Bobroff uncovers apparent hidden clauses in dramatic fashion

One of the most anticipated comebacks in history was the return of Mohammad Ali after his forced hiatus from boxing. While many thought he was washed out and finished, the former heavyweight champion of the world flexed his muscles and defeated George Foreman in Kinshasa to regain the world heavyweight title.

Many people felt the same about Ronald Bobroff, Director of Ronald Bobroff and Partners (RBP), after he was effectively silenced by the Constitutional Court earlier in the year after he was found guilty of overcharging clients when he handled their claims against the Road Accident Fund (RAF). It seems as if Bobroff was knocked down, but he was most certainly not knocked out.

Bobroff’s allegations

One of the features of Bobroff’s original battle in court was that Discovery Health bankrolled the legal fees of two of its clients who were apparent victims of Bobroff’s excessive legal fees. This sparked a war of attrition between Bobroff and Discovery Health.

In what can only be described as a sensational twist to the saga, Bobroff has made some serious allegations against Discovery Health on his website.

One of the most serious of these allegations is the practice of Discovery Health which potentially puts its clients in an impossible position. First of all, Bobroff alleges that there is a hidden clause in Discovery Health’s cover which states that the only medical care that a person is unconditionally entitled to arises from sickness. Bobroff points out that any care arising from incidents such as, but not limited to, road accidents, workplace injuries, dog bites and assaults are excluded.

If you are in hospital faced with medical care for an incident which Bobroff claims is excluded, you are then allegedly visited by a representative of Discovery Health’s medical team who forces you to sign a document saying that you have to refund the cost of care already provided to you or your dependants. Additionally, you have to claim from the wrongdoer at your own risk and cost and then reimburse Discovery Health in full for any medical costs paid by it. Bobroff then continues to say that if you do not do this, Discovery Health apparently terminates medical care.

Backing up these allegations

After the original saga between Bobroff and Discovery Health, which Bobroff lost, it would be safe to say that Bobroff may have had a significant personal axe to grind with Discovery Health, and that he is now using his company’s website as the whetstone. It is one thing to make bold statements, but these statements need to be backed up.

Ronald Bobroff and Partners client Mark Bellon sustained a serious brain injury in a road accident in 2006, and while he was in a coma, his wife Jody, pregnant with their fourth child, found herself confronted with a demand by Discovery Health that she immediately sign the company’s undertaking document.

Bobroff adds that while Mark was on a ventilator in intensive care fighting for his life, Jody was allegedly threatened that unless she signed Discovery Health’s undertaking document, Discovery Health would allegedly immediately terminate Mark’s medical care and reclaim the cost of medical care already rendered to him.

A year after Mark’s accident, Discovery Health apparently approached him directly, and Bobroff says that they again threatened to terminate medical care and to reclaim the cost of care already rendered if he did not sign Discovery Health’s undertaking document. At the time, Mark was suffering from the aftermath of the brain injury and was facing an uncertain future. He was in no position to pay Discovery Health almost R900 000. Bobroff claims that Mark was therefore given no choice but to give into Discovery Health’s apparent blackmail.

The information gathered from Bobroff’s website points out that Mark and Jody both had previously been employed by Discovery Health. Mark was a Senior Accountant and Jody was in Customer Relations. Neither of them had ever been informed that the only medical care they or their children were entitled to as of right, was that arising out of illness.

Discovery Health’s assurance and response

With no immediate response from Discovery Health at the time of making the allegations, any Discovery Health policyholder who had access to Bobroff’s website would have been deeply distressed and angered at the information provided by Bobroff.

Discovery Health did then respond to the allegations saying that the company does not differentiate between medical claims resulting from a motor vehicle accident and claims resulting from any other accident or illness. Discovery Health always pays for the treatment of any member or dependant injured in a motor vehicle accident in accordance with the member’s specific plan type, no questions asked.

If a member or a dependant subsequently becomes entitled to any benefit from the RAF, the member or the dependant may submit a claim to the RAF for the compensation and reimbursement of related medical expenses. Discovery Health does not force members to claim from the RAF.

If a member or dependant receives compensation from the RAF for medical expenses, the member must then refund those amounts previously paid by Discovery Health for the member’s medical expenses. This is to avoid the member being unjustly enriched at the expense of Discovery Health by receiving double compensation for the same health event. If a member does not receive compensation from the RAF, Discovery Health bears all the costs.

Editor’s Thoughts:
As with all cases, there is always two sides to the story. Bobroff is saying one thing, and Discovery Health is saying something completely different. One thing is for certain, the need for clarity in the industry is more pertinent now than it has ever been. Every single aspect of the cover a policyholder is taking out needs to be explained in detail so that the policyholder knows what he or she is agreeing to, there should be no hidden surprises. As for who is right between Bobroff and Discovery Health, only time will tell. Please comment below, interact with us on Twitter at @fanews_online or email me your thoughts [email protected].

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