Globemed Gulf Healthcare Solutions L.L.C. v Oman Insurance Company PSC [2017] DIFC CFI 051

January 30, 2024 court of first instance - Judgments

Claim No. CFI 051/2017

THE DUBAI INTERNATIONAL FINANCIAL CENTRE COURTS

IN THE COURT OF FIRST INSTANCE

BETWEEN

GLOBEMED GULF HEALTHCARE SOLUTIONS L.L.C.

Claimant

and

OMAN INSURANCE COMPANY PSC

Defendant

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JUDGMENT OF H.E. JUSTICE SHAMLAN AL SAWALEHI

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Trial :	18 May 2023 – 26 May 2023
Counsel :	Mr. Tom Montagu-Smith KC and Mr. Edward Knight, instructed by Clyde & Co for the Claimant Mr. Rupert Reed KC and Mr. Timothy Killen, instructed by Al Tamimi & Company for the Defendant
Judgment :	30 January 2024

UPON the Part 7 Claim Form dated 16 November 2017 (the “Claim”)

AND UPON the Trial held before H.E. Justice Shamlan Al Sawalehi on 18 May 2023 to 26 May 2023

AND UPON reviewing all material added on to the Court file

AND UPON reviewing the Rules of the DIFC Courts (the “RDC”)

IT IS HEREBY ORDERED AND DECLARED THAT:

1. The Claimant is valid.

2. The TPA Agreement is valid.

3. The period over which the provision of services under the TPA Agreement would run if the Defendant lawfully terminated the agreement at the earliest time possible is three years including the notice period.

4. The OIC Losses are to be calculated on the basis that Bupa would have consented to its portfolio being administered by the Claimant and that 50,000 lives would not have been excluded from the Claimant’s administration.

5. The Non-OIC Losses are assessed as being 25% of the Claimant’s total claim for Non- OIC Losses for each year for the duration of the TPA Agreement.

6. The Claimant’s losses in relation to volume rebates are to be assessed on the basis that the Claimant would not have obtained better rebate rates than the Defendant in fact obtained in the relevant period.

7. In relation to the interest calculation, revenue is to be counted on the entitlement basis.

8. In relation to payroll and general costs, to the extent there is any difference between the parties or the Defendant’s expert’s evidence is silent on a relevant matter, the calculation shall be based on the Claimant’s evidence.

9. In relation to rent, the Claimant’s expert’s approach shall be adopted.

10. In relation to amortisation, the two relevant assets shall be disregarded from the Claimant’s savings.

11. In relation to royalties, these shall be treated as savings.

12. No 51% reduction shall be made to the Claimant’s damages to reflect the Defendant’s subsidiary’s shareholding in the Claimant as contemplated in the MOU.

13. Text BoxThe Defendant shall pay a percentage of the Claimant’s costs proportionate to the percentage of the amount awarded to the Claimant out of the Claimant’s total claim.

Issued by:
Delvin Sumo
Assistant Registrar
Date of issue: 30 January 2024
At: 4pm

SCHEDULE OF REASONS

1. The Claimant’s case (“GMG”), in outline, is as follows. On 13 January 2015, it, a provider of third-party administration (“TPA”) services to health insurers, and the Defendant (“OIC”), a major insurer, entered into an agreement (the “TPA Agreement”) for the provision by GMG of TPA services to OIC in the UAE. On the same day, a separate contract (the “MOU”) was executed by GMG’s parent company (“GlobeMed”) and OIC’s subsidiary (“Synergize”) and, on 16 January 2015, by a corporate shareholder in GMG (“Kharma”) for, amongst other things, the assignment of 51% of the shares of GMG by Globemed and Kharma to Synerg