
Majority judgment ‘does not alter’ RAF’s liability for medical scheme members’ claims
The High Court in Cape Town rejects the Road Accident Fund’s contention that the Mlambo judgment has altered the legal landscape.
The High Court in Cape Town rejects the Road Accident Fund’s contention that the Mlambo judgment has altered the legal landscape.
It says 47% of members intend to make future claims – with 34% of those who have already claimed planning to do so again.
A regulatory expert believes the judgment misinterpreted key legal principles in its ruling on the RAF’s obligation to reimburse medical schemes.
The High Court says Discovery Health misconstrued the scope of the judgment that set aside the RAF’s first directive on the payment of medical scheme members’ claims.
Discovery Health’s quest for reimbursement from the RAF for medical expenses incurred by road accident victims has faced multiple legal hurdles, with new RAF directives complicating the situation.
Associate Professor Tasleem Ras’s analysis of a patient’s case highlights critical pitfalls in cancer care.
Schemes and healthcare professionals are at odds over whether these recoveries are justified, says the Council for Medical Schemes.
The investigation into the Road Accident Fund has uncovered a significant rise in default judgments, accumulating to R4.7 billion from 2018 through the second quarter of 2023.
The group attributed the turnaround in motor insurance to managing claims inflation and improving risk selection, resulting in a significant reduction in claims frequency.
As the two-pot retirement system goes live on 1 September, intermediaries must prepare to guide clients through the new structure.
Tarina Vlok, MD of Elite Risk Acceptances, explains the importance of educating policyholders about their insurance coverage and exclusions.
The medical scheme says it will use its reserves to limit contribution increases, while possibly improving members’ benefits and reducing co-payments.
Medihelp submitted a CMS-approved three-year plan, requiring gradual contribution increases to restore its reserves to the statutory 25% level.
The important statistic is the proportion of personal lines complaints relative to an insurer’s share of the total personal lines claims.
According to the latest SAPS crime statistics, there were 5 973 carjackings in the fourth quarter of 2023.
During National Youth Month, Marius Kemp from Santam emphasises the importance of insurance for young people, who often lack emergency savings.
The number of claims is expected to rise, and storm-hit policyholders in KwaZulu-Natal will also be filing claims.
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