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

Chapter 10 : Complaints and Appeals

48. Appeal to Council


(1) Any person who is aggrieved by any decision relating to the settlement of a complaint or dispute may appeal against such decision to the Council.


(2) The operation of any decision which is the subject of an appeal under subsection (1) shall be suspended pending the decision of the Council on such appeal.


(3) An appeal contemplated in subsection (1) shall be in the form of an affidavit directed to the Council and shall be furnished to the Registrar not later than three months, or such further period as the Council may, for good cause shown, allow, after the date on which the decision concerned was made.


(4) The date, time and place for the hearing of an appeal shall be determined by the Council and shall, not less than 14 days before such hearing, be made known in writing by the Registrar to the parties concerned.


(5) The persons contemplated in subsection (1) may appear before the Council and tender evidence or submit a written argument or explanation to the Council in person or through a representative.


(6) The Council may for the purposes of an appeal—
(a) in writing request any person who, in its opinion, may be able to give material information concerning the subject of the appeal or who in its opinion has in his or her possession or custody or under his or her control any document which has any bearing upon the subject of the appeal, to appear before it at a time and place specified in the written request, to be examined or to produce that document, and may retain for examination any document so produced;
(b) administer an oath to or accept an affirmation from any person called as a witness at the appeal; and
(c) call any person present at the hearing of the appeal as a witness and examine him or her and require him or her to produce any document in his or her possession or custody or under his or her control.


(7) The procedure at the hearing of an appeal shall be determined by the Council.


(8) The Council may after hearing the appeal confirm or vary the decision concerned, or rescind it and give such other decision as it may deem just.


(9) The decision of the Council shall be in writing and a copy thereof shall be furnished to the persons contemplated in subsection (1).