be heard.”
RAF must pay up
In a response to The Citizen’s questions, Discovery CEO Ryan Noach said the SCA judgement should put an end to the debacle.
“Discovery Health is still awaiting the 18(3) judgment [compelling RAF to comply and pay up] to further enforce the SCA ruling which will also supplement the various court findings of the unlawfulness of the RAF‘s internal directive.
“Given the SCA ruling, Discovery is confident that the RAF will, as a responsible sokonnect, fully comply with the SCA ruling and immediately resume paying past medical expenses in respect of injured medical scheme members.”
He added that the fund sought to “unlawfully discriminate” against medical scheme members by excluding them from payments.
“The [SCA] ruling also ordered that ‘there is no other compelling reason why an appeal should be heard’. In effect, this ruling should put an end to the debacle as SCA has upheld Discovery’s interdict that the directive was unlawful,” said Noach.
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RAF’s woes before courts
A litany of cases against the RAF by accident victims continue to pour in at various courts.
RAF bosses were recently scolded and slapped with a personal cost order by Mpumalanga High Court Judge President Francis Legodi, for failing to execute their duties and leaving cases in disarray. The RAF also removed its panel of lawyers in 2020 without a contingency plan.
Following the countless attempts by the court to get the fund to do its work, the RAF chose to settle after costly years of litigation in two cases that Legodi combined, because the claimants shared the same frustrations with the fund.
In their appeal against Legodi’s scathing judgement, RAF CEO Collins Letsoalo and the board claimed they were not aware of litigation by two of the claimants, saying Legodi made a mistake in his judgement.
They told the court that they were never going to allow attorneys whose term had expired and “acted contrary to the interests of RAF” to continue with their services.
In another adverse judgment in February in the same court, Legodi ordered Letsoalo and the board to explain why they rejected medical expenses claims.
The court further asked what the RAF plans to do with the accident victims while it appealed the ruling.
Legodi further invited all medical schemes and other interested parties affected by RAF’s policy to join and file their own affidavits in the matter.
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