The Road Accident Fund (RAF) and its chief executive officer have suffered a major legal defeat in the Supreme Court of Appeal after the court found they ignored court orders on medical scheme claims.

The legal fight between medical scheme administrator Discovery Health and the RAF started with a directive the RAF issued in August 2022. The directive told claims handlers to reject all claims for past medical costs if the claimant’s medical scheme had already paid for those costs.

Discovery challenged the directive in the High Court and won. On 27 October 2022, the court declared it unlawful and stopped it. The RAF then tried to appeal to both the Supreme Court of Appeal and the Constitutional Court but failed.

Despite these court orders, the RAF’s chief executive issued new internal directives in April and November 2023. These directives again tried to refuse payments for medical costs covered by medical schemes.

Discovery went to court on an urgent basis to have the RAF and its chief executive declared in contempt of court.

In a unanimous judgment, Court of Appeal Judge T.M. Makgoka found that the new directives were a deliberate attempt to get around the original court order. The judge said the matter had already been decided by the court.

The court stressed that state organs cannot undermine the authority of the courts by repeatedly offering new legal reasons for conduct already declared unlawful.

The Supreme Court of Appeal stopped the RAF and its chief executive from using the directives in question or making any deductions from compensation based on medical scheme payments. The court ordered them to report back within 14 days on how they have complied with the order.

ALSO READ: Road Accident Fund’s R400 billion crisis sparks fuel levy debate