Case Law[2025] ZAWCHC 110South Africa
Moss v Road Accident Fund (18326/2019) [2025] ZAWCHC 110 (17 March 2025)
High Court of South Africa (Western Cape Division)
17 March 2025
Judgment
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# South Africa: Western Cape High Court, Cape Town
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## Moss v Road Accident Fund (18326/2019) [2025] ZAWCHC 110 (17 March 2025)
Moss v Road Accident Fund (18326/2019) [2025] ZAWCHC 110 (17 March 2025)
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sino date 17 March 2025
SAFLII
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Certain
personal/private details of parties or witnesses have been
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IN
THE HIGH COURT OF SOUTH AFRICA
(WESTERN
CAPE DIVISION, CAPE TOWN)
Case
Number: 18326/2019
In
the matter between
JOHN
MOSS
PLAINTIFF
and
ROAD
ACCIDENT FUND
DEFENDANT
JUDGMENT
Date
of hearing: 12 March 2025
Date
of judgment: 17 March 2025
BHOOPCHAND
AJ:
1.
The Plaintiff, a 77-year-old male, was involved in an accident
on 28
September 2017. He lodged a claim against the Defendant, the
statutory body established under the Road Accident Fund Act,
56 of
1996 (‘the RAF Act’), to pay compensation for loss or
damages wrongfully caused by driving motor vehicles. The
Plaintiff
was cycling when he was struck by a car.
2.
The
Plaintiff sustained a vertebral artery dissection and cerebellar
infarction, which manifested later, but was attributed to the
accident.
[1]
There was no
diffuse or focal brain injury in the immediate aftermath of the
accident. Sequelae from the vertebral artery dissection
have settled.
The Plaintiff has experienced mild post-traumatic stress disorder.
The Plaintiff also sustained fractures to his
right outer clavicle
and right fourth rib and abrasions to the thigh, knee, and ankle. The
parties agreed that the claim for general
damages should be settled
at R650 000. The Defendant has agreed to provide the Plaintiff
with a section 17(4)(a) undertaking
to cover future medical and
related expenses. The Defendant’s attorney, however, did not
have instructions to settle the
claim piecemeal.
3.
The only outstanding head of damages that could not be resolved
was
that of past medical expenses. The Plaintiff claimed R34 286.59.
He paid R4 173.80 of this amount directly to the
service
providers, and his medical aid settled the balance of R30 112.79.
The Plaintiff provided the necessary vouchers to
support these
expenses. Defendant belatedly indicated its intention to oppose at
least a part of Plaintiff’s claim under
this head of damages.
The Defendant allegedly issued a notice of intention to amend
its plea and indicated that it would
seek a postponement of the
matter at the hearing scheduled to commence on 12 March 2025. None of
those papers were filed or placed
before the Court, not that the
Court would have allowed them at this late stage of the proceedings.
4.
The
Defendant has recently taken to challenging claims for past medical
expenses made by claimants who are members of medical schemes.
[2]
The Defendant issued a directive on 12 August 2022 instructing its
employees to reject past medical expenses presented by claimants
whose medical aid schemes had already paid for them. The basis for
the directive was that this group of claimants suffered no loss,
and
the Defendant was not statutorily obliged to refund them. The
Defendant issued a second directive on 13 April 2023 to
exclude
refunds for prescribed minimum benefits and emergency medical
conditions. The third directive issued on 2 November 2023
sought to
enforce the Defendant’s interpretation of section 19(d)(i) of
the RAF Act relating to third-party payments.
5.
It suffices to say that these directives raise numerous issues
of
common and statutory law, champertous transactions, subrogation,
insurance and medical schemes law. The Court has no intention
to deal
with them further, except to say that the Defendant’s attempt
to introduce them in such a haphazard manner is not
only
ill-conceived but also deserves deprecation. The defendant’s
attorney denied that the relatively small amount claimed
for past
medical expenses justified the costs-to-compensation ratio involved
in this matter. The Defendant’s stance meant
that the
77-year-old Plaintiff would have had to await settlement of his claim
whilst the Defendant exhausted litigation challenging
past medical
expenses already paid by medical aid schemes. Defendant had not
conceptualised a defence nor prepared to raise these
defences in this
matter timeously.
6.
The Defendant has drastically reduced its reliance on Counsel
to
defend its cases, choosing to overburden a select number of attorneys
employed in the offices of the State Attorney to shoulder
its
litigation obligations in this division. Previously disadvantaged
Counsel who relied upon this source of work are no longer
briefed,
and the goals of transformation of the profession suffer.
Ill-prepared attorneys often scurry between courts, appearing
in more
than one case per day. The Court is not directing any criticism
towards them, for they are overburdened with the Defendant’s
work. The Defendant has little consideration for the inconvenience
this causes to the Court and the prejudice its multipronged
attack on
settling claims has for claimants who must endure further delays as
they await finalisation of their matters.
7.
The
Defendant opposed the admission of the Plaintiff’s affidavit
submitted under Rule 38(2) instead of the Plaintiff testifying.
No
cogent reason was provided for the opposition to the admission of
Plaintiff’s affidavit, especially on whether Defendant
intended
to cross-examine Plaintiff on its content. As Plaintiff was present,
the Court heard his testimony on the narrow issue
of past medical
expenses. He confirmed the value of the vouchers contained in the
bundle of documents and that they concerned expenses
directly related
to his accident injuries and their sequelae. The futility of
Defendant’s stance was that Plaintiff was not
cross-examined at
all. The Defendant was less prepared to raise any defence against the
claim for past medical expenses than it
was in the
Van
Tonder
matter heard in this division.
[3]
8.
The Court has no reason to deny any part of the Plaintiff’s
claim for past medical expenses. Costs are within the Court’s
prerogative and shall be reflected in the following order.
There is
no reason for awarding an adverse costs order in this matter as it
proceeded to a hearing as scheduled, and the Applicant
did not have
to deal with the belated defence to his claim. The Court has not
endorsed all aspects of the draft order submitted
by the Plaintiff.
ORDER
1.
The Defendant shall pay to the Plaintiff’s attorneys the sum of
R684 286.59
(six hundred and eighty-four thousand two hundred
and eighty six rand and fifty nine cents only) (“the capital”),
by
way of an electronic transfer into the attorneys Trust Account,
within 180 days of this order, the details whereof are set out below.
2.
Interest on the capital shall operate from fourteen days of this
order to the
payment date. The Plaintiff shall not issue a writ
of execution against the Defendant before the expiry of 180 days of
this
order. The Plaintiff shall be entitled to the costs attendant
upon obtaining payment of the capital.
3.
Defendant shall provide an undertaking in terms of Section 17(4)(a)
of the Road
Accident Fund Act 56 of 1996 (“the undertaking”),
to compensate the Plaintiff for 100% of the costs relating to the
future accommodation of the Plaintiff in a hospital or nursing home
or treatment of or rendering of a service or supplying of goods
to
the Plaintiff after the costs have been incurred and on proof thereof
and arising from the motor vehicle collision which occurred
on 28
September 2017.
4.
The Defendant shall pay the Plaintiff’s party and party
costs. The Defendant shall pay Counsel’s taxed or agreed fees
on Scale B.
5.
The Defendant shall pay the costs of the Plaintiff-appointed expert
witnesses
reflected below within 180 days of being taxed or agreed
upon. The costs shall include the expert’s qualifying expenses,
reservation fees and all costs attached to the procurement of
medico-legal reports, including addendum reports where relevant, as
well as x-rays and any other related costs. The latter costs shall
also include attendance at Plaintiff’s and Defendant’s
medico-legal examinations.
5.1
The experts are:
5.1.1
Dr Rael Jaffe (Orthopaedic Surgeon);
5.1.2
Dr P Mukheiber (Kingsbury Radiology);
5.1.3
Dr Zayne Domingo (Neurosurgeon);
5.1.4
Dr Rosa Bredenkamp (Counselling Psychologist).
6.
If costs are not agreed upon, Plaintiff shall serve the Notice
of
Taxation on Defendant’s attorney of record.
7.
It is recorded that there is a valid Contingency Fees Agreement
in
place herein between the Plaintiff and DSC Attorneys, and there has
been full compliance with all relevant provisions of the
Contingency
Fees Act 66 of 1997
.
8.
The Plaintiff’s attorneys’ trust banking account details
are as follows:
Name of account
holder:
DSC Attorneys
Name of
Bank:
First National Bank
Branch:
Greenpoint
Account
number:
6[…]
Branch
code
210651
Bhoopchand AJ
Judgment was handed down
and delivered to the parties by e-mail on 17 March 2025
Plaintiff’s
Counsel: I
Ferreira
Instructed by: DSC
Attorneys
Defendant’s
Attorney: G Cerfontyne
Instructed by the State
Attorney
[1]
The vertebral artery supplies
blood to the brain and spinal cord. It runs along the
posterior
aspect of the neck. The cerebellum is the part of the brain that
controls balance, coordination, and movement. A dissection
of an
artery occurs when an inner layer tears and can occur in trauma,
among other causes. An infarction occurs when tissues
suffer a lack
of blood supply.
[2]
See e.g., Machi v Road Accident
Fund (2020-12687) [2025] ZAGPJHC 78 (3 February 2025),
Discovery
Health (Pty) Limited v Road Accident Fund and Another (2022/016179)
[2022] ZAGPPHC 768 (26 October 2022), Discovery
Health (Pty)
Ltd v Road Accident Fund and Another (2023/117206) [2024] ZAGPPHC
1303 (17 December 2024), Van Tonder v Road Accident
Fund (1736/2020;
9773/2021)
[2023] ZAWCHC 305
(1 December 2023) (‘Van tonder’)
[3]
Van Tonder supra
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