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Discovery agrees to pay up

Publish date: 16 March 2006
Issue Number: 1541
Diary: Legalbrief Today
Category: In Court

Africa\'s top medical health insurer, Discovery, has agreed to pay for the potentially life-saving drug Herceptin as demanded by some South African breast cancer sufferers, a court heard yesterday, according to a report on the FIN24 site.

Discovery said it agreed to pay for the treatment in a deal struck hours before a court was due to hear a case brought against it by Lisa Metzer, lawyer for a group of women patients. Metzer sued Discovery for breach of contract, arguing that it was refusing to pay for treatment as prescribed by her clients\' doctors despite them paying their premiums regularly. Discovery last year paid for some women to undergo the one-year treatment course, but said it had to stop paying for this because it was not ‘cost-effective’. It said its other members would have had to pay higher premiums to fund it. The High Court endorsed the deal, and set a date in late May to hear the matter in full. Metzer had sought an interim order because of the urgency of starting the treatment for the women. ‘This is a case that sets a precedent that medical aids (insurers) should not try to play doctor,’ Metzer said. Full report on the FIN24 site

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