Discovery Health has revealed it will seek to hold the Road Accident Fund (RAF) in contempt of court if it fails to comply with this week’s Constitutional Court decision to honour claims lodged on behalf of members injured in traffic accidents. A Business Day report says this follows it losing its legal battle to overturn a High Court interdict secured in 2022 declaring its decision to exclude claims from medical scheme members unlawful, after the Constitutional Court rejected its application to appeal the lower court’s ruling. In what the Business Day calls a surprise turn of events, RAF CEO Collins Letsoalo told the newspaper on Wednesday the RAF would not resume payments to medical schemes, despite the apex court’s decision. ‘We are surprised by Mr Letsoalo’s position, which appears not only to be antagonistic but also flies in the face of the clear and strong position taken by the courts,’

Written by Neesa Moodley | Published on 19 October 2023 Medical scheme members can rest easy after the Constitutional Court this week ruled in favour of Discovery Health in an echo of an earlier high court ruling. But the Road Accident Fund is not budging on its stance. Discovery Health took the Road Accident Fund (RAF) to court to declare as unlawful the RAF’s directive issued in August to exclude medical scheme members’ claims, and for the RAF to resume the processing of members’ road accident-related claims.  Discovery Health won the case. This week, the RAF’s application for leave to appeal to the Constitutional Court was refused, with a full costs order awarded to Discovery Health. The RAF directive, issued just over a year ago, instructed its various claims offices to stop processing medical scheme members’ claims.  “This constituted clear discrimination against medical scheme members who are road users and

Published to BusinessTech on 19 September 2023 Legal experts are crying foul over proposed changes to the Road Accident Fund, which will see the fund severely cut down on the support offered to road accident victims and negate compensation in some cases entirely. The Department of Transport gazetted the draft Road Accident Fund Amendment Bill, 2023 for public comment on 8 September, giving commentators just one month to provide feedback on the bill. Broadly, the bill aims to make a lot of changes to the way the RAF actually works, but one of the more contentious points is moving from a compensation model to a “benefits” model for those who are claiming. According to Advocate Justin Erasmus, Chairperson of the Personal Injury Plaintiff Lawyers Association (PIPLA), an association representing approximately 300 Personal Injury lawyers, legal practitioners are moving heavily against the bill. He said that over 5,000 objections have already

Written by Roy Cokayne | Published on 8 Sep 2023 CMS says RAF refusal is also not in the interest of beneficiaries of medical schemes. The Council for Medical Schemes (CMS) believes the Road Accident Fund’s (RAF) directive that no payments must be made to claimants if their medical aid scheme has already paid for their medical expenses arising from a road accident is not in line with the Medical Schemes Act. In a legal review of the issue, CMS senior manager for legal services John Letsoalo and CMS benefits management senior analyst Mpho Sehloho also concluded that the non-payment by the RAF of these medical costs is not in the interest of the beneficiaries of medical schemes. Discovery Health has been embroiled in court battles with the RAF over the directive, which it issued on 12 August 2022. The High Court in Pretoria declared the directive unlawful on 27

Published on 17 August 2023 by the Parliament of the Republic of South Africa To download the soundbite of the Chairperson of SCOPA, Mr Mkhuleko Hlengwa please click: https://iono.fm/e/1350371 Parliament, Thursday, 17 August 2023 – The Standing Committee on Public Accounts (SCOPA) is displeased with the disjointed claim management process at the Road Accident Fund (RAF), which continues to be an obstacle to claimants receiving what is due to them from the fund. The second leg of SCOPA’s oversight visit to the RAF has once again exposed deficiencies that render governance at RAF weak and unworkable. The committee noted that staff morale is low, and workers are subject to heightened levels of intimidation, which RAF management has been unable to address. While SCOPA is convinced of the need for consequence management, this should not be done maliciously, nor in a manner that targets individuals who have highlighted possibly controversial challenges

Written by Mayibongwe Maqhina | Published on 15 August 2023 The Road Accident Fund (RAF) will come under scrutiny when the Standing Committee on Public Accounts (Scopa) conducts an oversight visit at its offices on Wednesday. This follows a previous visit in June to investigate a dispute between the RAF and Auditor-General Tsakani Maluleke over the entity’s disclaimer audit opinion for the 2021/22 financial year. In her audit report, Maluleke said she was unable to obtain sufficient appropriate audit evidence for claims liabilities totalling R27.8 billion and claims expenditure amounting to R37.1bn as disclosed in the financial statements. She also said RAF had amended the accounting policy to recognise claims liabilities and claims expenditure. RAF amended its accounting policy regarding International Public Sector Accounting Standard 42 to recognise claim liability and expenditure as social benefits. This was in place of the generally recognised accounting practice, which applies to the RAF

Written by Kabelo Khumalo | Published on 26 June 2023 Discovery claimed medical schemes are losing R2m daily due to RAF’s unlawful directive. Medical schemes will have to stomach losses of up to R2m a day after the high court in Pretoria dismissed Discovery Health’s bid to compel the Road Accident Fund (RAF) to immediately process medical scheme members’ legitimate claims until the Constitutional Court decides on the dispute. SA has about 800,000 road accidents every year, according to data collated by the department of transport, translating to about 2,200 crashes daily. Medical schemes have historically submitted claims to the RAF after footing the bill for members injured in road accidents. However, the RAF shocked the establishment in August when it announced that it would no longer pay for past hospital and medical claims issued by members of medical aid schemes. Angered by the directive, Discovery interdicted the RAF in