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In October 2022, the High Court in KeyHealth Medical Scheme v Ngoepe No and Others considered whether the court a quo was correct in finding that a medical scheme was prohibited from using day-to-day benefits to fund the treatment and costs of Prescribed Minimum Benefit (PMB) conditions. The court found that the source of the…

Medical scheme rules may have no application if they fail to fulfil statutory law. The relationship between medical schemes and their members is not only governed by the medical scheme rules but primarily by obligations imposed by statute.

The public policy considerations taken into account in the Medical Schemes Act which give rise to prescribed…