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Two medical schemes fail to maintain prescribed solvency
ratioLevels have deteriorated across the board, and the industry is ‘still underpriced’
says Council for Medical Schemes.

By Roy Cokayne · 10 Dec 2025 04:01

Medical scheme members can expect the matter of underpricing to be ‘incrementally addressed through pricing adjustments’ over time. Image: AdobeStockMedical scheme members can expect the matter of underpricing to be ‘incrementally addressed through pricing adjustments’ over time.

Two medical aid schemes – Medihelp and Compcare – failed to maintain their solvency ratios at or above 25% in 2024, the minimum statutory level prescribed in the Medical Schemes Act.

This is revealed in the Council for Medical Schemes (CMS) Industry Report 2024, released last week.

The report shows that Medihelp’s solvency ratio was 33.93% in 2022, deteriorated to 23.84% in 2023, and fell further to 20.99% in 2024.

Compcare Medical Scheme’s solvency ratio deteriorated from 25.14% in 2023 to 21.83% in 2024.

The report states that 4.93% of beneficiaries in open schemes were covered by Medihelp and Compcare Medical Scheme in 2024, and that no restricted medical schemes failed to meet the minimum required solvency level at the end of 2024.

In 2023, Medihelp, Sizwe Hosmed Medical Scheme and Transmed Medical Fund failed to maintain their solvency ratios at the required minimum level.

Transmed inches up
Transmed Medical Fund attained a 25% solvency ratio during 2024, according to the 2024 CMS Industry Report.

It improved its ratio from 17.7% in 2022 to 23.79% in 2023.

However, the latter was at least the fourth consecutive year it failed to comply with the prescribed minimum after achieving a ratio of 19.72% in 2021 and 22.37% in 2020.

Provisional curatorship for Sizwe Hosmed

The CMS said in September it had obtained a Gauteng High Court order to place Sizwe Hosmed Medical Scheme under provisional curatorship and had appointed Lebogang Mpakati as the provisional curator.

It said it was common cause that Sizwe Hosmed had been experiencing financial difficulties and its solvency level had declined to a level far below the statutory requirement of 25%.

It said the scheme was recently informed by the South African Local Government Bargaining Council that it had not been granted accreditation to market the scheme and benefit options to local government employees for the 2026 year.

The CMS said Mpakati was expected to investigate Sizwe Hosmed’s financial position and advise on viable solutions and the future of the scheme, including a merger, liquidation, or continued existence.

Last week Mpakati indicated that the scheme had restored provider access and improved its claims processes – but despite the scheme having made “substantial progress” in stabilising its operations, its challenges remain.

Overall industry solvency ratio down

The CMS Industry Report said the overall industry solvency ratio of 40.87% in 2024 exceededed the minimum required, but showed a decline from 43.94% in 2023.

The solvency ratio of open schemes decreased by 2.68% to 33.36% in 2024 from 34.28% in 2023.

Restricted schemes experienced a decrease of 10.87% in their solvency ratio to 50.52% in 2024 from 56.68% in 2023.

The average industry solvency ratio has deteriorated over the past three years from 59.48% in 2022 to 56.68% in 2023 and 50.52% in 2024.

The CMS report attributes the industry-wide decrease in solvency levels to the growth in reserves not keeping up with the growth in contributions.

The report said Medihelp deliberately underpriced its benefits during the Covid-19 pandemic in an attempt to provide relief to its members.

It said the scheme experienced a 3.89% decrease in its insurance revenue per average beneficiary per month (pabpm) from 2021 to 2022 compared to an average Consumer Price Index (CPI) of 6.9% during the same period.

The report said Medihelp corrected its pricing for the 2024 financial year and experienced an increase of 13.79% in its insurance revenue pabpm, compared to the average CPI of 4.4%.

It said the scheme submitted the required business plan in terms of Regulation 29, which was subsequently approved by the registrar of medical aid schemes.

The dreaded ‘death spiral’

The report noted that: “Schemes with higher demographic profiles are at particular risk of the so-called ‘death spiral’, where adjustments to price appropriate for the profile of its members might result in the unaffordability of contributions and the subsequent loss of its younger members, thereby exacerbating the effect.”

Why Human Expertise Still Matters in an AI‑Driven Insurance World
from Elna Rudman Brokers

In today’s fast‑moving world, technology and artificial intelligence are transforming the way financial and insurance services operate. These tools help us work faster, analyse information more accurately, and provide you with better access to data and solutions.
But at Elna Rudman Brokers, we believe something very important:
Technology should never replace the human touch — it should strengthen it.

The Power of Human + AI Working Together
AI can process information at incredible speed, but it cannot understand your life, your fears, your goals, or your family the way a real person can. Insurance is not just numbers and systems — it is deeply personal. It involves your health, your home, your livelihood, and the people you love.

That is why our approach combines the best of both worlds:

AI for efficiency
- Faster access to product information
- Improved accuracy
- Better comparisons and insights

Human expertise for understanding
- Empathy when life becomes complicated
- Guidance during stressful claims
- Personalised advice based on real‑world experience
- The ability to listen, interpret, and solve problems with care

Why the Human Touch Matters
A machine can calculate a premium.
But it cannot hear the worry in your voice when you call after an accident.
It cannot understand the complexity of a family’s needs.
It cannot stand up for you when a claim is unfairly delayed.

Only a human adviser can do that.
At Elna Rudman Brokers, we bring decades of experience, personal relationships, and a deep understanding of your unique circumstances. AI helps us work smarter — but our humanity helps us serve you better.

Your Life. Your Needs. Your Broker.
As technology evolves, our commitment remains the same:
To protect you, guide you, and support you with empathy, integrity, and personal care — strengthened, not replaced, by modern tools.
If you ever have questions, concerns, or need advice, we are here to help — not as machines, but as people who genuinely care.

Contact us for all your insurance needs [email protected]

TOP FIVE MOST HIJACKED CARS

As reported by BusinessTech, the latest statistics show that the following five car models are most liable to be stolen:

Toyota Hilux
Volkswagen Polo Vivo
Ford Ranger
Toyota Corolla
Hyundai Grand i10
Cars
The Toyota Hilux is popular among South Africans, making it a target for criminals.

As you can see, the Toyota Hilux – with an average value of R450 000 – tops this list. It’s one of the best-selling bakkies in South Africa. Additionally, over the years, this car model has acquired a reputation as one of the most popular targets among criminals.

This is due to the high demand for the Hilux, as well as its easy resale and spare parts values.

The Volkswagen Polo Vivo is popular among South African drivers, so there’s a high demand for its parts as well. Similarly, the Ford Ranger, Toyota Corolla and Hyundai Grand i10 are coveted for their high resale values.

WHAT OTHER CARS MADE THE LIST?
In addition to these vehicles, five other car models also garnered a spot on the list:

Isuzu KB Series
Nissan NP200
BMW 3 Series
Renault Kwid
Kia Picanto
Whether it’s the luxury appeal, such as in the case of the BMW 3 Series, or the compatibility of the Nissan NP200 or the Kia Picanto, criminals will take chances to lay their hands on these motor vehicles.

There are several ways you can mitigate the risk of hijackings.
According to MoneyToday, Gauteng is South Africa’s most dangerous province, representing 62% of all thefts.

Vehicle theft is common between the hours of 22:00 and 02:00.

When it comes to hijackings versus theft, hijackings sit at 23% – up by 5% – in comparison to theft at 77%.

If you own one of the car models mentioned on the list, you are strongly advised to invest in a GPS tracking device and alarm system, install a steering wheel lock, gear lock or immobiliser, and make use of secure, covered areas for parking and protecting your car.

You’re also urged to remove all valuables from your vehicles, change your driving patterns to avoid predictability and, above all, be vigilant. Report all suspicious activity – including incidents of hijacking – to your nearest police station.

News Letter November 2025

Understanding Voluntary Excess in Vehicle Insurance:

A recent case
FAIS Ombud

Finding insurance that fits your budget and provides the appropriate level of cover is a careful balancing act that remains a grudge purchase for most. Financial Services Providers (FSPs) and here we refer specifically to short-term insurance intermediaries, have specific duties in terms of the General Code of Conduct for Authorised Financial Services Providers and Representatives, (‘the Code’).
They must clearly explain what the insurance policy being recommended provides in terms of benefits, and also ensure that the product being recommended is appropriate to your specific needs and circumstances. The FSP must ensure that the prospective client is placed in a position to make an informed decision, which is a vital aspect of the financial planning process. It is important for consumers to be aware that a cheaper premium may not provide the cover required. Any decision made in respect of the most appropriate option in terms of cover and premium must be made in consultation with the FSP, and with full knowledge and understanding of the implications and consequences of the option ultimately accepted.

One of the ways that one can look to reduce the monthly premium payable in respect of a short- term insurance policy is through the application of a voluntary excess. An excess is the first portion of your vehicle claim that you must pay before the claim is proceeded with or when you collect the vehicle etc. To facilitate a lower premium, you can opt for a voluntary excess, which is the amount you agree to pay, in addition to the compulsory excess. The increased excess does provide for a reduced premium, as you assume a greater portion of the risk in the event of an accident or loss, but it is not a decision that should be taken lightly. You must ensure that you consult with your FSP and fully appreciate the implications and consequences of such a decision.

A recent case considered by this Office has drawn attention to the concept of voluntary excess in vehicle insurance. The complainant bought a VW Polo R-Line valued at R336,000 and applied for comprehensive vehicle insurance. The policy was set up with coverage based on the retail value, along with a chosen excess of R5000 and a monthly premium of over R3000 for a 25-year-old, who was a first-time driver. However, looking for more affordable premiums, the policyholder switched to another insurer.

In switching the policy to another insurer, the complainant was able to reduce his premium by agreeing to a voluntary excess. The challenge arose when the policyholder had an accident, resulting in the vehicle being written off. During the claims process, the policyholder was informed that the voluntary excess was set at 55%, significantly reducing the value of the claim.

The complainant approached this Office for assistance. When this Office listened to the sales recordings, we found that the excess provision and details were well explained at the time of purchase. The insurance provider informed the complainant about the 55% voluntary excess, clearly describing how it works, even using different scenarios. There was no basis for a finding to be made against the FSP.

Whilst we were unable to assist this complainant, the case highlights the importance of clearly appreciating the implications of your decisions. Policyholders are urged to seek advice, thoroughly read policies, and clarify all doubts, ensuring that one can make informed choices regarding insurance coverage.

Speak to Chantal Du Plessis about Insuring your car correctly with repudiable Insurers - Contact [email protected]

Choose your Medical Scheme Wisely.

Medical Schemes Open Season 2026: How to choose a medical scheme or benefit option

It is open season for medical scheme members! Most schemes have now announced their 2026 contribution and benefit updates, which take effect from 1 January. Whether you are happy with your current option or thinking about switching, be sure to review your choices and finalise your decision by late November or early December.

With so many options available, choosing the right one can feel overwhelming, but you do not have to figure it out alone. The CMS has put together a quick guide to help you make an informed decision.

Handy tips to consider when choosing a medical scheme

Contact your current or potential scheme for an information brochure and get familiar with the scheme rules and benefits before choosing an option that fits your needs and budget.

Remember, you may also use a healthcare broker that is registered with the CMS to review benefit options, but this is not compulsory.

Before you commit, take a moment to:
• Find out what late joiner penalties or waiting periods may apply to you.
• Understand your rights and the fine print that could influence the scheme’s decision-making process. While it is important to provide information such as medical history, your medical scheme cannot charge you more because you are older or living with an illness. Contribution differences may only be based on:
o Income
o number of dependants, or
o both
• Familiarise yourself with the Prescribed Minimum Benefits
(PMBs) to know what your scheme will cover in full if you use a Designated Service Provider (DSP), and any co-payments and limits that may apply if you choose a non-DSP. Learn more about DSPs and emergency care here.
• Review the medicine formularies because if your prescribed medicine is not on the scheme's approved list, you have to make out-of-pocket payments.
• Find out what late joiner penalties or waiting periods may apply to you if you are joining a new scheme. Click here to read more on disclosure of information, as failure to do so may lead to denied claims or even termination of membership.
• It is also essential to know the difference between medical scheme coverage vs. health insurance.

Contact Pieter Rudman for Medical Aid and Gap Cover advice [email protected]