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Two Gweru-based eye specialists are suing Premier Service Medical Aid Society (PSMAS) for more than $460 000 after the health insurer failed to settle claims made by its members.

NV Patel Optical Company (Pvt) Ltd and Dr Narendrakumar Somabhai Patel this week filed summons at the Bulawayo High Court citing PSMAS as the defendant.

NV Patel Optical Company is demanding $250 635 from PSMAS, while Dr Patel is suing the medical aid society for $214 118,55.

The money is for medical services rendered to PSMAS members up to February 20 2015.

According to the summons filed by the two medical health providers through their lawyers Chitere Chidawanyika and Partners, PSMAS has continuously neglected to settle its debt despite demand.

“The plaintiffs claim against defendant for payment of the sums of $214 118,55 and $250 635 being the total amounts due in respect of medical services rendered to defendant’s members and at defendant’s special instance and request for a period extending to February 20 2015,” said the ophthalmologists’ lawyers.

The lawyers said despite admitting owing the two health service providers, PSMAS has failed to settle the debt.

According to the court papers, the two medical firms are demanding that PSMAS pay an interest of five percent calculated from February 20 2015 to the date of full and final payment and the cost of suit at attorney-client scale.

PSMAS has not yet filed a notice to enter an appearance to defend the summons.

PSMAS early this month instructed medical service providers to demand cash upfront from its members intending to receive treatment, saying the move was aimed at preventing its debt to health service providers from ballooning and to avoid further litigation.

More than 30 health service providers have been instructed not to accept the society’s medical aid packages and members who seek their services will have to apply for reimbursement from the society’s offices.

PSMAS’s problems have been largely blamed on the mega salaries which were being awarded to ousted chief executive Cuthbert Dube and his executives.

Dube was taking home more than $500 000 in salary and allowances each month, at a time the medical aid society was failing to pay the health service providers and was accumulating the debt.

The medical aid society said stopping the service providers from treating patients on its medical aid was part of its strategy to avoid further litigation at a time it was facing liquidity challenges.

PSMAS is facing about $8 million in litigation since December last year.

The medical aid society is being sued by a number of service providers for defaulting on settling claims.

Health service providers have since December last year been filing their applications at the High Court separately.

Patients have complained that PSMAS health institutions are always congested and it takes days for one to be admitted.

The majority of the society’s clients are civil servants.

Finance and Economic Development Minister Patrick Chinamasa recently said the liquidity challenges facing the country resulted in Treasury failing to remit members’ subscriptions to PSMAS.

Source : The Herald