Anglo Medical Scheme Privacy Statement
Definitions
The Scheme refers to Anglo Medical Scheme, registration number 1012, registered with the Council for Medical Schemes. You can find us at 144 Oxford Road, Melrose, Johannesburg, 2091.
The Administrator refers to Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider, the administrator and managed care organisation for Anglo Medical Scheme.
We, us, our refer collectively to the Scheme and the Administrator.
You and your refer to the member and the dependants on the Scheme which may include your spouse, children and other dependants, collectively "your dependants".
Your personal information refers to personal and special personal information about you. It includes information about race, gender, sex, pregnancy, biometrics, marital status, national, ethnic or social origin, colour, sexual orientation, age, physical or mental health, well-being, disability, religion, conscience, belief, culture, language and date of birth of the individual amongst other things.
Process(ing) (of) information means the lawful and reasonable automated or manual activity of collecting, recording, organising, using, storing, updating, distributing and removing or deleting personal information to ensure that such processing is adequate, relevant and not excessive given the purpose for which it is processed.
Competent person means anyone who is legally competent to consent to any action or decision being taken for any matter concerning a member or dependant for example a parent, legal guardian or a legal representative appointed by a court to manage the finances, property, or estate of another person unable to do so because of mental or physical incapacity.
How we will process and disclose your personal information and communicate with you
Part 1 - Introduction
1. The purpose of this Privacy Statement is to set out how we collect, use, share and otherwise process your personal information, in a manner that is compliant, ethical, adheres to industry best practice and applicable protection of personal information legislation as enacted from time to time.
2. This Privacy Statement applies to you if you engage with us physically through our offices, or virtually through our website (https://www.angloms.co.za), email, mobile applications such as the Anglo Medical Scheme App, social media platforms, over the phone, or otherwise as may be the case from time to time.
3. When you engage with us, you entrust us with personal information about you.
4. We are committed to protecting your right to privacy. We will keep your personal information confidential. We take protecting your personal information seriously and are continuously developing and updating our security systems, processes and data governance policies.
5. We have a duty to take all reasonably practicable steps to ensure your personal information is complete, accurate, not misleading and updated on a regular basis. To enable this, we will always endeavour to obtain personal information from you directly. Where we are unable to do so, we will make use of verifiable independent third-party data sources. Thus, your personal information comprises information you may have given to us yourself or we may have collected from other sources.
6. You understand and/or acknowledge that when you include your dependants, on your application, we will process their personal information for the activation of the plan/benefit and to pursue their legitimate interests. By submitting your dependants' relevant personal information, you hereby confirm that you are duly authorised to share such information with us.
7. If you are giving consent for a person under 18 (a minor) you confirm that you are their parent or legal guardian and that you give consent for us to process their personal information for the purposes covered in this Privacy Statement.
8. If you share your personal information with any third parties, we will not be responsible for how they use this information nor be responsible for any loss suffered by you.
Part 2 - Applying for and administering your membership
9. You understand, accept and consent that we may process your personal information for the following purposes:
9.1 to verify the accuracy, correctness and completeness of any information provided to us in the course of processing an application for membership or providing services related to the membership;
9.2 for the administration of your Scheme benefits;
9.3 for the provision of managed care services to you on your plan;
9.4 for the provision of relevant information to a party contracted by the Scheme and/or its administrator who requires this information in order to provide a healthcare service to you on your -plan;
9.5 to profile and analyse risk;
9.6 to share your personal information with external health providers for them to assess or evaluate certain clinical information, in the event that you are subject to such a clinical assessment; and/or
9.7 to investigate and/or remedy fraud, waste and abuse.
10. By signing this application form, you expressly consent that, for purposes of processing your application for membership, underwriting, determining contributions, collection of funds due to the Scheme from you, and/or any other matter relevant to administering your membership to the Scheme, we can obtain and share information about your creditworthiness, or the creditworthiness of any payer of your contribution. This includes information about credit history, financial history, judgments, default history and sharing of information for purposes of risk analysis, tracing and any related purposes.
11. Examples of parties from whom we may obtain, and to whom we may disclose, your personal information for the purposes outlined above include, but are not limited to:
11.1 All relevant sources, including medical practitioners, contracted service providers, providers of financial services, financial advisers, credit bureaus (or credit providers' industry association or industry body), or industry regulatory bodies ("relevant sources") and further processing of such information to consider your membership application, to conduct underwriting or risk assessments, or to consider a claim for medical expenses. We may (at any time and on an ongoing basis) verify with the relevant sources that your personal information is true, correct and complete;
11.2 If you have joined as a member of an employer group, getting from and sharing with your employer information that is relevant to your application;
11.3 Communicating with you about any changes in your benefits/plan, including your contributions or changes and enhancements to the benefits you are entitled to on the plan you have chosen;
11.4 Transferring your personal information outside the borders of the Republic of South Africa where appropriate, for example to administer emergency or treatment benefits, or if you provide an email address which is hosted outside the borders of South Africa, or for processing, storage or academic research;
11.5 Sharing your personal information to be processed by healthcare providers via a health information exchange in order to improve members' treatment and healthcare outcomes.
12. We have the right to communicate with you electronically about any changes on your benefits/plan, including your contributions or changes and improvements to the benefits you are entitled to on the plan you have chosen.
13. We may process your personal and/or depersonalised information for the following purposes:
13.1 for research and analysis; or
13.2 to support disease management programmes which may include initiatives that -
13.2.1 enables the early identification of medical conditions and/or other lifestyle risks;
13.2.2 provides personalised advice to you about such medical conditions risks to your health based on market and behavioural research and analysis carried out using your personal, special and or depersonalised information;
13.2.3 encourages you to change your lifestyle to lessen the impact of such conditions and risk;
13.2.4 assists you to become healthier - for example by seeing a healthcare practitioner, having additional tests done or activating benefits including enabling the provider of such programmes to incentivise the undertaking of these activities on such terms and conditions applicable to the programme; and/or
13.2.5 enables communication with you about all of the above by means of any communication channels including the Anglo Medical Scheme App.
14. We will transfer your personal information outside South Africa only:
14.1 if you give us an email address that is hosted outside South Africa; or
14.2 to administer certain services, for example, cloud services.
15. When we share your information, we will ensure that the company, person or regulatory body (in or outside of South Africa) to whom we pass your personal information to, agrees to treat your information with the same level of protection as we are obliged to.
16. You have the right to object to the processing of your personal information and have a choice whether or not to accept these terms and conditions. However, using your plan benefits will be taken as your acceptance of the above terms and conditions to activate and service your medical scheme membership.
Part 3 - Sharing your information with third parties
17. If a third party asks us for any of your personal information, we will share it with them only if:
17.1 you have already given your consent for the disclosure of this information to that third party; or
17.2 we have a legal or contractual duty to give the information to that third party.
18. We will provide your personal information to any Discovery Limited entity only if you have already given informed consent for such disclosure to them and only for the following purposes:
18.1 to allow for the administration of your profile/membership/plan with the entity with whom you or your dependant/s already have a relationship; or
18.2 where you or your dependant/s have applied for a product, service or benefit from such an entity for the purposes of underwriting.
19. Your personal information may be shared with third parties such as academics and researchers, including those outside South Africa. We ensure that the academics and researchers will keep your personal information confidential and all data will be made anonymous to the extent possible and where appropriate. No personal information will be made available to an academic or research party unless that party has agreed to abide by strict confidentiality protocols that we require. If we and/or the academic and researcher publish the results of this research, you will not be identifiable.
20. You have the right to object to the sharing of your personal information for the purposes and the instances set out in this part of the Privacy Statement and any such objection will not affect your application for membership and/or the manner in which your membership to the Scheme is administered. You can access the Privacy Statement by going to the following link https://www.angloms.co.za/portal/ams/privacy.
Part 4 - Your consent
21. You consent and agree to the terms and conditions set out above and that:
21.1 we may process your information, including personal and special personal information, for the purposes set out above and understand that in doing so, we are required to adhere to South African legislative reporting obligations and to perform transaction monitoring activities;
21.2 we may communicate such personal information to local regulatory bodies as well as to other relevant governance structures of Discovery Limited or any of its relevant entities if any legislative reportable matters are identified; and
21.3 we may collect your information from your employer. Each party accepts responsibility to the extent that the activities of processing personal information fall under the control of that party and agree to indemnify the other party/ies against any loss or damage, direct or indirect, that an employee may suffer because of any unauthorised use of the employee's personal information or if a breach of the employee's personal information occurs, but only if the processing of that personal information is controlled by that party.
22. We may process your information using automated means (without human intervention in the decision-making process) to make a decision about you or your application for any product or service. You may query the decision made about you.
23. It is important that you be kept updated about any offers and new products that are made available from time to time by the Scheme or Administrator. In order to do so, we may need to obtain information and/or data from third parties including any entity of Discovery Limited, that provide relevant product and/or services. Furthermore, we, any entity of Discovery Limited and/or any contracted third-party service providers may need to communicate (including electronically) with you about these.
24. Please indicate by ticking the box alongside if you do not wish to obtain such data and/or information or receive such communications for this purpose. You may at any time opt out of electronic marketing by calling us. We will store your personal information in order to action this request and action it as soon as reasonably possible.
25. Unless required by law to keep your personal information for a certain period of time or purpose, you agree that we may keep your personal information until you ask us to delete or destroy it. You have the right to ask us to update, correct or delete your personal information, unless the law requires us to keep it. Where we cannot delete your personal information, we will take all practical steps to de-identify it, and for purposes of proof, retain a secure copy of your request.
26. If we become involved in a proposed or actual amalgamation, transfer or merger, acquisition or any form of sale of any assets, as appropriate, we have the right to share your personal information with third parties in connection with the transaction. In the case of such an event, the new entity will have access to your personal information. The terms of this Privacy Statement will continue to apply.
27. Where we are required by law to collect and keep personal information, we shall do so. At a minimum, this includes the following:
27.1 Legislation applicable to us:
Medical Schemes Act, 1998
The Consumer Protection Act, 2008
The Protection of Personal Information Act, 2013
Electronic Communications and Transactions Act, 2002
Promotion of Access to Information Act, 2002
27.2 Legislation specific to the Administrator only:
Financial Advisory and Intermediary Services Act, 2002
Part 5 - General
28. The Scheme may change this Privacy Statement at any time. It is your responsibility to check our website regularly to ensure that you are aware of these changes. By continuing to be a member you agree that the latest version will apply to you. The current version is available on https://www.angloms.co.za/portal/ams/privacy
29. You have the right to know what personal information we hold about you. If you wish to receive this information, please complete a 'PAIA Form to Request Access to Records' on https://www.angloms.co.za/portal/ams/privacy and specify the information you would like. We will take all reasonable steps to confirm your identity before providing details of your personal information in respect of this request. We are entitled to charge a fee for this service and will let you know what it is at the time of your request.
30. If you believe that we have used your personal information in a way that is contrary to this Privacy Statement, you have the right to lodge a complaint with the Information Regulator, under POPIA, but we encourage you to first follow our internal escalation and/or disputes process to resolve the matter. We explain the escalation and/or disputes process on the website https://www.angloms.co.za/portal/ams/privacy or you can contact the Administrator's Information Officer at privacy@discovery.co.za. If, thereafter, you feel that we have not resolved your complaint adequately, kindly contact the Information Regulator at: The Information Regulator (South Africa) | Woodmead North Office Park | 54 Maxwell Drive | Woodmead | Johannesburg | 2191 | Tel: +27 (0) 10 023 5200 | POPIAComplaints@inforegulator.org.za.