The Council for Medical Schemes v Genesis Medical Scheme (20518/2014) [2015] ZASCA 161 (16 November 2015) per Leach JA at para 43 (Petse, Willis, Mbha and Zondi JJA concurring).
The relationship between a medical scheme on the one hand and its members on the other, is not governed solely by that scheme’s rules but also by the obligations imposed by statute upon medical schemes. These latter obligations cannot be evaded by a medical scheme purporting to contract with its members by prescribing rules having a contrary effect. It is not only, as counsel for the appellants argued, simply a question of legality and the enforcement of an obligation imposed on medical schemes by statute, but the enforcement of public policy that leads to that result. Consequently, DL Pearmain The Law of Medical Schemes in South Africa, correctly observes that ‘(a)lthough the Act states that a scheme is bound by its rules, if one or more of those rules is contrary to law, the law will take precedence.’[para 7.1.1] After all, s 29(1)(o) provides that no medical scheme shall carry on business unless it provides for the scope and level of minimum benefits that are prescribed. If Genesis carries on business as a medical scheme, which it does, then it must supply the benefits it is required to provide by the Act and the regulations.