S.J.J.W v Road Accident Fund (19574/2017) [2023] ZAWCHC 25 (8 February 2023)

Parties

Procedural Posture

Civil Trial / Final Judgment

Legal Issues

1. 1 Whether the Road Accident Fund is liable to compensate the plaintiff for past medical expenses paid by his medical aid scheme.
2. 2 Whether the defendant may deduct amounts paid by the plaintiff's medical aid from the quantum payable for past medical expenses.
3. 3 Whether the defendant's August 2022 directive refusing reimbursement of medical aid payments is lawful.

Ratio Decidendi

The court held that the defendant is liable to compensate the plaintiff for past medical expenses, including those paid by his medical aid scheme, Momentum. The principle of res inter alios acta and established case law dictate that medical aid benefits are collateral and must be disregarded in the calculation of damages. The defendant's August 2022 directive purporting to exclude reimbursement of medical aid payments was found to be unlawful and inconsistent with section 17 of the Road Accident Fund Act. The court found no basis to delay finalisation of the matter pending possible appeals, as the law currently stands in favour of the plaintiff. The defendant's liability is unaffected by...

Court Disposition

The defendant is ordered to pay the plaintiff the full quantum of damages, including past medical expenses paid by his medical aid scheme, and to provide an undertaking for future medical costs. Costs are awarded to the plaintiff.

Orders

• The Defendant shall be liable for 100% of the Plaintiff’s damages as set out in the order.
• The Defendant shall pay R4,273,170.00 to the Plaintiff’s attorneys in respect of loss of income and general damages.