Case Law[2022] ZAGPPHC 348South Africa
Delicate Debt Collectors (Pty) Ltd v Director-General of the Department of Labour and Others (65869/2020) [2022] ZAGPPHC 348 (25 May 2022)
Judgment
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# South Africa: North Gauteng High Court, Pretoria
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## Delicate Debt Collectors (Pty) Ltd v Director-General of the Department of Labour and Others (65869/2020) [2022] ZAGPPHC 348 (25 May 2022)
Delicate Debt Collectors (Pty) Ltd v Director-General of the Department of Labour and Others (65869/2020) [2022] ZAGPPHC 348 (25 May 2022)
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sino date 25 May 2022
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Policy
HIGH
COURT OF SOUTH AFRICA
(GAUTENG
DIVISION, PRETORIA)
CASE
NO: 65869/2020
REPORTABLE:
NO.
OF
INTEREST TO OTHER JUDGES: NO
REVISED.
DATE:
25 MAY 2022
In
the matter between:
DELICATE
DEBT COLLECTORS (PTY) LTD
Applicant
and
THE
DIRECTOR-GENERAL OF THE
DEPARTMENT
OF LABOUR
First
Respondent
THE
COMPENSATION COMMISSIONER
Second Respondent
THE
MINISTER OF EMPLOYMENT AND LABOUR
Third Respondent
Reasons
for Judgment
This
matter has been heard in open court and is otherwise disposed of in
terms of the Directives of the Judge President of this
Division. The
judgment and order are accordingly published and distributed
electronically.
DAVIS,
J
[1]
Introduction
These
are the reasons for an order granted against the Respondent for
payment of R 4 122 675,22 together with interest
and costs
in respect of fees owed to medical practitioners in respect of
services performed in terms of the Compensation for Occupational
Injuries and Diseases Act 130 of 1993(the Compensation Act).
[2]
The parties
2.1
The applicant is a debt collection company
which represents 176 medical doctors, medical specialists and other
medical practitioners
registered as such in terms of the Medical,
Dental and Supplementary Health Services Provisions Act, 56 of 1974.
2.2
The applicant’s clients rendered
services to employees who have sustained injuries during the course
of their employment.
The medical practitioners’ fees are
prescribed and annually published in the Government Gazette.
2.3
The first respondent is the
Director-General of the Department of Labour and is the accounting
officer for that department.
2.4
The second respondent is the Compensation
Commissioner (the Commissioner), who assists the first respondent in
terms of section
2(1)(a) read with section 6A of the Compensation
Act. He receives notices of assessments, claims for
compensation, medical
reports, practitioners’ accounts,
objections, applications, returns of earnings and administers
payments and penalties.
The Commissioner also determines the
rules and particulars to be furnished in connexion with the payment
of fees and expenses of
medical practitioners on behalf of the first
respondent.
2.5
The third respondent is the Minister of
Labour in his capacity as such.
[3]
The nature of the claims
3.1
The administration of their claims for fees
and expenses places an immense burden on medical practitioners in
private practice.
The applicant administers these claims,
submits them in the correct format to the Commissioner and deals with
administrative queries,
reconciliations and expediting of payments.
For this, it earns a commission from the medical practitioners.
3.2
In the main application, spreadsheets of
claims submitted and payments received were produced. These
comprised of schedules
of outstanding invoices, schedules of accepted
claims, schedules of claims not accepted, schedules indicating
invoices which were
either only paid partially or which were paid
late and therefore attracted interest, schedules of unregistered
claims and a schedule
of claims which fell under a previous case
against the respondents (Case No 36487/17). The schedules also
differentiated
between the two systems used by the Commissioner for
administering claims and payments, being “UMEHLUKO” and
“COMPEASY”.
The nett result of all these schedules
and computations totalled an outstanding amount of R 16 627 978,00.
3.3
It is not necessary purposes of these
reasons to refer to the structure and operation of the Act. It
will suffice to provide
the reader with an overview of how claims are
generated, processed and paid. In practice an injured employee
approaches a
medical practitioner with an employer’s report (a
WC12 form) and a copy of his ID document. After the
consultation
the medical practitioner completes a first medical
report (WC14) wherein the clinical evaluation of the employee and a
description
of the accident is recorded. The employer then
submits both the WC12 and WC14 forms to the Commissioner
electronically via
an online portal or by hand. Upon receipt,
the claim is registered and a claim number is sent to the employer as
proof of
successful submission of a claim. Hereafter the claim is
adjudicated and either accepted or liability is denied. This
function
is carried out by the Commissioner. If the claim
is accepted, further medical expenses are then paid by the
Commissioner
in terms of the Act. Invoices for services
rendered in respect of accepted claims are “switched”
electronically
by the applicant and the respondents make bulk
payments back to the applicant or the services provider.
Allocation of payments
to specific invoices are then made upon
receipt of remittance advices which links the payments to various
individual invoices.
3.4
The parties have a long history of
interaction with each other, spanning almost a decade. Since
2013 the agreement had been
reached that qualifying claims submitted
by the applicant would be settled within 60 days. This
agreement has been confirmed
in an email from the Department’s
then Medical Payments Director, dated 9 May 2013.
3.5
Despite the above and the reasonably
straightforward system of claims submission, verification,
adjudication, processing and payments,
the applicant had had to
resort to this court on numerous occasions in order to enforce
payment of claims which were mal-administered,
delayed or simply not
paid. Examples of this were described in the founding affidavit
as being litigation instituted
under case numbers 20549/2014,
31912/2015, 25923/2016 and 36487/2017 in this Court.
[4]
Debatement of accounts
4.1
Due to the volume of claims, the number of
employers, employees, service providers and medical practitioners
involved as well as
the various steps to be verified before claims
can be processed, the debatement of accounts featured prominently in
the applicant’s
recovery efforts on behalf of its clients, both
in and out of court. This resulted in various “debatement
meetings”
with various representatives of the Respondents and
only when that didn’t bear fruit or did not finally resolve the
issues,
the applicant resorted to this Court. This is the
position with the current matter.
4.2
By the time the current matter was finally
ripe for hearing, certain verification procedures had already further
progressed matters
and a number of payments had been made. The
respondents were, however, not in a position to tell the court what
portion of
the originally claimed R 16 million remained outstanding
and in respect of which invoices the outstanding amount was.
One
must appreciate that the claims vary in both nature and extent.
Some are, for example between R20 000, 00 to R30 000,00
for
specialist procedures but some are for as little as anything under
R500,00. The schedules and spreadsheets entails literally
hundreds upon hundreds of entries. I refer to two randomly
chosen examples, one for a medical services provider and the second
for a practitioner. The particulars are supplied in columns in
the spreadsheets under the headings: Line no, Practice no,
Practice
Name, Patient Name, Claim, Batch, Batch date, Status, Service, Submit
Date, Invoice no, Date paid, Capital 60 days from
submit, Paid,
Reject, remaining Capital without interest, Remaining Capital after
interest and payments. The particulars
of the two examples are:
37, 0522066, Botes & Associates, Fourie SJ, 11027366, DDCWCC784,
20200722, ACCEPTED, 2019/07/15, 2019/09/23,
0071894, R 7614, 96,
2019/11/22, R 7614, 96, R 457,15, R 8 072, 07 and 11, 4208196,
Abdool-Carrim ATO, Mathebula, S, 11098741,
DDCWCC 785, 20200724,
ACCEPTED 2018/03/05, 2018/05/14, 0020611, R 22 588, 57,
2018/07/13, R 22 588, 57, R 3 508,
96, R 26 097, 53.
4.3
The answering affidavit did not
sufficiently clarify the debatement of the account. In particular,
where allegations were made by
the respondents that they had made
payment of hundreds of thousands of rands, the allegation of payments
were found to be only
partially correct, as a large portion thereof,
related to claims which did not form part of the current litigation.
The initially
claimed amount had been reduced, but no means
extinguished.
4.4
The matter was to come before Strydom J on
2 September 2021 as an opposed motion. On the eve of the
hearing before him, the
Respondents alleged that they were, despite
all the preceding processes outlined above, not in possession of the
invoices and supporting
documents for the balance of the applicant’s
claims. These claims had by that time been reduced to R
4 748 004,
00. The applicant agreed to re-furnish
these documents. Consequently, Strydom J postponed the matter
on 2 September
2021 and gave an order which included the following:
“
2.
The Applicant is ordered to:
2.1
Submit the invoices pertaining to
the capital amount of R 4 748 004,00 to the Respondents on
or before Wednesday 17 September
2021.
2.2
Supply all actual invoices or copies
with supporting medical reports.
3.
The respondents are ordered to consider all the invoices referred to
herein on or before
29 September 202 and:
3.1.1
furnish the Applicant with a list of
invoices which are rejected or partially rejected on or before 13
October 2021;
3.1.2
furnish against each rejection or
partially rejected invoice a detailed reason for such rejection and
if invoices are rejected by
reasons of being a “duplicate”,
furnish the Applicant with a payment remittance proving such
duplication, before 13
October 2021.
3.2.1 Pay all
undisputed invoiced amounts or reasonable in accordance with the
tariff and furnish the Applicant with a corresponding
payment
remittance before 13 October 2021;
3.2.2
To quote the line number of each invoice so addressed in accordance
with the document line numbers as it appears in “Annexure
B
updated (caselines 009-1) column 1
”
.
4.5
The applicant has complied with its
obligations in terms of the order and a nominated senior official in
the respondents’
“Medical Department” acknowledged
receipt of the required documents on 17 September 2021 on behalf of
the respondents.
4.6
The respondents, however, failed to comply
with their agreed obligations as contained in the order and further,
save for a couple
of hundred thousand Rands, failed to make payment.
This prompted the applicant to claim costs on a punitive scale by way
of a further supplementary affidavit dated 11 November 2021.
4.7
The matter was set down on my opposed
motion court roll for hearing on 23 November 2021. On 22
November 2021, the respondents
delivered an affidavit by a director
of medical claims in the Department of Labour. In the affidavit
condonation was sought
for non-compliance with the order of Strydom
J. Despite having agreed to the order and the time-frames
contained therein,
the respondents proffered a litany of reasons why
they could not comply therewith. In conclusion, the deponent to
the affidavit
stated the following” “
The
respondents in this matter merely want to furnish the court with the
spreadsheet of invoices
which is
a response to all the invoices
which have been furnished by the Applicant in compliance with the
court order …. The said spreadsheet is attached
herein
as annexure DDC2
”. (My
underlining for emphasis).
4.8
Reliant on the submission made in the
affidavit, echoed by the respondents’ counsel, that “
the
amount owed will be significantly lower and therefore the applicant
ought to reconcile the spreadsheets
”,
I allowed the matter to stand down until 14h00 or 25 November 2021.
4.9
Despite the time period afforded the
applicant to deal with this belatedly produced spreadsheet being
extremely truncated and severely
restricted and curtailed by the
respondents’ non-compliance with a court order, the applicant’s
officials, its managing
director and its legal team worked through
the night and produced a substantive response. It dealt
with a reconciliation
of the newly submitted spreadsheet, the
verification of the applicant’s system of record keeping and,
at the request of the
court, a re-verification of the amounts of
interest claimed. The summarised results were contained in an
affidavit from which
the following extracts are relevant:
“
4.
The gist of the Respondents’ Annexure DDC2 is that the
Respondents paid an amount of R 3,1 million
towards the outstanding
claims. This annexure is not remotely correct.
5.1
Which claims were/were not considered by Respondents since 2
September 2021; all the claims marked as “N/A”
(no value
is available) were not considered. I extracted the “N/A”-
claims and compiled Annexure “JUB 5
– not considered by
CF”. I also reconcile all the N/A’s with the
Applicant’s system and found that
2127 claims to the value of R
2 372 084.45 are still unpaid. The interest component
on the claims not considered
amounts to R 950 994.97.
5.2
Which claims were rejected or partially rejected by the Respondent
with detailed reasons; I attached hereto
Annexure “JUB 6 –
rejected – no reasons furnished” which amounts to 107
claims to the value of R 169 242
66. Not a single reason
is advanced for the rejections. The interest component amounts
to R 52, 917.47.
5.3
Which payments were returned to the Respondents due to payments made
to outdated or closed bank accounts.
The Applicant made the
Respondents aware of this and tried to rectify their mistake, but to
no avail. I humbly refer the
Honourable Court to “Annexure
JUB 7 – Bank Account Error – payment returned”.
The capital on this
component amounts to R 31 223.53 and the
interest thereon amounts to R 14, 787.64.
5.4
Which claims are shown in annexure “DDC2” as being paid.
The payments do not relate to the
amounts currently in dispute.
It reflects to historic payments which is irrelevant. I humbly
refer the Honourable Court
to Annexure “JUB8 – paid
historically – not part of the court order”. The
capital amounts to R 823 177.80
and the interest amounts of R
526 081.21.
5.5
Which claims were paid by the Respondents with corresponding payment
remittances and which amount is no longer
payable. I humbly
refer the Honourable Court to “Annexure JUB 9 – Common
cause payments”. On the
amounts so paid, the Respondent
paid short in the capital amount of R 144, 206.38 and the interest
thereon amounts to R 75 572.68.
6
Interest calculated on short payments and late payments
I confirm that I
included interest on outstanding amounts in the “annexure JUB
10 – interest on historic payments”
according to the
following principles:
6.1
All interest were calculated at 7% per annum in accordance with the
applicable Government Gazette;
6.2
Only simple interest was charged;
6.3
Interest was calculated from day 61 after submission of invoices in
accordance with the agreement reached
with the Respondent;
6.4
All payments were firstly allocated towards interest and lastly
towards capital;
6.5
I adhered to the in duplum principle i.e interest never exceeds the
capital amount;
6.6
The interest component is calculated on the capital amount of R
582 740.40, as well as on multiple
other accounts which were
previously long overdue;
6.7
The calculated interest amounts to R 5 013 304.22 and it
appears at the top of columns 5 (4 275 787.76),
7
(697 125.47) and 8 (40 391.00) of “Annexure JUB 10 –
interest on historic payments”. In order
to reimburse the
service providers for losses occasioned by the time value of money, I
humbly request the Honourable Court to give
judgment in favour of the
Applicant as requested
”
.
4.10
From the above and further examples in the
affidavit of how individual line items were treated in the
applicant’s spreadsheets
which were either ignored by the
respondents or in response to which only partial payments were made,
I was satisfied that the
applicant’s calculations were the
correct reflections of the status of the claims. This includes
the interest calculation
on both present and previous unpaid claims.
The respondent’s belated recalculations were wholly too
unsatisfactory
for a court to rely thereon with any reasonable
measure of certainty or probability of correctness. The
deficiencies of aforementioned
“Annexure DDC2” and the
non-compliance with the particularity required in the previous order,
resulted that no “real
or genuine” dispute had been
raised by the respondent in respect of the balance of claims.
See:
Wightman t/a JW Construction v
Headfour (Pty) Ltd
[2008] ZASCA 6
;
2008 (3) SA 371
(SCA). The lack of compliance with a court order also justified
a punitive costs order being made against the respondents.
[5]
In the premises, and after hearing further
argument on 25 November 2021, I made the order which is repeated here
for sake of completeness:
1.
The
Respondents are ordered to pay the capital amount of R 4 122 675.22
to the Applicant into the trust account of Izak
J. Croukamp Attorneys
Inc., Absa, Account no. [....], Branch Kolonnade, Cheque Account,
Ref: CD0111;
2.
The
Respondents are ordered to pay the interest amount of R 6 633 658.19
to the Applicant into the trust account of Izak J. Croukamp
Attorneys
Inc., Absa, Account no. [....], Branch Kolonnade, Cheque Account,
Ref: CD0111;
3.
The
Respondents are ordered to pay interest on the amount of R 10 756
333.41 at 7% per annum from 25 November 2021 until date of
payment;
4.
Respondents are hereby ordered to pay the cost of the application
incurred by
the Applicant since 3 September 2021 on an
attorney-and-client scale.
N
DAVIS
Judge
of the High Court
Gauteng
Division, Pretoria
Date
of Hearing: 25 November 2021
Date
of Order: 25 November 2021
Reasons
furnished: 25 May 2022
APPEARANCES:
For
Applicant:
Adv N van der Walt
Attorney
for Applicant:
Izak J.
Croukamp Attorneys, Pretoria
For
Respondents:
Adv K Mashaba
Attorneys
for Respondents: The State
Attorneys, Pretoria
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