Doctor loses R7m payback appeal bid

Retired Mthatha surgeon Professor Lizo Mazwai has failed in his Grahamstown High Court application for leave to appeal against a judgment ordering him to pay back over R7-million which a medical aid mistakenly paid into his account.

Mazwai, who is also a former long-serving dean of Walter Sisulu University medical school, has fought tooth and nail against paying back the money to Metropolitan Health. Instead, Mazwai blew the bulk of the money as he said he had believed it to be a legitimate pension payout.

He will now have to pay back Metropolitan Health some R7.08-million plus interest of 9.5% backdated to January last year.

He had spent all but R2.5-million on “investments” and paying off debts.

Mazwai fought Metropolitan Health’s claim largely on a technicality. He questioned why he should pay back Metropolitan when it had technically been the Government Employees Medical Scheme (Gems) that had mistakenly put the money in his account.

According to court papers, the error had come about when Mazwai’s account administrators, Medical EDI Services – which assists doctors to submit claims to medical aids – filled in an incorrect amount in what was termed the software’s “multiplier column”.

So instead of claiming for one operation at a cost of R2800, it had claimed for 2469 operations at that price. The result was a hefty bill of over R7-million being submitted to Metropolitan Health which administers claims on behalf of Gems.

Metropolitan Health’s computer software had not picked up what Mazwai termed the “glaring” anomaly and had approved the payment. Gems had duly paid Mazwai.

Metropolitan Health had paid back Gems in an apparent acknowledgement that it should have picked up the error. In turn, Gems had ceded the claim against Mazwai to Metropolitan Health. Mazwai questioned the legitimacy of the cession.

But acting judge Nicola Redpath-Molony rejected his argument, and said he had provided no evidence that the cession was not above board.

She also dismissed Mazwai’s claim that the money must have been put into his account as part of a money-laundering scheme.

She dismissed his application for leave to appeal with costs.

Mazwai was ordered to pay both the legal costs incurred in the original claim and in his application for leave to appeal.

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