Fri. Aug 23rd, 2019

How to claim from the Road Accident Fund

Everything you need to know about claiming from the RAF.

how to claim from the road accident fund 1024x544 - How to claim from the Road Accident Fund

Before you register a claim for a serious injury or death caused by a road accident that occurred in South Africa, it’s important that you understand the role of the RAF and who is entitled to claim. We’ve compiled a list of frequently asked questions about the RAF to help you with the claim process.

What is the Road Accident Fund?

The mandate of
the Road Accident Fund (RAF) is to
“provide appropriate cover to all road users within the borders of South
Africa; to rehabilitate persons injured, compensate for injuries or death and
indemnify wrongdoers as a result of motor vehicle accidents in a timely, caring
and sustainable manner; and to support the safe use of our roads.”

The RAF was
established in South Africa by an Act of Parliament and commenced operations in
May 1997. At the time, it assumed all the rights, obligations, assets and
liabilities of the Multilateral Motor Vehicle Accidents Fund under the Road
Accident Fund Act.

Why
was the Road Accident Fund established?

The RAF plays a critical role in supporting and directly
contributing to the growth of the South African economy. The knock-on effect of
serious injuries and deaths caused by road accidents has a devastating effect
on the victims and their dependents which in turn, negatively impacts on the
growth of our economy.

This is due largely due to the fact that active members of the
private or public sector who suffer serious injuries in road accidents are
often not able to work, either on a temporary or permanent basis. This
generally causes a financial setback and sometimes financial ruin. A death
often leaves dependents in financial difficulties.

Basically, the RAF provides a safety net for victims of road accidents that ensures they receive social insurance cover until they’re able to work again or, in the case of a death, their dependents are compensated for loss of income and support.

The RAF is funded by a levy on fuel used for all road users. It
extends to all members of society living within the borders of South Africa,
but it does not extend to drivers of motor vehicles that are found to be
negligent.

Do you need an expert lawyer to fight your case with the Road Accident Fund?

 Click here to submit a claim

What
type of cover does the Road Accident Fund provide?

The RAF provides
two types of cover:

  • personal insurance cover for serious
    injuries, general damages or death as a result of a road accident
  • indemnity cover for wrongdoers
    to protect them against legal claims if they are not to blame for the accident

The RAF covers members of the South African public and all
foreigners living, employed or holidaying within the borders of the country.

What
does the Road Accident Fund cover?

The RAF covers victims of a road accident – which includes the
actual individual harmed and his/her dependents – from suffering financial
ruin. It covers all medical and related costs that are needed to restore an
accident victim to good health so he/she can recover fully and return to work
and/or generate an income.

In addition, the RAF compensates the accident victims for loss of income while they are recuperating. In the case of a death, the fund compensates dependents for loss of income and support. It also pays general damages to accident victims which covers pain and suffering, loss of amenities of life, disability and disfigurement. In the case of a fatal accident, the RAF covers funeral costs.

Lastly, the RAF indemnifies the wrongdoer from liability. In other
words, the RAF covers the wrongdoer (the person who caused the accident)
against legal claims made by the victim. This includes legal fees.

The RAF only covers a wrongdoer if they are not to blame for the accident. If the wrongdoer is partly to blame for the accident, the RAF pays out a percentage relative to his/her negligence.

Who
can claim from the Road Accident Fund?

A person may
only claim if he/she was not solely negligent in causing the accident. Typically,
the person is a victim of a road accident that was caused by someone else. The
other person may be partly or entirely to blame.

If the person
claiming compensation is partly to blame for an accident, the RAF pays out
according to a formula which considers the percentage of blame assigned to each
party.

Both South
African residents and non-residents may claim from the Road Accident Fund if
the accident happened within the borders of South Africa.

A person may
claim from the RAF if he/she:

  • was injured in an accident and
    was not solely responsible for the accident
  • is the driver responsible for
    the accident but is not the owner of the vehicle, and the accident happened due
    to the negligence of the owner (for example, unroadworthy car, worn tyres or
    worn brake pads)
  • is a dependent of the deceased
    victim
  • is a parent or legal guardian
    of a minor who is seriously injured
  • is a family member or employer
    of the deceased victim and responsible for paying the funeral costs

Who
cannot claim from the Road Accident Fund?

A person cannot
claim from the RAF if he/she:

  • was the driver of the vehicle
    and solely responsible for the accident (total negligence)
  • was the only person involved in
    the road accident and no-one else was injured or died as a result of their
    negligence
  • only suffered damage to a
    vehicle or personal property e.g. damaged wall, goods carried in a delivery
    van, domestic pets or livestock etc.

Who
typically claims from the Road Accident Fund?

  • drivers
  • passengers
  • pedestrians
  • bystanders
  • cyclists
  • motorcyclists

Start the process to get the compensation you deserve. No win, no fee. claims.co.za for a dedicated attorney to fight your case against the Road Accident Fund.

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here to submit a claim

What
can you claim from the Road Accident Fund?

The RAF
compensates a claimant for the following:

  • medical costs that are directly
    related to injuries sustained in a motor vehicle accident
  • funeral expenses if a person
    dies in a road accident
  • general damages for pain and suffering where an injury is deemed serious, the loss of an unborn child or serious disfigurement that may cause emotional or mental scarring or loss of bodily functions
  • loss of earnings if a person is
    temporarily or permanently unable to work
  • loss of financial support if
    the victim who died is the main income earner

Does it matter where the road
accident was?

It doesn’t matter where the road accident took
place as long as it was within the boundaries of South Africa. The RAF covers
you even if you are seriously injured on a country road, as long as you are not
the sole cause of the accident.

The same applies to bystanders,
pedestrians, cyclists and motorcyclists. Any road user is entitled to claim for
a serious injury caused by a road accident, as long as he/she was not solely to
blame for the accident.

How does the Road Accident Fund assess my claim?

The severity of the
injury is the key factor in determining how much the RAF will compensate victims
or their dependents. In particular, whether the injury is serious enough to have
a long-term impact on a person’s ability to work and earn an income in the
present and future.

Other factors
taken into consideration include:

  • the age of the road accident
    victim; in other words, if they are young enough to recover quickly and fully
    from their injury
  • whether the person is covered
    by another source of insurance, such as disability cover or life assurance

What
is regarded as a serious injury?

The RAF has strict criteria to determine whether an injury qualifies as ‘serious’. It is based on the guidelines of the American Medical Association’s (AMA) Guide to the Evaluation of Permanent Impairment, Sixth Edition.

The assessment
of an injury considers the ‘Whole Person Impairment’ (WPI) which, in turn, is
expressed as a percentage. The Minister of Transport set the WPI threshold at
30%. An injury assessment must be made by an approved medical specialist who
has the requisite AMA qualification.

Examples of
injuries that meet the 30% injury include paraplegia, permanent brain damage
and amputation. A road accident victim or his/her dependents may be entitled to
claim compensation for general damages even if the 30% impairment is not met
but where physical, emotional and mental suffering can be proven.

Examples of this
include:

  • long-term physical damage or
    loss of bodily functions
  • severe and permanent
    disfigurement
  • long-term mental or behavioural
    issues (PSTD)
  • loss of an unborn child (grief)

What
injuries are not covered by the Road Accident Fund?

Injuries that
are not deemed serious and therefore not covered by the RAF include:

  • bruises and sprains
  • superficial cuts and scrapes
  • torn ligaments
  • whiplash
  • loss of digits (fingers and
    toes)

How
do I claim from the Road Accident Fund?

If you qualify
to claim from the Road Accident Fund for a serious injury incurred in a
road accident that was not solely your fault or the fault of a deceased victim
of a crash, you’ll follow the following process:

Gather the
evidence

It’s important to gather as much evidence as possible to support your claim. This includes witness statements, medical reports and police statements as well as tax invoices and bank statements with details of costs incurred. If you were unconscious or incapacitated after the accident, hopefully, you’ll find witnesses to come forward with the information.

Obtain the relevant reports

You need a police report and/or case number of the accident as well as other supporting documents. The information is available on the RAF website if you are submitting a claim on your own, otherwise, your lawyer will advise you what reports and information are needed.

Be assessed by a qualified
medical professional

Your claim for
general damages must be supported by a Serious Injury Assessment Report which
is completed by a qualified medical practitioner who has the requisite AMA
qualification. The doctor must confirm that your injury is serious enough to
merit compensation for general damages.

Get
expert legal representation

You can make a
direct claim to the RAF but it’s highly recommended that you go through a
suitably qualified lawyer that specialises in road accident claims. It’s a long
and tedious process submitting a claim to the RAF and using an attorney with
the right knowledge and experience to handle your claim gives you the greatest
chance of success.

Register
a claim with the RAF

All forms required
to register a claim with the RAF can be downloaded on its website. If you’re
using expert legal representation, your attorney will do it for you once he/she
has all the relevant documents.

RAF investigates

Once the claim
has been registered on the RAF system, an investigation will be conducted to
decide whether your claim is valid or not. You may be contacted and asked to
submit additional reports or supporting documents. The RAF has a grace period
of 120 days to investigate your claim; however, it often takes much longer for
a case to be investigated and move onto the next step.

Wait
it out

The RAF is
underfunded and burdened with inefficiencies so you cannot rely on an immediate
payout. If the RAF takes an unreasonably long time to investigate your claim,
your attorney may choose to issue a summons to inform them that the matter may
go to court. The same will apply if the RAF rejects your claim.

Once it’s been decided the claim will be pursued in court, a trial date will be set. This can be a very frustrating and time-consuming process, and often takes many months to even a few years to be resolved.

Receive
your settlement

If all goes well, you will receive a payout from the RAF after your claim has been investigated and a settlement amount has been determined. The RAF will often ask a claimant to settle out of court for a percentage of the amount that they should receive. It’s an option for someone who wants to be paid out quickly but it’s advisable to wait it out to receive the full compensation due to you.

Do
I need a lawyer to claim from the Road Accident Fund?

You can make a
direct claim from the RAF; in fact, the fund encourages it. However, it’s a
complicated process and many claims are rejected by the Fund. For this reason, most
people opt to register a claim through an attorney firm that specialises in
road accident claims.

Whichever option
you take, there are three steps to follow:

Step 1:
Compile the necessary documents

  1. The police report and/or case
    number of the accident
  • Serious Injury Assessment
    Report completed by a doctor with requisite AMA qualification for general
    damages
  • Witness testimonies and
    photographic evidence of accident scene
  • Motivating testimony as to how
    the serious injury has impacted on your ability to work and earn an income

Step 2:
Complete the submission forms

A claim is
lodged using Form 1. This provides the RAF with basic information on the
claimant, the vehicles and the parties involved in the road accident as well as
the date and place of the accident and the amounts claimed. Both drivers are
required to submit details of the accident in two separate accident report
forms.

The medical
report from the doctor that treated the accident victim is included in the
submission. If a person is claiming general damages, the Serious Injury
Assessment Report must confirm that the injury is serious and to what extent it
impacts on the person’s current and future well-being.

All forms
required to submit a claim to the RAF can be downloaded on its website.

Step 3: Submit
the documents

Only submit the
documents once everything that’s needed has been completed and all supporting
documents are available. The documents must be submitted in hard copy; they
cannot be emailed to the RAF.

Once the claim
has been registered, it will be investigated. If your claim is successful,
you’ll be paid out by the RAF in due course. The process should take a few
months but it can take up to 3 to 5 years based on the current state of the
RAF.

Is
there a time limit for claiming from the Road Accident Fund?

You have to
claim within three (3) years of the date of the accident in a case where the
wrongdoer has been identified.

If the wrongdoer is not identified, for example, a hit-and-run accident; you are required to submit a claim within two (2) years of the date of the accident.

The wrongdoer is
not regarded as prima facie identified (sufficient to establish identity) if
only the following is provided:

  • vehicle registration number is
  • full name and surname

Do you need an expert lawyer to fight your case with the Road Accident Fund?

Click here to submit a claim

How long does the Road Accident Fund take to payout?

The timing of
the claim process is heavily impeded at the moment by a severe backlog within
RAF of claim settlements. At the moment, it can take up to 3 to 5 years to
receive a payout. The sooner you register your claim, the sooner it will be
investigated and a settlement reached if approved.

Am
I guaranteed a payout from the Road Accident Fund if I qualify to claim?

In theory, yes.
Your claim should be successful if you meet the criteria set out by the RAF.
However, the RAF is underfunded and struggling to meet its financial
obligations. As a result, claim investigations and payouts have backed up and,
in many cases, claimants are waiting a number of years before receiving
compensation.

The official statement from the RAF is that the money raised through the fuel levy is not sufficient to cover the number of claims that should be settled each month. As a result, the RAF is burdened with a backlog of outstanding claim settlements.

Even with a
bail-out by the Treasury in 2015, the RAF has not been able to bridge the gap
in its financial obligations and the current business model is not sustainable.

The RAF’s
fault-based system is also cited as another reason why there is such a backlog
of claim settlements. The process of determining the percentage of each
driver’s liability is lengthy and inefficient.

Small claims of
R100 000 or less are paid out first. As a result, road accident victims who are
due large settlements usually have to wait the longest.

The RAF is
looking at a long-term solution to improve how quickly they investigate and
process claims; and future increases in the fuel levy will be required to
sustain the RAF’s capital reserves.

How
much does the Road Accident Fund pay claimants?

The RAF pays out
based on your level of responsibility if you were the driver and caused the
accident, and on the level of injury if you were the victim of a road accident.
The RAF considers the short- and long-time consequences of an injury which is
determined by a suitably qualified medical practitioner.

Since August
2008, claims for loss of earnings and loss of present and/or future support
have been capped at a prescribed amount. This amount is adjusted by the
inflation rate.

The RAF pays for
the funeral costs in the case of a death. This covers the cost of cremating the
deceased or burying them in a grave. If the deceased was the breadwinner,
his/her dependents are entitled to claim for loss of support.

The RAF only
pays out for general damages where the injury is deemed serious. Medical costs
are paid according to prescribed medical aid rates.

Click
here to register a claim

How does the Road Accident
Fund pay a claimant?

Caps and thresholds were applied in 2008 to the amount of compensation a claimant can receive. Regardless, payouts for serious injury is still significant. Once the RAF has determined a settlement amount, payment is made directly into your bank account.

Once the RAF has
approved your claim and reached a settlement amount, a discharge form is issued
with is a statement of the agreed amount. The payment is made once the
discharge form is signed and lodged.

You don’t need a separate bank account if you have a savings or cheque account with a registered bank in South Africa. However, you do need to supply RAF with a letter from your bank that verifies your bank with the institution and your bank details.

If you don’t
have a bank account, you need to provide the RAF with a written letter that
authorises them to make the payment into another person’s bank account. A
letter from their bank verifying the account details must also be submitted to
the RAF.

If you have
claimed from the RAF through an attorney firm, the payment goes directly to
them. They then subtract their fees and pay over the balance into your personal
bank account.

How do I check my Road
Accident Fund claim?

If you are working through a legal firm
that specialises in claiming from the RAF, your lawyer will check your Road
Accident Claim and keep you up-to-date. If your claim is rejected or is taking
to long to be investigated, your lawyer may issue them with a notice that the
claim will be taken to court as the next step.

If you have made a direct claim, you can
contact a RAF consultant to check your claim and how far it is progressing. You
need to supply the consultant with your identity number; all your information
can be found on the RAF system.

Can
a driver claim from the RAF if he/she caused the accident?

The driver who
caused the accident cannot claim from the RAF if he/she was solely to blame.
The only exception is if the person was driving a vehicle owned by someone else
and the accident was the result of the owner’s negligence or a mechanical
problem. In this case, the driver is not solely responsible for the accident as
the vehicle owner takes the blame for not maintaining his/her vehicle properly.

One element of
the RAF’s mission is to indemnify the wrongdoer from liability. The driver who
caused the accident BUT is not guilty of negligence may still be covered by the
RAF if they are being sued by the road accident victim or his/her dependents.
This protects someone from being ruined financially where they are not solely
to blame for the accident.

Can I claim for a hit-and-run
road accident?

The general rule
of the RAF is the identity of the driver and/or owner of the vehicle must be
included when the claim is registered. This is obviously not possible in the
case of a hit-and-run accident but you are still entitled to compensation for a
serious injury.

If you cannot
provide any details of the wrongdoer (not identified), then bear in mind that
the time limit to claim drops from 3 years to 2 years from the date of the
accident.

What information must I get at
the scene of the accident?

It’s important to gather as much information and photographic evidence as possible at the scene of an accident because it’s too late when the accident scene has been cleared away. For a hit-and-run accident, gather as much information as you can from witnesses and the emergency response team as well as their contact details.

Important information needed for a road accident:

  • first name and surname
  • address (residential, postal or
    work)
  • contact details (landline,
    mobile)
  • identity number
  • vehicle registration number
  • name and contact details of any
    witness
  • name and contact details of
    traffic officers or emergency personnel
  • any details of the river (sex,
    age, race etc.)
  • photos of the accident scene
    (position of vehicle)
  • damage to the vehicle
  • physical location where the
    accident occurred
  • date and time of the accident

Can I lodge a claim for a
minor?

A parent or legal guardian can lodge a claim with the Road Accident Fund on behalf of a minor if he/she is 18 years and younger. The person responsible for the minor has 3 years in which to register a claim if the wrongdoer is identified.

If the wrongdoer
cannot be identified, a parent or legal guardian has 2 years from the date of
the accident to register a claim on behalf of a minor.

Once a minor
turns 18, he/she has a period of 3 years to register a claim as long as the
wrongdoer is identified. If not the wrongdoer is not identified, the 2-year
prescription period applies as mentioned above; where it is the duty of the
parent or legal guardian to register the claim for the minor. You cannot wait
to turn 18 years old if the wrongdoer cannot be identified.

claims.co.za for a dedicated attorney who specialises in Road Accident Fund claims – 25 years’ experience and over 2 500 successful claims

Click here to register a claim with an RAF Attorney.

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