SWAZI MED ADAMANT THAT DR LUKOJI REMAINS SUSPENDED
FOLLOWING an urgent application filed by Manzini based private medical practitioner Dr Tshibungu Jean Lukoji against his suspension as direct payee at Swazi Med, the latter insists that the doctor is still suspended.
Last week, High Court Judge Sipho Nkosi advised both parties to have a meeting where they would discuss a proposal offered by Swazi Med.
The Medical Aid Scheme had proposed that Dr Lukoji could provide service to its members, but payment could not be made to him directly, instead the members would in turn file claims for same.
However, when both parties appeared in court on Wednesday, it transpired that they had not reached a consensus as Swazi Med, through its lawyers senior attorney Mangaliso Magagula and Nolwazi Kunene from Magagula/ Hlophe Attorneys, insisted that the doctor remained suspended.
They submitted that there has been a long standing rule within the scheme which is used in working with service providers and such entails its members being treated by doctors of their own choice and later lodge claims with the scheme personally as members.
They stated that Swazi Med bent backwards for members and owed its existence to them since it was not a profit driven scheme, and even when it makes profits, same are ploughed back to the fund and could not act contrary to the interest of its members.
They submitted that Swazi Med took the decision to suspend Dr Lukoji to protect its members and the scheme, and has no intention whatsoever to cause harm as indicated that the rules allow that members could make a direct claim without having to pay cash.
In any event, according to Swazi Med, a service provider was not paid cash when rendering service to Swazi Med members but submits a bill payable at the end of the month.
They argued that it is in the best interest of the members of the scheme to have their monies protected and as managers of the scheme, Swazi Med could not allow a situation where the alleged fraudulent claims occur.
Seeing that both parties were not in agreement, Judge Nkosi allowed them to again meet outside Court D and find a lasting solution that would be in the interest of both the members and the doctor.
However, when they returned to court, lawyer Magagula submitted that Dr Lukoji remained suspended.
He said from what they discussed with the other party, it was evident that Dr Lukoji still wants to be a direct payee, a thing which Swazi Med could not allow.
Lawyer Jose Rodrigues for Dr Lukoji then submitted that they were not in agreement with Swazi Med and applied that the matter be postponed to a later date for full-blown arguments in the application filed by Dr Lukoji.
Dr Lukoji had submitted that he now fears that his private practice might shut down following his suspension. This, he said, might result to his children who are in university being forced to drop out due to financial constrains, following his continued suspension.
Swazi Med has proposed that same should apply with Dr Lukoji and its members as there is nothing preventing him from providing service to its members, save for the fact that he would no longer be a direct payee as it was the case before. The previous status quo would allow Dr Lukoji to provide service to Swazi Med’s members and directly file claims in respect of the treatment administered.
SUSPENDED: Dr Tshibungu Jean Lukoji.