Discovery to appeal ruling

WRANGLE: ACCIDENT FUND NOT OBLIGED TO PAY CLAIMS PAID BY MEDICAL AID SCHEMES

- Ina Opperman

Discovery Health will appeal the judgment of the High Court in Pretoria that the Road Accident Fund (RAF) does not have an obligation to pay claims for accident victims whose health care costs were already paid by their medical aid schemes.

A full bench of the court dismissed a case brought by Discovery Health to force the RAF to reimburse the medical scheme for costs it pays to its members.

In its application, Discovery Health asked the court to force the RAF to comply with an earlier order by Judge Mandla Mbongwe to pay the disputed medical expenses.

The RAF sent out an internal memo in August 2022, changing a 100-year position on claims payments and instructed its offices to exclude medical scheme members from legitimate health care claims against the RAF.

After failing to engage the RAF to resolve the matter, Discovery Health took the matter to the high court and secured an interdict declaring the RAF's exclusion of medical aid members unlawful.

The RAF applied to the Supreme Court of Appeal (SCA) for leave to appeal in February last year.