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Legal Ruling on MVA Fund Dispute

This document summarizes a court case between Taswald July (plaintiff) and the Motor Vehicle Accidents Fund (defendant). The plaintiff claimed the defendant failed to fulfill obligations from a settlement agreement resulting from a 2005 car accident. The defendant filed exceptions to the plaintiff's pleadings. The court dismissed the exceptions, finding the plaintiff's allegations disclosed a potential cause of action. The court also clarified the MVA Fund Act allows the Fund to make payments directly to claimants or to service providers on their behalf.

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0% found this document useful (0 votes)
262 views17 pages

Legal Ruling on MVA Fund Dispute

This document summarizes a court case between Taswald July (plaintiff) and the Motor Vehicle Accidents Fund (defendant). The plaintiff claimed the defendant failed to fulfill obligations from a settlement agreement resulting from a 2005 car accident. The defendant filed exceptions to the plaintiff's pleadings. The court dismissed the exceptions, finding the plaintiff's allegations disclosed a potential cause of action. The court also clarified the MVA Fund Act allows the Fund to make payments directly to claimants or to service providers on their behalf.

Uploaded by

André Le Roux
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 17

SUMMARY REPORTABLE

CASE NO.: I 3417/2007

IN THE HIGH COURT OF NAMIBIA

In the matter between:

TASWALD THEO JULY PLAINTIFF

and

MOTOR VEHICLE ACCIDENTS FUND DEFENDANT

PARKER J

2009 November 25

_______________________________________________________________________

Practice - Pleadings – Exceptions to plaintiff‟s pleadings –

Court finding that the fact that the plaintiff

bases his claim on his interpretation of s. 10 (5)

(a) of the Motor Vehicle Accident Fund Act, 2001

(Act No. 4 of 2001) that is different from the

defendant‟s interpretation cannot render the

plaintiff‟s claim excipiable – The Court finding

further that the test to be applied is always

whether the facts pleaded disclose a cause of


2

action – In instant case the Court finding that

the plaintiff‟s allegations that in breach of the

settlement agreement between the parties the

defendant did not make an undertaking to the

service provider and the defendant failed or

refused to make payment timeously to the

service provider resulting in the plaintiff being

obliged to make payment to the service provider

disclose a cause of action – Court finding

furthermore that whether the plaintiff will

succeed in proving the allegations in the trial in

due course should not be part of the

consideration of the exception – Court holding

that the exceptions were not well founded –

Consequently, the Court dismissing exceptions

with costs.

Statute - Section 10 (5) (a) of the MVA Fund Act (Act No. 4

of 2001) – Court finding that in terms of

subsection 5 (a), read with subsection 7, of s. 10

of Act No. 4 of 2001 the MVA Fund is not

restricted only to making undertakings on behalf

of a patient (claimant) to a service provider and

making payment to such service provider but the


3

MVA fund may also make payment directly to a

patient for certain costs and claims.

Held, that exception is restricted to matters of law, and facts alleged are
taken as admitted.

Held, further that a defendant who takes an exception should satisfy the
Court that on all reasonable constructions of the plaintiff‟s
particulars of claim no cause of action is or can be disclosed.

Held, further, that in terms of subsection 5 (a), read with subsection (7),
of Act No. 4 of 2001, the MVA Fund may make an undertaking to a
service provider on behalf of a claimant to which it makes payment
for certain services rendered or certain goods supplied or the Fund
may make advance payments directly to the claimant in respect of
medical costs, loss of income or loss of support.
4

REPORTABLE

CASE NO.: I 3417/2007

IN THE HIGH COURT OF NAMIBIA

In the matter between:

TASWALD THEO JULY PLAINTIFF

and

MOTR VEHICLE ACCIDENT FUND DEFENDANT

CORAM: PARKER J

Heard on: 2009 November 2

Delivered on: 2009 November 25

______________________________________________________________________

JUDGMENT:

PARKER, J.:

[1] The plaintiff instituted action against the defendant by combined

summons on 7 November 2007. In his particulars of claim, the plaintiff

states that in March 2005 the plaintiff was involved in a motor vehicle

accident in which he sustained bodily injuries, and the defendant

accepted liability for the plaintiff‟s damages in terms of s. 10 of the Motor

Vehicle Accidents Fund Act, 2001 (Act No. 4 of 2001) („the MVA Fund

Act‟).
5

[2] Pursuant to the defendant‟s acceptance of liability, as aforesaid,

the plaintiff and the defendant entered into a Settlement Agreement. The

parts of the agreement that are relevant for my present purpose are:

(1) Clause 2 – „Cash payment‟: Under this item the parties


agreed that upon the conclusion of this written agreement
the MVA Fund of Namibia („the Fund‟) would make certain
cash payments in the form of a cheque payment to the
plaintiff. The total amount payable is N$301,621.75.

(2) Clause 3 – „Undertakings‟: Under this item the parties have


agreed that upon conclusion of this written agreement, the
Fund will be liable in respect of the following Undertakings,
which are furnished in terms of Section 10 (5) (a) of the
MVA Fund Act.

a. Future medical expenses


The fund undertakes to pay for the cost of
future medical treatment of the victim (i.e. the
plaintiff), including future accommodation in
hospital or nursing home, the rendering of
services and the supplying of goods in respect
of the treatment as recommended in Medico-
Legal Reports (whatever that means), prepared
by the following person(s):

Dr. Steytler – treatment required is for


total knee replacement and (the)
accident related injuries to a value (of)
N$200,000.00.
6

[3] Under Clause (3) of the agreement under the heading

„Undertakings‟ the only item appearing under this heading is „a. Future

medical expenses‟. This Clause is so inelegantly drafted that the

confusion is created that apart from (a), there are other items to follow,

e.g. (b), (c), (d), etc; but the only item appearing under the heading of

Clause 3, as I have said, carries the letter (a) – a single item. I am,

therefore, entitled to take it that only one undertaking was made by the

defendant and agreed by the plaintiff, as has been set out above. Mr.

Ueitele‟s (the defendant‟s counsel‟s) reference in his submission to the

„first undertaking‟ is, therefore, not only wrong but woolly.

[4] Another important clause for my present purposes is Clause 6,

which provides:

Where the Fund has authorised such treatment or Hospitalization,


the Fund will be liable to pay for the costs in accordance with the
aforesaid undertaking. Where treatment or Hospitalization occurs
without prior authorization, the Fund may at its discretion pay for
such treatment or Hospitalization. If it is found that there has
been an over-payment, the Fund shall be entitled to correct the
overpayment by deductions from the next payment due, and if
necessary, from successive payments thereafter, or if that is not
possible, (by) claiming reimbursement.

[5] The other Clauses are Clauses 4, 5, 7, 8, 9, and 10. I shall refer to them
when it becomes necessary to do so.
7

[6] To return to the papers filed of record; on 16 January 2008 the

defendant excepted to the plaintiff‟s particulars of claim. The plaintiff

filed amended particulars of claim on two occasions; that is, on 24 April

2008 and lastly on 28 May 2008. This was followed on 15 July 2008 by

the plaintiff serving a notice of bar on the defendant. Thereafter, on 22

July 2008 the defendant followed with a plea together with a notice of

exception that was identical in material respects to the exception the

defendant had filed on 16 January 2008. It is this 22 July 2008 notice of

exception which I must now determine in the present proceedings. The

defendant has raised three exceptions (i.e. what the defendant

characterizes as three grounds of the defendant‟s exceptions).

[7] In his heads of argument filed on 27 October 2009 (I shall revert to

the filing of the heads in due course.), Mr. Ueitele states that he would

not pursue the second ground of the exception because, according to

him, this ground had been raised in relation to the plaintiff‟s initial

particulars of claim but the defect in relation to the second ground has

now been rectified. If follows that I must concern myself with only the

first exception (exception (1)) and the third exception (exception (3)) to the

plaintiff‟s amended particulars of claim.

[8] In Joseph Frans Kuiiri v Bulk Trade and others Case No. I 103/05

(judgment of 31 March 2006) (Unreported), I stated at p. 12, „The crisp

question to determine is essentially this: is the defendant‟s contention


8

that the plaintiff‟s pleading objected to, taken as it stands, is legally

invalid for its purpose well founded? (see Salzmann v Holmes 1914 AD

152 at 156).‟ I then proceeded at pp. 12-13 of the judgment to set out

briefly as follows what I consider to be the general principles of law on

exception:

It is a cardinal principle in dealing with exception that if evidence can be


led, which disclosed a cause of action alleged in the pleading, that
particular pleading is not excipiable. Thus, a pleading is excipiable on
the basis that no possible evidence led on the pleading can disclose a
cause of action. (See McKelvey v Cowan NO 1980 (3) SA 525 (Z) at 526 C-
F.) Besides, as Mr. Coleman, counsel for the plaintiff, submitted, an
exception is restricted to pure matters of law and facts alleged are taken
to be admitted. (Isaacs, Becks Theory and Principles of Pleading, 982: par.
62.) In other words, “[F]or the purposes of exception the facts pleaded
must be accepted as correct.” (Marney v Watson and another 1928 (4) SA
140 (C) at 144 F-G) That is so, unless the facts pleaded are plainly false
and so clearly baseless that it cannot possibly be proved. (Van Winsen, et
al., The Civil Practice of the Supreme court of South Africa (Now the High
Court and Supreme Court of South Africa), 1997: p 492, and the case there
cited)

That is the manner in which I determine the defendant‟s exceptions in

the instant case.

[9] I proceed now to determine the first exception (exception (1)) which

is framed in the following terms:


9

(1) The claim by the Plaintiff for payment to himself of a sum in


respect of medical expenses undertaken by the Defendant to be
paid in terms of section 10 (5) (a) of the Motor Vehicle Accidents
Fund Act 2001 is bad in law as the legislation only allows the
Defendant to undertake to make such a payment to the provider
for the goods supplied or the services rendered.

[10] I pass to test the basis of the defendant‟s exception (1) which is

undoubtedly based on the interpretation and application of the relevant

provisions of s. 10 of the MVA Fund Act.

[11] In my opinion, there is not even a modicum of merit in the

defendant‟s exception (1). This objection falls to be rejected for the

following reasons. First, the fact that a plaintiff puts a particular

interpretation on a statutory provision that is different from the

interpretation that the defendant puts on that statutory provision, and

the plaintiff makes a claim based on his or her interpretation of the said

provision, cannot render the plaintiff‟s claim excipiable. In this regard, I

do not see on what ground the plaintiff‟s pleading can be declared bad in

law. It has been said that exception may be taken when the defect in the

pleadings appears ex facie the pleadings. (Van Winsen, et al. supra at p.

492, and the cases there cited)

[12] In the instant case, I do not find any defect – ex facie or otherwise –

in the plaintiff‟s pleadings, as claimed by the defendant in its exception

(1). It would have been a different matter if the defendant‟s objection is


10

that there is no provision in the MVA Fund Act on which the plaintiff can

possibly base his claim, or that the plaintiff‟s claim is based on a

provision of a statute other than the MVA Fund Act. Second, s. 10 (5) (a)

of the MVA Fund Act, which Mr. Ueitele is so much enamoured with,

does not, as Mr. Dicks, counsel for the plaintiff, correctly submitted,

restrict the Fund to only one course of action in terms of the said s. 10

(5) (a) of the MVA Fund. That the defendant has more than one option

under s. 10 (5) (a) is clear from the words of the paragraph, and what is

more, the defendant does not deny that it has followed another option of

making payment in the past directly to the plaintiff, and not to the

service provider, the Roman Catholic Hospital („the Hospital‟).

[13] This conclusion, with the greatest deference, makes the

submission by Mr. Ueitele fallacious, untenable and, above all,

inconsequential; that is, the submission „that clearly, in terms of section

10 (5) (a) of the Act, the Fund can only give an undertaking to the

provider of medical services (and not to the injured person), and in terms

of any such undertaking can only make payment after the services have

been rendered obviously to the person to whom the undertaking has

been given).‟ The submission adds no weight at all; it is petitio principii.

Of course, if the defendant makes an undertaking to X Hospital, it can

only make payment to X Hospital; but that is not the issue. What is in

issue is that the plaintiff alleges that s. 10 (5) (a) does not say that the

Fund must always, no matter what the circumstances are, only make an
11

undertaking to a service provider, keeping the claimant (patient)

completely out of the equation. As I have held above, such contention is

not in accordance with the statutory provision nor the defendant‟s own

practice, at least as respects the plaintiff, as I have mentioned previously.

[14] Thus, in this regard, as I have already mentioned, s. 10 (5) (a) and

(7) are significant and apropos of the point under consideration. Section

10 provides:

(5) Where a claim for payment of compensation under subsection (1)


is made and the claim includes a claim for –
(a) costs for future accommodation in a hospital or nursing
home, future medical treatment, the provision of future
medical services or the provision in future of goods, the
Fund may give a written undertaking to the provider of
services or goods to the effect that the services or goods will
be paid for from the Fund and thereafter pay for the
provided costs of the services or goods after the services
have been rendered or the goods have been supplied; …

(7) Where necessary the Fund may, in respect of medical costs, loss of
income or loss of support, make an advance payment to a claimant.

[15] Accordingly, if s. 10 of the MVA Act is interpreted and applied in a

way as would give meaning to the intertextuality of the various provisions

of that section, particularly s. 10 (5) (a) and (7) of the Act, it seems to me

clear that the defendant‟s contention that the claimant cannot be paid

any compensation and that payment of any such amount can be paid to
12

only the service provider has, with the greatest deference, no basis in

law; that is, the MVA Act.

[16] Mr. Ueitele submitted further that as „a practical matter those in

Namibia providing medical services would rely on the undertaking from

the Fund as being in effect a guarantee that they would be paid for

medical services rendered to persons injured in motor vehicle accidents.‟

The submission is, with respect, irrelevant because it is presumptuous: it

presumes that which the plaintiff in his pleadings alleges, namely, that

the defendant did not make any undertaking to the Hospital as it should

have done in terms of the settlement agreement and further that the

defendant failed or refused to make payment timeously to the Hospital

and so therefore the plaintiff was obliged to make payment personally to

the Hospital. In the face of these allegations, the issue of undertaking

and guarantee does not arise.

[17] The aforegoing conclusions also affect the defendant‟s third

exception („exception (3)‟), which is framed in the following terms:

The claim by the plaintiff is bad in fact and discloses no sustainable


cause of action as no allegation is made that any sum is in fact due to
the Roman Catholic Hospital (the Hospital) in respect of any medical
goods supplied or medial services rendered to the Plaintiff on 17 April
2007.
13

[18] The defendant avers that in terms of the settlement agreement it

made an undertaking to the service provider being the Hospital. For this

averment the defendant relies on a letter, dated 23 January 2007, from

the defendant to the Hospital. The heading of the said letter is

„Treatment for MVA patient‟. It is not in dispute that the patient is the

plaintiff. What is in dispute is this: the plaintiff alleges that the

defendant breached a relevant provision of the settlement agreement

because the defendant did not make an undertaking to the Hospital and

did not make payment timeously to the Hospital and as a result of the

defendant having failed or neglected to pay within a reasonable time an

amount of N$101,275.51 which was there and then due to the Hospital,

the plaintiff on or about 30 May 2007 was obliged to pay the account

with the Hospital. Thus, the plaintiff alleges that in breach of the

settlement agreement the defendant did not make an undertaking to the

Hospital and did not make payment timeously to the Hospital and so the

plaintiff was obliged to make payment to the Hospital. I do not find that

the facts the plaintiff has pleaded thereanent his claim are plainly false

and so clearly baseless that they cannot possibly be proved at the trial

(Van Winsen, et al. supra at p. 493, and the case there cited).

[19] It is accordingly my view that the plaintiff has pleaded the

aforementioned facts; and the facts pleaded disclose a cause of action,

and on the authorities outlined previously, for the purposes of the

exception the facts pleaded must be accepted as correct. (Marney v


14

Watson and another supra) Whether the plaintiff can prove the

allegations is not a matter for me to decide as I determine the exceptions,

which is my present burden. (Joseph Frans Kuiiri v Bulk Trade (Pty) Ltd

and others supra at p. 19)

[20] From all the aforegoing reasoning and conclusions, I find that the

defendant has not satisfied the Court that on all reasonable

constructions of the plaintiff‟s amended pleadings „no cause of action is

or can be disclosed (Namibia Breweries Ltd v Seelenbinder, Henning &

Partners 2002 NR 155 at 159A).‟ It follows indubitably that the

exceptions taken by the defendant must fail.

[21] At the commencement of the proceedings I heard arguments

respecting Mr. Ueitele‟s Notice of Motion in which he moved the Court to

condone his late filing of his heads of argument. Mr. Dicks submitted

that the application was hopelessly late because his instructing counsel

received the Notice of Motion less than an hour before the hearing of the

application. He, therefore, urged the Court to dismiss the condonation

application with costs.

[22] In such condonation application it is trite rule of practice that the

applicant (counsel of the defendant in casu) must give an acceptable

explanation for his or her default. In these proceedings, the two main

reasons in counsel‟s affidavit are that, counsel says, he travelled to „rural


15

Namibia‟ on an „unscheduled‟ Electoral Commission business and he had

no access to email facilities, and furthermore, it was only on 20 October

2009 that he was able to „locate the Senior Counsel‟ to prepare the heads

of argument. I think these are not reasons; they are excuses, as I shall

demonstrate shortly.

[23] As far back as 23 July 2008, counsel knew what objections he had

raised against the plaintiff‟s pleadings and the grounds therefor. Counsel

does not say why he did not instruct senior counsel to draft the heads of

arguments for more than 12 months. In any case, the matter was on 6

July 2009 set down for hearing on 2 November 2009, and the defendant‟s

counsel filed his heads as late as 27 October 2009. For some 12 months

prior to 6 July 2009, when the matter was set down, counsel was certain

that the defendant‟s objections to the plaintiff‟s pleadings were alive and

on the cards, but for reasons counsel does not tell the Court, counsel

decided to wait until the first week of October 2009 to instruct the Senior

Counsel to prepare the heads of argument, and he could „only locate the

Senior Counsel on 25 October 2009‟. He or she must be a very illusive

Senior Counsel, indeed, if I may add in parentheses.

[24] Be that as it may, in all this, it is significant to note that the Notice

of Motion was not filed with the Court. It was just placed on the court

file on the Friday next preceding the date of the hearing of the matter. I

heard arguments on the exceptions and I have referred to the heads of


16

argument of both counsel, and so it would have served no useful purpose

to strike off Mr. Ueitele‟s heads, as Mr. Dicks invited me to do, but I think

this is a proper case where it is just and fair that I evoke subparagraph

(6), read with subparagraph (7), of paragraph 20 of the CPD and mulct

the defendant with costs occasioned by the hearing of the condonation

application, even though condonation application was successful.

[25] The order of the Court is that –

(1) The defendant‟s counsel‟s late filing of his heads of argument

is condoned, and further that the defendant must pay the

plaintiff‟s costs occasioned by the hearing of the defendant‟s

counsel‟s condonation application; such costs to include the costs

consequent upon the employment of instructed counsel.

(2) The defendant‟s exceptions are dismissed with costs; such

costs to include the costs consequent upon the employment of

instructed counsel.

_____________

PARKER, J
17

ON BEHALF OF THE PLAINTIFF: Adv. G Dicks

Instructed by: LorentzAngula Inc.

ON BEHALF OF THE DEFENDANT: Mr. S Ueitele

Instructed by: Ueitele & Hans

Legal Practitioners

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