The Road Accident Fund (RAF) says it will approach the Constitutional Court after the Supreme Court of Appeal (SCA) dismissed its application to appeal against a judgment that prevents it from rejecting claims for medical expenses where these expenses have been paid by medical schemes, not claimants.
Discovery Health, the largest administrator of medical schemes in South Africa, took the RAF to the High Court after the fund issued an internal directive in August 2022 instructing regional managers to reject claims if a medical scheme has already paid them.
Discovery obtained an interdict preventing the RAF from implementing the directive. In January 2023, the High Court denied the RAF leave to appeal the judgment.
Read: Ruling in dispute between Road Accident Fund and Discovery Health over claims
The following month, the fund applied to the SCA for leave to appeal.
In a brief judgment handed down on 11 April, the SCA said: “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.”
Dr Ryan Noach, the chief executive of Discovery Health, said the SCA’s ruling “should put an end to the debacle”, because the appeal court upheld Discovery’s interdict that the directive was unlawful.
But RAF spokesperson Linda Rulashe said the fund will petition the Constitutional Court for leave to appeal. The fund would not comment further.
Meanwhile, the RAF has not resumed paying the past medical expenses of scheme members injured in motor vehicle accidents.
In March, Discovery Health applied to the High Court in terms of section 18(3) of the Superior Courts Act, to compel the enforcement of the interdict against the RAF’s directive.
Noach said Discovery hoped the court will uphold its section 18(3) application, compelling the RAF to resume payments immediately.
“It is our considered view, as guided by counsel, that the rulings of the High Court and the Supreme Court are absolutely unequivocal and clear and should be respected to bring an end to the continued futile attempts of the RAF to frustrate this process,” he said.
