Simpson v Selfmed Medical Scheme and Another (91/93) [1994] ZASCA 191; [1995] 2 All SA 124 (A) (30 November 1994)

Simpson v Selfmed Medical Scheme and Another (91/93) [1994] ZASCA 191; [1995] 2 All SA 124 (A) (30 November 1994)

The court held that the appellant failed to satisfy the requirements for admission to the first respondent medical scheme under section 20(1)(f) of the Medical Schemes Act. The evidence presented did not establish that the appellant was a member of a registered medical scheme for a continuous period of two years immediately prior to her application, nor that her application was necessitated by a change of employment. The further evidence sought to be introduced was not sufficiently weighty or conclusive to alter the outcome. The orders of the full court refusing the application to lead further evidence and dismissing the appeal were upheld.

Citation
[1994] ZASCA 191
Parties
Appellant: Luzelle Elizabeth Simpson; Respondent: Selfmed Medical Scheme; Respondent: South African National Medical Fund Limited
Court
Supreme Court of Appeal
Jurisdiction
South Africa
Judgment Date
30 November 1994
Case Number
91/93
Procedural Posture
Civil Appeal / Appeal From Full Court Judgment, Following Dismissal of Application in the Cape of Good Hope Provincial Division
Outcome
Appeal dismissed with costs; application to lead further evidence refused with costs.
Judges
Hoexter, Hefer, Kumleben, F H Grosskopf, Van den Heever
Legal Topics
Medical Schemes Act, Admission to Membership, Leave to Lead Further Evidence, Interpretation of Statutory Requirements
Civil Procedure Commercial and Corporate Medical Schemes Act Admission to Membership Leave to Lead Further Evidence Interpretation of Statutory Requirements

Case Brief

Summary, issues, holding and outcome

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Parties

Luzelle Elizabeth Simpson

Appellant

Selfmed Medical Scheme

Respondent

South African National Medical Fund Limited

Respondent

Procedural Posture

Civil Appeal / Appeal From Full Court Judgment, Following Dismissal of Application in the Cape of Good Hope Provincial Division

Legal Issues

  1. 1 Whether the appellant met the statutory requirements for admission to the first respondent medical scheme without a waiting period or new restrictions under section 20(1)(f) of the Medical Schemes Act.
  2. 2 Whether the appellant's application for membership was necessitated by her changing employment as required by the Act.
  3. 3 Whether the appellant was a member or a dependant of a member of a registered medical scheme for the prescribed period.

Ratio Decidendi

The court held that the appellant failed to satisfy the requirements for admission to the first respondent medical scheme under section 20(1)(f) of the Medical Schemes Act. The evidence presented did not establish that the appellant was a member of a registered medical scheme for a continuous period of two years immediately prior to her application, nor that her application was necessitated by a change of employment. The further evidence sought to be introduced was not sufficiently weighty or conclusive to alter the outcome. The orders of the full court refusing the application to lead further evidence and dismissing the appeal were upheld.

Court Disposition

Appeal dismissed with costs; application to lead further evidence refused with costs.

Orders

  • The appellant's application for leave to lead further evidence on appeal is refused with costs.
  • The appeal is dismissed with costs.