
In what promises to be a david versus Goliath battle, the little people are set to take on medical scheme giant Discovery Health, in the equivalent of a "class action" to try to recoup more than R400 million they were allegedly overcharged.
A Pietermaritzburg company has taken up the cudgels on behalf of 244 000 Discovery members who were billed a so-called ancillary fee, on top of their contributions, between 2001 and 2005.
According to Wynand Venter, managing director of brokers Wynsam Wealth - which is not charging affected members to become part of the lawsuit - the fee charged by Discovery was illegal in terms of Section 21A of the Medical Schemes Act.
The same fee was not charged to members of groups larger than 35, in spite of the Act stipulating that no medical scheme may charge different rates to different people based on "arbitrary conditions".
Accordign to the Act, the only variations in contribution rates may be based on income and number of dependents.
Vente said they would sue Disocvery Health on behalf of both past and current members who had been affected. "Most members are not aware of the charges levied or of the illicitness of their nature, even though more than R110m was collected by Discovery every year in this fashion, with more than 240 000 members affected," he said.
Venter said the fee was not paid to the medical scheme but to the administrator, "for extra services", and was made to appear compulsory. Even Discovery staff believed it was compulsory and had advised brokers and membes as such.
In June 2005, discovery settled a claim by an individual member claiming back this fee in the Randburg Magistrate's Court, although it did not admit liability. It did, however, stop charging the ancillary fee the same year.
Disocvery Health's head of research and development, Alan Pollard admitted the company had settled that claim "because it wasn't worth going the legal route", but that it would "have to go to court" to defend the Wynsam Wealth claim.
"We pride ourselves on our products and the excellent value for money we offer, and we view this as an attempt by this broker to get these services (for which the members were paying the ancillary fee) for free. We think the action is inappropriate and will have to go to court because we don't see the justification for this," Pollard said.
The extra charges for individuals and small groups of less than 35 members had been "an economy of scale issue", and the benefits had included thngs like emergency response and motor vehicle accident cover.
Venter's claim is that Discovery Health's marketing material of the time made the fee appear compulsory, but Pollard countered that "our submission is that members could opt out."
Venter said his company was confident that Disocovery Health created the impression the fee was compulsory, and "we have gathered sufficient evidence to prove this".
Venter's reason for taking on the battle, he said, was because "South Africans are tired of being ripped off". Members who wish to join the lawsuit can sign a power of attorney at www.wynsam.co.za or call Venter at 0860 103816.