Sechaba Medical Solutions v Sekete (216/2014) [2015] ZASCA 8 (11 March 2015) per Wallis JA (Navsa DP, Shongwe JA and Dambuza and Mayat AJJA concurring)

The Supreme Court of  Appeal disallowed the appeal.  The issues in dispute were whether claims lie against medical scheme after authorisation of treatment by the medical scheme and whether it creates a contract between the healthcare provider and medical scheme.  Gen-Health Medical Scheme was a medical scheme with some 13 000 members.  On 12 October 2010 it was placed in final liquidation but prior to that it had been under curatorship since at least 2008. Sechaba was the administrator in respect of Gen-Health and was appointed to compromise or admit claims by Gen-Health’s members against the scheme in liquidation. Claims totalling some R28 million had been proved in the liquidation.  Life Healthcare represented 18 medical facilities and hospitals that rendered services to Gen-Health’s members prior to its liquidation.  It submitted 19 claims for proof at a special meeting of creditors and they were duly admitted.   Sechaba and Gen-Health challenged the decision but it failed before Murphy J in the high court.