Johannesburg - The National Consumer Commission wants
"discriminatory" rules in medical aid schemes to be declared
unconstitutional, The Sunday Independent reported.
According to the report medical aid schemes are sexist
towards pregnant women and discriminates against foreigners.
The commission has turned to the Equality Court, where it is challenging four of South Africa's top medical aids and the Council for
Medical Schemes.
The commission pointed to certain "discriminatory"
clauses that technically exclude women who fall pregnant before they join the schemes from benefiting from the medical aid.
The respondents in the case were the council, Medscheme,
which is an administrator of Bonitas and Fedhealth, Momentum Health and
Medshield. Bonitas and Fedhealth were also respondents.
Director of legal services at the commission, Oatlhotse
Thupayatlase, told the newspaper that when the Council for Medical Schemes was
asked about the clauses it said they protected the schemes from "free
riders" or people who took out medical aid schemes when they knew that
they were pregnant and wanted to benefit.
Last June, the commission asked random medical aid schemes
to submit their rules for investigation to see if they complied with the
Consumer Protection Act.
It found that each medical aid had clauses stipulating a
three-month general waiting period when someone joined and a "condition
specified" waiting period of up to 12 months.
In its court papers the commission said: "The
commission submitted to the schemes that the waiting period of three months and
exclusion of 12 months for a condition that was there within three months of
taking the cover, refers to 'pregnancy'.
"That being the case, it meant that the said clauses
are discriminatory based on gender."
Medscheme argued on behalf of Fedhealth and Bonitas that the
reason for the waiting period is to protect the scheme from people who join with the aim of undergoing an expensive procedure and then resign afterwards.