Medihelp Medical Scheme v De Wet and Others (2022-010668) [2025] ZAGPPHC 1353 (17 December 2025)

begin wrapper begin container begin header begin slogan-floater end slogan-floater - About SAFLII About SAFLII - Databases Databases - Search Search - Terms of Use Terms of Use - RSS Feeds RSS Feeds end header begin main begin center # South Africa: North Gauteng High Court, Pretoria South Africa: North Gauteng High Court, Pretoria You are here: SAFLII >> Databases >> South Africa: North Gauteng High Court, Pretoria >> 2025 >> [2025] ZAGPPHC 1353 | Noteup | LawCite sino index ## Medihelp Medical Scheme v De Wet and Others (2022-010668) [2025] ZAGPPHC 1353 (17 December 2025) Medihelp Medical Scheme v De Wet and Others (2022-010668) [2025] ZAGPPHC 1353 (17 December 2025) Download original files PDF format RTF format make_database: source=/home/saflii//raw/ZAGPPHC/Data/2025_1353.html sino date 17 December 2025 IN THE HIGH COURT OF SOUTH AFRICA GAUTENG DIVISION, PRETORIA Case number: 2022-010668 Date of hearing:  9 December 2025 Date delivered: 17 December 2025 (1)                REPORTABLE: YES /NO (2)                OF INTEREST TO OTHERS JUDGES: YES /NO (3) REVISED DATE 17/12/25 SIGNATURE In the application between: MEDIHELP MEDICAL SCHEME                                                                           Applicant and MICHANEY DE WET                                                                                First Respondent RARE DISEASES SA MPC Second Respondent THE COUNCIL FOR MEDICAL SCHEMES                                            Third Respondent THE REGISTRAR FOR MEDICAL SCHEMES                                                                           Fourth Respondent JUDGMENT SWANEPOEL J : [1]      The applicant seeks leave to appeal against my order of 31 October 2025. Much of the argument put up by the applicant is repetitive of the arguments made at the hearing, and which I have addressed in my judgment. [2]      There are, however, specific aspects that I believe should be addressed in this judgment. The first is the contention that the order of Millar J is the subject of an appeal before the Full Court of this Division. That is not correct. It is the order of Munzhelele J, which ordered that effect must be given to the Millar J order until Part B of the application is resolved, which is under appeal. Therefore, the Millar J order is not suspended. [3]      The second aspect that I wish to address is the contention that the interpretation of the Millar J order is in dispute, and that, because of the interpretation that the applicant places on the order, it believes that the order lapsed when the Registrar of the Council for Medical Schemes made a finding on the first respondent’s complaint. For that reason, applicant says, it is not mala fide, and “cannot possibly” be in contempt of the order. [4]      One can say what one wishes on paper. The question is though, whether the statement made on affidavit is credible? It is impossible to see into a party’s mind to determine whether a party is mala fide or not. A Court can only examine the facts, and then say, having considered the facts, what the party’s intent is. It is this type of inferential reasoning that Courts apply constantly. [5]      The starting point is the contention that different interpretations can be placed on Millar J’s order. The material provisions of the order read as follows: “ 1.        The condition that Zachary De Wet (“Zachary”) has been diagnosed with, namely Hunters Syndrome MPS II is declared a Prescribed Minimum Benefit (PMB) Condition under the category 901 K as listed in Annexure A of the Regulations of the medical Schemes Act 131 of 1998. 2. Pending the resolution of Part B , the first respondent is ordered to: 2.1       authorize the treatment and care costs of all medical interventions required by Zachary and prescribed by his treating practitioners for Hunters Syndrome MP II as PMB level of care, which treatment includes inter alia Elaprase, a registered enzyme replacement therapy, within 30 days of this order; To pay accounts and/or claims for healthcare services rendered by the treating practitioners within 30 days of presentation of the account and/or claim thereof, in accordance with regulation 6 of the Medical Schemes Act, 131 of 1998.” (my emphasis) [6]     The words “Part B” in the Millar J order refers to Part B of the notice of motion which reads: “ TAKE NOTICE THAT the applicants intend to lodge a complaint with the second respondent in terms of section 47 of the Medical Schemes Act, 131 of 1998 and to take any and all further steps in terms of the Medical Schemes Act 131 of 1998 to ensure that the first respondent: 1. Authorizes and pays for the medical care and treatment of the condition that Zachary De Wet (“Zachary” has been diagnosed with, namely Hunters’ Syndrome MP II, as prescribed by his treating providers as a Prescribed Minimum Benefit (PMB) condition under the category 901K as listed in the Annexure A of the Regulations of the Medical Schemes Act, 131 of 1998 ; 2. Pays the accounts and/or claims for healthcare services rendered by the treating providers as a Prescribed Minimum Benefit (PMB) and within 30 days of presentation of the account and/or claim therefore, in accordance with regulation 6 of the Medical Schemes Act, 131 of 1998 alternatively within such reasonable time as will be determined by the second respondent.” (my emphasis) [7]       Part B cannot be understood to only refer to the lodging of the complaint with the Registrar under section 47 of the Medical Schemes Act, 1998 (“the Act”). It clearly refers, as I have highlighted, to the taking of any and all steps allowed by the Act. That is, however, the interpretation first placed on the order by the applicant: that the order lapses upon the complaint being lodged. The applicant later changed its approach and took the stance that the order lapsed upon the Registrar making a decision on the complaint. [8]      To the applicant’s knowledge, the Act provides for appeals against a decision of the Registrar, first to the Council in terms of section 49, and then to the Appeal Board in terms of section 50. It is not rationally possible to interpret the words “and to take any and all steps in terms of the Medical Schemes Act” in any other manner than that they refer to subsequent appeals against a finding of the Registrar as is provided for in sections 49 and 50 . Nonetheless, the applicant inexplicably took the view that once the Registrar had made a decision, the Millar J order lapsed. [9]      When the import of the Millar J order was made clear by the judgment of Munzhelele J, the applicant took that order on appeal, in order to justify its ongoing refusal to comply with Millar J’s order. Shortly before the appeal was to be heard on 6 November 2024 the applicant delivered the reconsideration application (on 25 October 2024), which caused the appeal to be postponed at the applicant’s request. The applicant’s conduct begs the question: If it were confident of its case in the appeal, why would it, firstly, deliver a reconsideration application at virtually the last minute, but secondly, why would the applicant attempt to have an order that on its own version had lapsed, reconsidered? [10]    The only answer that makes any sense is that the applicant has deliberately contrived a scheme to avoid compliance with the Millar J order. [11]    I bear in mind that the test laid down in Plascon-Evans Paints Ltd v Van Riebeeck Paints (Pty) Ltd [1984] ZASCA 51 ; 1984 (3) SA 623 (A) requires me to accept the applicant’s version (as respondent in the contempt application) unless it is clearly untenable. In my view, the applicant’s interpretation of the Millar J order requires one to completely ignore the words “and to take any and all steps in terms of the Medical Schemes Act” in Part B of the notice of motion. It requires extreme, self-serving mental gymnastics to arrive at the applicant’s interpretation of the order. [12]    If a respondent puts forth a version that does not bear rational scrutiny, the version must be rejected, which I do. The order of Millar J is so clear that I do not believe that the applicant truly believes its own interpretation of the order. This strengthens my view that the applicant’s failure to comply with the order is mala fide. In my view the applicant continues to be in contempt of the order of Millar J. It should comply with the order by funding Elaprase until the order is set aside. [13]    My order of 31 October provides that the Principle Officer of the applicant shall be committed to imprisonment unless the applicant purges its contempt by providing medical care for Hunters’ Syndrome, excluding the funding of Elaprase. That does not mean that the applicant is not required by the Millar J order to provide Elaprase. It is. However, the first respondent chose to limit the relief that she sought against the applicant by excluding the provision of Elaprase from the contempt order. I granted the exact order sought, but had I been requested to provide for the medication itself, I would have done so. [14]    For the above reasons, and the reasons set out in my judgment of 31 October 2025, the application for leave to appeal must be dismissed. [15]    I make the following order: The application for leave to appeal is dismissed with costs on Scale C, including the costs of two counsel where so employed. SWANEPOEL J JUDGE OF THE HIGH COURT GAUTENG DIVISION PRETORIA Counsel for the applicant: Adv. A Bava SC Adv. E Kromhout Instructed by: GMI Attorneys Counsel for the respondent: Adv RJ Moultrie SC, Adv M Peacock Instructed by: HJW Attorneys Hearing on: 9 December 2025 Judgment on: 17 December 2025 sino noindex make_database footer start