Lower Road Accident Fund medical tariffs challenge stumbles over fund’s reluctance to disclose details

Judge Ronel Tolmay last year suspended the implementation of new medical tariffs and ruled that her order would remain in place pending the outcome of a further application in which the court would be asked to review and set aside the tariffs. Picture: File

Judge Ronel Tolmay last year suspended the implementation of new medical tariffs and ruled that her order would remain in place pending the outcome of a further application in which the court would be asked to review and set aside the tariffs. Picture: File

Published May 25, 2023

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Pretoria - In the latest development regarding the challenge to the medical tariffs promulgated last year relating to victims of road accidents who claim compensation from the Road Accident Fund, the court has now placed the RAF on terms to produce the documents on which the decision was based which would leave people out of pocket.

Judge Ronel Tolmay, sitting at the Gauteng High Court, Pretoria, last year suspended the implementation of these tariffs.

She ruled that her order would remain in place pending the outcome of a further application in which the court would be asked to review and set aside the tariffs.

The new tariffs were promulgated by Minister for Transport Fikile Mbalula, under which medical professionals in the private sector were to be paid reduced amounts.

The National Council for Persons with Disabilities (NCPD) and the Law Society of South Africa (LLSA) launched the urgent application as they are of the view that the new tariff structure would have disastrous consequences for road accident victims in need of emergency or specialised care.

It was argued that the proposed tariffs were so high that accident victims without means or medical aid would no longer be able to obtain the care they needed in the private sector.

In terms of the medical tariffs which the applicants are now asking the court to overturn, the RAF would pay much less than the actual costs incurred, leaving accident victims out of pocket and with no other remedy.

These tariffs also do not cover certain critical services, such as air ambulances by helicopter, which places road accident victims at serious risk. The new tariffs are a departure from the existing tariffs as they offer far less, the LLSA said.

This is the reason why it and NCPD are challenging the constitutionality of these tariffs.

It will be on the basis that they are irrational, unreasonable and unjustifiably limits the rights of access to health care.

Following Judge Tolmay’s order last year, placing the implementation of these tariffs on halt pending the review application, the RAF wanted to appeal the decision, but the judge refused leave to appeal.

The RAF has since applied for leave to appeal to the Supreme Court of Appeal, which is yet to determine this application.

In a statement issued yesterday, the law society said the interdict remains binding in the interim.

The main review proceedings brought to set aside the impugned medical tariffs were initially set down to be heard this month.

However, the RAF failed to produce documents which shed light on the decision-making process, and the factors that were at play in the mind of the transport minister when approving the decision to promulgate the impugned medical tariffs.

The minister claimed that these documents were not in his possession and had to be sought from the RAF which, in turn, refused their disclosure.

The LSSA and NCPD subsequently had to pursue the production of these documents by way of an interlocutory application.

In the build-up to the hearing of this interlocutory application, Judge Ingrid Opperman issued directives ordering the RAF to file papers explaining their recalcitrance.

The RAF persisted in its refusal.

The judge subsequently granted an order directing the RAF to produce the documents within five days, on the basis that the documents are relevant to explain the decision-making process by the minister of transport to approve the impugned medical tariffs.

Judge Opperman expressed her displeasure with the RAF’s conduct, which she said was “not only discourteous and unprofessional, but also the very opposite of rule-abiding”.

Judge Opperman granted a punitive costs order against the RAF and she called on the CEO and board chairperson of the RAF to file affidavits to explain why they should not each be held personally liable to pay the costs of the interlocutory application.

The LSSA welcomed the judgment and orders granted by Judge Opperman, and said it is now waiting for the RAF to produce these documents, so that the main review application can get off the ground.

Pretoria News