Check mate: Medical scheme’s decision-making and the rights of the member
09 December 2015
Membership of a medical scheme is, more often than not, a relatively painless exercise and one that provides great benefits to members throughout the year. However, in certain cases, decision making by a medical scheme in respect of the accessibility of benefits by certain members may not prove advantageous or beneficial to members especially where that decision making process ends up in a medical scheme refusing to provide benefits to a member particularly members suffering with chronic conditions such as various forms and types of cancer.