The National Consumer Commission is taking four medical schemes to the Equality Court for contravening provisions of the Consumer Protection Act.
Encouraged by regulators such as the Council for Medical Schemes and facing tough economic conditions, members of medical schemes are becoming increasingly militant. But the commission is taking on practices protected by law.
The commission is challenging "late joiner" penalty fees for people who join schemes after the age of 36 and waiting periods imposed before members get full benefits.
National Consumer Commissioner Mamodupi Mohlala-Mulaudzi said yesterday her organisation had lodged papers with the Equality Court on June 28.
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The medical schemes taken to task are Fedhealth, Momentum, Medshield and Bonitas.
Ms Mohlala-Mulaudzi said schemes "want people to join at a young age. They use the late joiner fee to subsidise older members.
"Some people can’t afford to join early - what about people who don’t grow up in South Africa and come back as adults?"
She criticised the three-month and 12-month waiting periods, saying members should have access to benefits "from day one". The 12-month period discriminated against pregnant women.
"In terms of the Consumer Protection Act, when I pay I must get the service," she said. "The act states that if there is a transgression against consumers that affects their constitutional rights, we can refer the matter directly to the Equality Court."
Medshield acting executive principal officer Jonathan Phillips said his company would defend the court action, as it applied its rules according to the Medical Schemes Act. "The waiting period applies to condition-specific exclusions permitted as per the Medical Schemes Act. Late joiner penalty fees are applied specifically to discourage anti-selective behaviour as well as to protect the best interests of the overall membership," he said.
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