I was sent medical aid accounts that sho...

Asked by KENZtck on 07-06-2024 14:07:06
Question posted in the Malpractice Law category relating to Gauteng

I was sent medical aid accounts that should be refunded by my practice for patients seen between 2013 and 2016. i didn't agree to that directive as patients were seen and managed as well as overheads of running the practice paid.

For more than 5 years there was no communication between myself and the medical aid administrators ( medscheme and discovery)  until in 2023 when momentum called that they are representing sasolmed and i should pay back more than 2 million rands for what i still don't know. i told them that case have reached its prescription period and i can't discuss it ad they went silence as i requested a prescription letter.

this morning i received a letter from discovery demandig same amount as they are now representing sasolmed. i haven't responded yet hence in need of an attorney who could assist me end this whole thing as i strongly believe that this matter is prescribed 




Message from the Lawyer

Posted by Att. Patrick on 07-06-2024 14:21:40

Hi there and thank you for your question,

I am a practicing attorney based in South Africa and I will assist you with your question. Please feel free to ask as many follow up questions in order to clarify your question. If you have a new question, you must please open a new thread.

Please keep in mind that our discussions is for general information purposes only. Our engagement on this website does not create an attorney-client relationship.

Based on what you've explained, I think that you are quite correct that their claim against you would have prescribed. As you are no doubt aware, most claims prescribe after 3 years from the date that the debt is due.

This means that if the medical aid was entitled to a refund in 2013 for whatever reason, they would have 3 years to the day to institute legal proceedings against you for the recovery. If they fail to do this, then your defence to the claim would be: "The claim has prescribed and is no longer enforceable."

Can you send me a copy of the letter of demand so I can review it? -- PatrickLegalQuestions<at>outlook.com

Message from the client

i did email. please confirm receipt

Message from the Lawyer

Posted by Att. Patrick on 10-06-2024 22:42:38

I have received your email with the 2 letter attachments. The letters do not go into much detail as to how the amounts were calculated or arrived at. However, they do explain the basics as to why Discovery thinks that it is owed the money. 

My previous advice in relation to the probable prescription of Discovery's claim stands, and I think that prescription is a good defence that you can raise! 

Message from the Lawyer

Posted by Att. Patrick on 11-06-2024 12:11:23

I unfortunately do not consult with clients directly as it is against the T&C of this website. What you will need to do is to consult with a private attorney directly. I can't refer you to a specific lawyer, but I can direct you to https://www.southafricanlawyer.co.za, where you can find a list of qualified lawyers in your area who will be able to assist you further!

Answer Accepted

This answer was accepted on 11-06-2024 13:46:56

Message from the client

Good Morning Patrick

thanks very much for your response

I would like to consult with you directly on one on one

what's the procedure to achieve my request and costs as i have to respond to this people



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