n South African Law Journal - 'Can I have two medical aids at the same time? No, because the government says so' : shedding some light on the prohibition of concurrent membership of more than one medical scheme
|Article Title||'Can I have two medical aids at the same time? No, because the government says so' : shedding some light on the prohibition of concurrent membership of more than one medical scheme|
|© Publisher:||Juta Law Publishing|
|Journal||South African Law Journal|
|Affiliations||1 University of the Western Cape|
|Publication Date||Jan 2012|
|Pages||478 - 503|
In the insurance industry, an insured may have as many health or accident and health policies as is deemed fit to provide full indemnity. Double insurance in this manner is permissible due to the principle of indemnity, whereby an insured is only indemnified to the extent of his or her insurable interest which represents the amount of the loss suffered. In addition, the principle of contribution operates by requiring an insurer to pay only its rateable portion of the loss suffered by the insured. The principles of indemnity and contribution prevent the insured from fraudulently generating a profit from being doubly insured. Section 28 of the Medical Schemes Act 131 of 1998 prohibits a person from being a member of more than one medical scheme at the same time, even though there may be good reasons for this, which may range from necessity to convenience. The nature and form of medical insurance is considered in an attempt to uncover the reason for the prohibition. This article endeavours to show that medical insurance as provided by a medical scheme is sufficiently akin to a health or accident and health policy, as provided by a long or short term insurer, to allow for comparison and to permit concurrent membership of more than one medical scheme. In conclusion, no clear reason for the prohibition in s 28 can be found and possible policy considerations are doubtful at best.
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