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.

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

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?

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.

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.