Court: No RAF breach

WARNING TO DISCOVERY: 'WE'RE COMING FOR OUR ILLEGALLY CLAIMED MONEY'

- Roy Cokayne

Discovery Health's application for an order declaring the Road Accident Fund (RAF) to be in breach of a previous high court order related to the RAF's liability for the payment of the past medical expenses of road accident victims who are members of medical schemes has been dismissed with costs by the High Court in Pretoria.

A full court comprising Judge Dunstan Mlambo, Judge President of the Gauteng Division of the High Court, Judge Noluntu Bam and Judge Ingrid Opperman, who issued a dissenting ruling, handed down the judgment on Tuesday.

RAF CEO Collins Letsoalo said the RAF is "happy with the judgment" and described it as "a watershed for South Africa and the RAF".

Letsoalo said Discovery Health must know that "we are coming for our money they [Discovery] have claimed illegally from the RAF".

"I have no idea how much it is. But Discovery said to us that they are losing R500 million a year by not claiming from us.

"We will get our accountants to work on it and then we will give them the bill. We want that money back so that it can go to our claimants," he said.

RAF is 'not an insurer'

Letsoalo referred to two paragraphs in the judgment that he indicated were particularly interesting because they say the RAF is not an insurer.

Letsoalo has claimed for some time now that the RAF is a social benefit fund.

"We have been saying this for a very long time. It's good that this comes from the full bench of the high court.

"Prescribed minimum benefits (PMBs) and emergency medical services are exclusive obligations of medical aids and the RAF is not an insurer and subrogation does not apply in this case, and medical aids are not insurers themselves," he said.