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South Africa decisions
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Machi v Road Accident Fund (2020/12687) [2025] ZAGPJHC 445 (9 May 2025)
The High Court granted leave to appeal in a Road Accident Fund dispute over past medical expenses paid by a medical scheme, finding compelling reasons and prospects of success.
Esack N.O v Road Accident Fund [2025] ZAWCHC 27; 2025 (4) SA 201 (WCC) (4 February 2025)
The court held that the defendant is liable to compensate the plaintiff for past hospital and medical expenses paid by the deceased's medical aid scheme. The majority judgment in Discovery Health did not alter the established legal position, as it did not decide the deductibility of medical aid payments and cannot override Supreme Court of Appeal authority. The principle of res inter alios acta remains applicable, and payments by medical aid schemes, even for prescribed minimum benefits or emergency medical conditions, are not deductible from the plaintiff's claim against the Road Accident Fu…
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Discovery Health (Pty) Ltd v Road Accident Fund and Another (2023/117206) [2024] ZAGPPHC 1303; [2025] 2 All SA 113 (GP); 2025 (3) SA 225 (GP) (17 December 2024)
The majority held that the RAF did not breach the Mbongwe J order by relying on the two subsequent directives, as those directives were based on new legal premises not considered in the original judgment. The court found that Discovery Health had standing to enforce the Mbongwe J order as a party with a judgment in its favour. However, the subsequent directives, premised on statutory obligations under the Medical Schemes Act and section 19(d)(i) of the RAF Act, were not unlawful on their face and remained operative until reviewed and set aside. The principles of res judicata and res inter ali…
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Visser v Road Accident Fund (990/2022) [2024] ZANCHC 83 (30 August 2024)
The court found that the Road Accident Fund is liable to compensate the plaintiff for her past medical and hospital expenses, including those paid by her medical aid (POLMED) and out-of-pocket payments. The defendant's application for postponement or removal of the matter was refused, as the Supreme Court of Appeal had already dismissed the RAF's application for leave to appeal in the related Van Tonder matter, and an application for reconsideration does not automatically suspend proceedings. The evidence presented by the plaintiff and her husband was uncontroverted, and the defendant failed…
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Moeketsane Patrick Marasi v Road Accident Fund (164/2021) [2024] ZAFSHC 262 (30 August 2024)
The court held the Road Accident Fund liable for past medical expenses paid by the plaintiff’s medical aid and awarded R76,997.14.
Bezuidenhout v Road Accident Fund (1284/2012) [2024] ZAFSHC 224 (1 August 2024)
The court held the Road Accident Fund liable for past medical expenses already paid by the plaintiff’s medical aid, applying res inter alios acta and granting costs.
Gunther v Road Accident Fund (24228/16) [2024] ZAWCHC 153 (6 June 2024)
The court found that the plaintiff's claim for past medical, hospital and related expenses is not based on subrogation but on section 17 of the Road Accident Fund Act. The defendant's reliance on subrogation and exclusion of liability under section 19(d)(i) of the RAF Act and the Medical Schemes Act was rejected as unmeritorious and contrary to established legal principles. Benefits received from a medical aid are collateral and do not absolve the defendant from its statutory obligation to compensate the plaintiff. The plaintiff proved her entitlement to compensation for past medical expenses…
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Bester obo C & E.N v Road Accident Fund (3200/2019) [2024] ZAECMKHC 67 (30 May 2024)
The court exercised its discretion under Rule 38(2) to allow evidence of past hospital and medical expenses to be adduced by affidavit, as the defendant did not oppose this method and the evidence was undisputed. The court found that payment of medical expenses by a medical aid scheme does not absolve the defendant of liability to the plaintiff. The principle of res inter alios acta applies, meaning the defendant cannot benefit from payments made by third parties such as medical aids. The plaintiff is entitled to recover the expenses from the defendant and is obliged to reimburse the medical…
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Banda v Road Accident Fund (5168/2021) [2024] ZAGPJHC 483 (9 May 2024)
The High Court held that the RAF remains liable for past medical expenses paid by the plaintiff’s medical aid, treating the payment as a collateral benefit.
Road Accident Fund v Sheriff of the High Court for the District of Centurion East and Another (083710/2023) [2023] ZAGPPHC 1777 (11 October 2023)
The court held that the Road Accident Fund is not entitled to a stay of execution of writs issued for payment of medical expenses already paid by medical schemes. The law obliges the RAF to compensate plaintiffs for such expenses, as payments by medical schemes are collateral benefits and do not diminish the plaintiffs' patrimonial loss. The RAF's directive to reject these claims has been set aside, and its pending application for leave to appeal does not justify non-compliance with valid court orders. The RAF has not brought rescission applications in any of the matters and has failed to dem…
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