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Medical Schemes Act, 1998 (Act No. 131 of 1998)

Chapter 9 : Powers of Registrar

44. Inspections and reports

 

(1) A medical scheme shall, at the written request of the Registrar, or during an inspection of the affairs of a medical scheme, by the Registrar or such other person authorised by him or her, produce at any place where it carries on business, its books, documents and annual financial statements in order to enable the Registrar or such other person authorised by him or her to obtain any information relating to the medical scheme required in connection with the administration of this Act.

 

(2) The Registrar, or such other person authorised by him or her, shall in addition to the powers and duties conferred or imposed upon him or her by this Act, have all the powers and duties conferred or imposed upon an inspector appointed under section 2 of the Inspection of Financial Institutions Act, 1984 (Act No. 38 of 1984), as if he or she has been appointed an inspector under that Act.

 

(3) Any reference in this Act to an inspection made under this section shall also be construed as a reference to an inspection made under the Inspection of Financial Institutions Act, 1984.

 

(4) The Registrar may order an inspection in terms of this section —
(a) if he or she is of the opinion that such an inspection will provide evidence of any irregularity or of non-compliance with the Act by any person, or
(b) for purposes of routine monitoring of compliance with this Act by a medical scheme or any other person.

 

(5) The Registrar may, at any time by notice in writing, direct a medical scheme to furnish to him or her within a period specified in that notice, or within such further period as the Registrar may allow—
(a) a statement of its assets and liabilities, including contingent liabilities; and
(b) any other document or information specified in the notice, relating to the financial or other affairs of the medical scheme over a period likewise specified.

 

(6) The Registrar may direct that any statement furnished to him or her under subsection (4), or any document so furnished and which relates to the financial affairs of that medical scheme, shall be accompanied by a report thereon by the auditor of the medical scheme, and in which the auditor shall state—
(a) in what manner and to what extent he or she has satisfied himself or herself as to the amount of the liabilities and contingent liabilities shown in the statement;
(b) in what manner and to what extent he or she has satisfied himself or herself as to the existence of the assets shown in the statement;
(c) to what extent he or she has satisfied himself or herself that the particulars of such assets which are shown in the statement are correct;
(d) whether or not, in his or her opinion, the basis of valuation of each of the various kinds of assets adopted by the medical scheme is financially sound;
(e) whether or not, in his or her opinion, the medical scheme is in a sound financial condition;
(f) if he or she is of the opinion that the medical scheme is not in a sound financial condition—
(i) in what respects the condition of the medical scheme is in his or her opinion unsound; and
(ii) what the causes or probable causes are of such unsound condition;
(g) such other particulars as he or she deems relevant for the purposes of this Act; and
(h) such other particulars as the Registrar may deem necessary.

 

(7) The Registrar may, if he or she, on account of any statement, document or information furnished to him or her by virtue of subsection (4), deems it necessary in the interest of the members of the medical scheme concerned, and, after consultation with the Financial Services Board established by section 2 of the Financial Services Board Act, 1990 (Act No. 97 of 1990), by notice in writing direct the medical scheme to furnish to him or her a report compiled by an actuary, in the form and relating to the matters specified by the Registrar in the notice.

 

(8) The Registrar may, on the authority and in accordance with the instructions and directions of the Council, from time to time place any restriction on the administration costs of a medical scheme in respect of any financial year, and may for this purpose prescribe the basis on which such costs shall be calculated.

 

(9) The Registrar may, if he or she is, on account of an inspection or investigation in terms of this Act or on account of any report, document, statement or information furnished to him or her under this section, of the opinion that a medical scheme is or may be rendered not financially sound—
(a) by notice in writing direct the medical scheme to take such steps as may be specified in the notice which are, in the opinion of the Registrar, necessary—
(i) to ensure the financial soundness of the medical scheme; or
(ii) in the interests of the members of the medical scheme;
(b) at any time demand from the medical scheme such financial guarantees and guarantee deposits as will in the opinion of the Registrar ensure the financial stability of the medical scheme; and
(c) subject to the provisions of this Act, take such other steps as may in his or her opinion be necessary to ensure the financial soundness of the medical scheme.

 

(10) The Registrar may, for the purposes of paragraph (a) of subsection (8), by notice in writing direct the medical scheme concerned—
(a) to amend, within a period specified in the notice, the rules of the medical scheme in the manner indicated in the notice; or
(b) to conduct, within a period or for a period specified in the notice, the business of the medical scheme in a manner determined by the Registrar and specified in the notice.

 

(11) The Registrar may, if a medical scheme fails to amend its rules as directed by the Registrar under subsection (9)(a) within the period specified in the notice concerned. amend such rules, and such amendment shall be deemed to be an amendment within the meaning of section 31.