Our Pro Bono Team launched an urgent application to intervene in the application brought by Health Squared Medical Scheme for leave to apply in terms of section 51 (2) of the Medical Schemes Act 131 of 1988 for its voluntary winding up.
On Sunday, 28 August 2022, the Pro Bono team launched an application to intervene in the urgent application brought by Health Squared Medical Scheme for leave to apply in terms of section 51 (2) of the Medical Schemes Act 131 of 1988 for its voluntary winding up.
We acted for two renal patients and the South African Nephrology Society - a non-profit organisation that represents the interests of patients with kidney disease.
The Medical Schemes Act requires schemes to maintain a minimum solvency level of 25% as a buffer against any unexpected surge in claims, but Health Squared's solvency ratio was already lower than that in 2020. By June 2022, that ratio had plummeted to 3.79%.
In view of the impending liquidation proceedings, a communication was sent to members of the Scheme by Health Squared on 18 August 2022, informing them of the situation and stating that no benefits would be paid after 31 August 2022. This short period of time was wholly insufficient for members to procure substitute medical aid cover. Our patient clients submitted to the court, that renal patients usually have 3 dialysis sessions per week lasting 3 to 5 hours which most are unable to afford without medical cover. The submission stated that there should be no interruption in medical aid benefits for renal patients because without dialysis and transplant treatment, patients will simply die. According to them in the absence of medical cover it was impossible for them to access health care in the public sector due to waiting lists.
After our papers were lodged, the trustees of Health Squared through their lawyers entered into negotiations with the intervening party. The trustees adopted a resolution consenting to extend ex gratia benefits to members experiencing life-threatening risks, including kidney dialysis treatment, until 30 September 2022.
This one month "reprieve" is considered a lifeline not only to the scheme's 54 renal failure patients, but to all members facing grave life-threatening risks.
The Nephrology Society was deeply appreciative of Webber Wentzel's pro bono offering which allowed it to intervene on behalf of patients who did not have the resources and know how to act fast enough to secure their medical benefits.
Judge Crutchfield granted our client leave to intervene. She also granted Health Squared leave to apply for liquidation on 27 September 2022. The resolution protecting patient interests was incorporated into the order of court.
On 8 September 2022, the Judge issued a rule nisi order appointing a curator with the return day of 27 September to confirm such an appointment. Our team consisted of Asmita Thakor, Matthew Ilsley and Emily Elphick. Counsel who acted pro bono in the matter were Adv Gerald Farber SC and Adv Yusuf Saloojee.
This matter is in line with goals 3 (good health and well-being) and 10 (reduced inequalities) of the United Nation's Sustainable Development Goals.