ROAD ACCIDENT FUND
What is the Road Accident Fund
- • The Road Accident Fund (RAF) is a government-run insurance scheme as described in the amended Road Accident Fund Act 56 of 1996.
- • It pays compensation to road accident victims who are injured.
- • The RAF also compensates dependants of those who are killed as a result of negligence of the driver or owner of a motor vehicle at any place within South Africa.
Who can claim?
- • If the accident was not entirely your fault, you can claim
- • Injured passengers in a car, taxi, bus, truck, bakkie or motorbike can claim
- • Dependants of a breadwinner can also claim
Why do you need an attorney?
- • An attorney who specialises in RAF claims has the expert knowledge and experience to assist you and to ensure that your claim is properly calculated and submitted to the RAF in accordance with the Act and Regulations.
- • There are also time limits that apply to every claim therefore if you do not submit your claim on time your claim will prescribe.
What is the process of claiming from the RAF and how much will it cost? Claiming from the RAF is a very expensive process.
Attorneys can carry all the costs that are necessary to prosecute your claim up until your claim has been finalised on the basis that they will be repaid those costs out of the proceeds of your claim when it becomes settled (based on a contingency fee agreement).
Attorneys can take up your case either:-- • On a contingency basis (no win no fee basis) or
- • In terms of a fee agreement where normal fees as per an agreed tariff would apply.
- • To lodge any claim, medical records need to be obtained first from the relevant hospitals and doctors which need to be paid for
- • Documents also need to be obtained from SAPS which also requires payment
- • Medical reports (RAF1 form and RAF4 form) need to completed by the hospital and doctors and be paid for
It must further be noted that claiming from the RAF is a very technical and complicated process. An affidavit explaining how the accident occurred must be lodged with your claim. Only those injuries deemed to be serious by the RAF will be accepted.
You need to know how much you are claiming for as required by the RAF1 form. You can claim for various heads of damages such as pain and suffering, loss of amenities of life, disfigurement, disability and shock, loss of income, loss of earning capacity, future medical costs, past medical expenses and funeral expenses.
To qualify for general damages you will need to lodge a serious injury assessment report (RAF4 form) from a suitably qualified medical expert who has assessed your injury as ‘serious’ as provided for in the Act.
An attorney specialising in RAF claims has knowledge and experience to advise you whether the amount offered by the RAF to settle your claim is fair and reasonable according to your particular case and injuries.
Contingency Fee explained further
- • An attorney is entitled to charge a success fee in addition to the normal fee
- • The amount of the success fee is regulated in terms of the Contingency Fees Act. The fee may not exceed 25% of your capital amount, or 100% above the normal fee, whichever is the lesser amount.
- • Other expenses such as medical expert fees, medical record fees, police documents, court fees etc. will also be for your account however some of these costs can be recovered from the RAF as part of the party-and-party costs where applicable.
Can you claim directly from the RAF?
- • Yes you can however you are not obliged to agree to claim direct from the RAF
- • Although RAF may assist you by explaining how to claim and assist with information regarding the forms and procedures, you will need to obtain and pay for all the supporting documents required, including medical reports and records on your own
- • Remember, the RAF is the very body against whom you are claiming. It is their job to investigate and exclude all claims it considers invalid
- • There may be a difference of opinion between you and the RAF as to whether you qualify for compensation based on the merits of your case
- • Should you qualify in respect of merits, a dispute may still arise between you and the RAF regarding the value of your claim. Remember, the RAF has to be satisfied that your injury is ‘serious’ before you are entitled to any money for your pain and suffering
- • The RAF may reject your claim either based on how the accident happened (the merits of the case) or as not being ‘serious’. They may also decide to offer you only a percentage of your loss if they are of the view that you were partly to blame for the accident
- • Without any advice from an expert attorney, you will have no way of knowing whether the settlement you are being offered is fair or not and or whether the claim was validly rejected. By the time you seek advice from an independent attorney it may be too late
Past and future Loss of income or earnings
Any injured person may claim his/her proven past and future loss of income from the RAF such person is, as a result of the injuries sustained not able to work. A cap may apply depending on the date on which the third party claim arose. Support for a dependent of a deceased victim In the event that a breadwinner is killed as a result of a motor vehicle accident, the dependant/s of the breadwinner can claim for loss of support provided the breadwinner was not entirely at fault.
Support for a dependent of a deceased victim
In the event that a breadwinner is killed as a result of a motor vehicle accident, the dependant/s of the breadwinner can claim for loss of support provided the breadwinner was not entirely at fault.
Past and future hospital and medical expenses
- • An injured person may claim all his/her proven past and future medical expenses from the RAF. The medical expenses must be directly related to the injuries sustained in the accident. If the medical expenses are not related to the injuries sustained in the accident the RAF will not be liable to compensate such person.
- • Only proven medical expenses will be compensated. The injured person must furnish the RAF with proof that the medical expenses were indeed incurred. A supplier of medical services such as a hospital or medical practitioner also has the right to claim directly from the RAF such expenses. Where the RAF paid the medical expenses to the supplier the injured person can no longer claim the medical expenses from the RAF.
- • An injured person can also claim his/her expected future medical treatment costs from the RAF, if it is proven that such future treatment costs are likely. The RAF will issue to the injured person with a medical undertaking that would enable the third party to receive future medical treatment subject to certain terms and conditions. The RAF may elect to pay either the injured person or the supplier in respect of claims made in terms of the undertaking.
- • Non-emergency medical expenses are compensated if the cost of the medical expense is reasonable and provided the medical treatment was necessary.
Necessary funeral expenses
The RAF is liable to compensate the person who was in law responsible to pay for the funeral expenses of a person killed in a motor vehicle accident. The RAF’s liability to compensate the funeral costs are limited to the necessary actual costs to cremate the deceased or to inter him or her into the grave.
Apportionment of Damages
- • The scheme of an injured person’s compensation as per the RAF Act is based on the common law; therefore an injured person’s entitlement to compensation is reduced in proportion to their own fault (negligence) in causing the motor vehicle accident.
- • In instances where the injured person has failed to wear a seatbelt (motor vehicle driver / passenger) or a safety helmet (motor cyclist) thereby contributing to the severity of the injuries; such failure is taken into consideration by the RAF when assessing the amount of compensation due to such injured person.
Collateral Benefits
Sometimes a third party receives payment from sources other than the RAF in respect of the third party damages. Certain of those payments may be considered by the RAF when assessing the amount of compensation due to the third party.