Road Accident Fund cannot appeal hospital, medical claims ruling

Road Accident Fund CEO Collins Letsoalo. Picture: Thobile Mathonsi/African News Agency (ANA)

Road Accident Fund CEO Collins Letsoalo. Picture: Thobile Mathonsi/African News Agency (ANA)

Published Oct 20, 2023


Pretoria - The Constitutional Court this week refused to entertain an application by the Road Accident Fund (RAF) for leave to appeal against a ruling in which a judge earlier put an end to its directive that it would no longer pay for past claims for medical expenses by members of medical aid schemes injured in vehicle accidents.

In terms of the directive, the RAF made it clear that it would not make payments in cases where claimants’ medical aid schemes have already paid for their accident-related injuries.

The Gauteng High Court, Pretoria, last year declared the directive pertaining to medical aid payments unlawful. This followed an urgent application by Discovery Health.

In January, the court dismissed an application by the RAF for leave to appeal against the judgment.

The RAF then approached the Supreme Court of Appeal for leave to appeal, but this was turned down by the SCA. The fund then decided to head to the apex court.

But the highest court in the country handed down an order in which it said it had considered the application for leave to appeal and has concluded that it “does not engage the jurisdiction of the court”.

Consequently, leave to appeal must be refused, the order read. The matter was considered by nine judges, among them Deputy Chief Justice Mandisa Maya.

The effect of the Concourt ruling is that claimants who belong to medical aid schemes retain the right to claim medical expenses incurred after an accident from the RAF. The RAF is compelled to process these medical bills.

Discovery argued all along that medical aid schemes would be out of pocket if the new directive to reject claims for past medical expenses already paid was implemented.

It argued before the high court earlier that medical aids were losing millions daily while they could not claim from the fund the medical costs incurred by members involved in vehicle accidents.

Six law firms that challenged then-transport minister Fikile Mbalula’s appointment of RAF CEO Collins Letsoalo will, meanwhile, head to the Concourt after they lost their legal bid last year to have him axed from his position.

Judge Brenda Neukircher found at the time that the lawyers and their firms did not have the legal standing to launch the application. She said it was thus not necessary for her to decide on the merits of the application.

But the attorneys from the law firms, which include K Malao Inc, Senne Company Inc, and Mabuse Attorneys, all of whom were former RAF panel attorneys, are not letting the matter rest here.

They have launched an application with the apex court in which they will ask for leave to appeal against last year’s judgment. They will ask the court to declare that they have the legal standing to apply for Letsoalo to be axed and said that last year’s order against them in this regard should be overturned.

They will also persist in their application for the appointment of Letsoalo be declared unlawful and for his post to be advertised within two months of a court order in their favour.

They said if the court did not find in their favour, they at least wanted to have the cost order awarded against them last year overturned.

Attorney Kabelo Malao said in an affidavit before the Concourt that the initial application to have Letsoalo axed, which they had lost, was not brought because they were malicious. Malao made it clear that they had genuine concerns over how the RAF was managed.

He said they were not only acting in their own interest, but also in the interest of the public.

Malao and the other applicant attorneys maintained that Letsoalo’s appointment was irrational and should be set aside. They expressed frustration at the manner in which he handled payment claims for road accident victims.

They said that many of their clients remained out of pocket despite court orders that they be compensated by the fund.

According to them, a dysfunctional RAF adversely affected the rights of plaintiff attorneys.

Meanwhile, the RAF has not yet had a chance to file its opposing papers, as the attorneys only filed their application with the Concourt a week ago.

Pretoria News