Nosana v Road Accident Fund (1092/2021) [2023] ZAFSHC 354 (8 September 2023)

Parties

Procedural Posture

Civil Trial / Final Judgment

Legal Issues

1. 1 Whether the plaintiff is entitled to claim past medical expenses paid by a medical aid scheme from the Road Accident Fund.
2. 2 Whether the defendant's internal directive can lawfully exclude liability for medical expenses already paid by a medical aid scheme.
3. 3 Whether section 17(1) of the Road Accident Fund Act excludes compensation for medical expenses covered by private medical schemes.

Ratio Decidendi

The court held that the defendant's liability to the plaintiff arises from section 17(1) of the Road Accident Fund Act and is not affected by the plaintiff's contractual relationship with a medical aid scheme. The defendant remains liable for past medical expenses, even if those expenses were paid by the medical aid. The internal directive relied upon by the defendant is inconsistent with the enabling statute and unlawful. The principle of double compensation does not apply to private medical aid benefits, and the plaintiff is entitled to recover the full amount of past medical expenses from the defendant. Costs follow the cause.

Court Disposition

Plaintiff's claim for past medical expenses succeeds. Defendant ordered to pay the full amount claimed, together with costs and interest.

Orders

• The Defendant shall pay to the Plaintiff the sum of R2 061 630.53 within 180 days in respect of the Plaintiff's claim for past hospital and medical expenses, past and future loss of earnings, and general damages.
• In the event of late payment, the Defendant shall be liable for interest at the prevailing rate from the 15th calendar day after the date of this Order to date of payment.