no respite for 10 000
Over 10000 members of liquidated Renaissance Medical Aid Scheme will have to wait until the end of April to find out what happened to their money.
Rob du Toit, director of Quantum Underwriting Advisors in Port Elizabeth and a former member of Renaissance, says he suspects foul play in the downfall of the medical aid scheme that racked up R60million in debt.
The Medical Schemes Act requires a minimum solvency ratio of 25percent to be maintained by all medical schemes.
Last year Renaissance slipped to 18percent cash compared to gross annual contributions, a clear sign of trouble.
According to Du Toit, the Council for Medical Schemes (CMS) allowed the scheme to run under curatorship illegally jeopardising members' policies and draining funds.
"No one is above the law," Du Toit said. "They did it because someone probably told them they could recover their debts by raising customer premiums.
"Doctors, hospitals and specialists stopped giving service to clients of the medical scheme and many of them left to take up policies with other schemes.
"They (Renaissance) didn't settle any of the outstanding claims from the people who left, rather using the remaining money for some of the claims of the people who chose to stay," he said.
Three months after the curator was appointed, the CMS found that Renaissance could not be sustained and ordered it to be liquidated. By then only around 4000 members remained out of 10000, most still with outstanding medical claims.
Patrick Matshidze, the medical schemes ombudsman, said there was no foul play and that the scheme was allowed to run even though it had dipped below the 25percent mark because of certain signs of promise in the business.
"There are many factors that affect insolvency and we couldn't be so dogmatic as to close each scheme based on one criteria.
"We feel it was a wise decision at the time to place it under curatorship, but we saw that the debt was more significant than before and we decided to close it down," Matshidze said.
He also said there were no corrupt practices by the CMS, adding: "If Mr Du Toit has any evidence he must bring it to the attention of the liquidator and the police."