Road Accident Fund ( RAF ) – How To Claim And The Most Frequently Asked Questions
Have you been in an accident? Do you know how to claim from the Road Accident Fund? Here's everything you need to know:
The Road Accident Fund (RAF) was established in South Africa by an Act of Parliament and has been available to the South African public and all foreigners who live or visit South Africa since May 1997.
It's mandate 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."
In current news, the Department of Transport has tabled the Road Accident Benefit Scheme (RABS) Bill before the National Assembly which will see the RAF being phased out and replaced by the RABS. Advocacy groups and opposition parties strongly oppose this proposal and have rallied to put the brakes on it.
Until such time or if ever the RABS replaces the RAF, the South African public will continue to claim from the embattled state-supported insurance scheme. It takes time; so the sooner you submit your claim with all the relevant documents, the better.
What is the Road Accident Fund?
The RAF was established in South Africa by statue to provide compulsory state-supported insurance cover to any person who is seriously or fatally injured while using South African roads. This includes not only the South African public but all foreigners living or holidaying within the borders of the country.
It's compulsory cover to the extent that the insurance premiums are collected by RAF through a levy imposed on motor vehicle fuel. In other words, every time you fill up your vehicle with petrol or diesel, you are automatically contributing to the RAF.
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How does the Road Accident Fund work?
The RAF works on the basis that you are assigned a percentage of responsibility (blame) for the accident. If your claim is successful, the RAF pays you an amount that represents the percentage that was not deemed your fault.
It provides two types of cover:
- Personal insurance cover to accident victims or their families
- Indemnity cover to wrongdoers for civil liability.
This means that anyone seriously injured in a motor vehicle accident caused by a negligent driver may claim for compensation for medical costs and lost income. In the case of a death, the family is compensated for loss of support and general damages.
In addition, the person who caused the accident is indemnified against any claims for compensation for a serious injury. The reason behind this is the state wishes to limit the financial burden that the wrongdoer is already under; giving him or her a chance to recover and return to work to continue contributing to the South African economy.
Who can claim from the Road Accident Fund?
Any person who is seriously injured in a road accident within the boundaries of South Africa may claim from the RAF as long as the accident was not his or her fault. The person who caused the accident may not claim from the RAF if he or she was negligent and entirely to blame for seriously injuring or killing a person(s) in a road accident.
For a fatal road accident, the immediate family may claim for general damages if the person who died was not negligent.
A RAF claim may only be lodged if a person was:
- Seriously injured in a road accident but was not entirely responsible for it
- The driver responsible for the accident but not the owner of the vehicle, where the accident was caused by the owner's negligence (failed or worn brakes, unroadworthy vehicle etc.)
- The child, spouse or other dependent of the road accident victim, and has lost financial support as a result of the fatality
- A close family member who paid for the funeral costs.
A RAF claim is not considered if the person:
- Was the owner of the vehicle and solely responsible for the accident
- Was the only person involved in the accident and no-one else was injured.
Typically, the RAF covers the following road users in the case of a serious injury or fatality where the person was not entirely responsible for the accident:
What does the Road Accident Fund cover?
The RAF provides cover for the following which results from a serious injury or death caused by a road accident within South Africa's borders where the person was not entirely at fault (compensation based on percentage of liability):
- Emergency and other medical costs
- Loss of present and future income
- General damages for pain and suffering
- Loss of present and future financial support where a breadwinner dies in a road accident
- Funeral costs for a family member who died in a road accident.
How does the Road Accident Fund assess a serious injury?
The Road Accident Fund Act was amended in 2005 to re-address the criteria for compensating victims of a road accident for general damages for pain and suffering, but only for what is classified as a serious injury. The RAF refers to the guidelines provided by the American Medical Associations (AMA) Guide to the Evaluation of Permanent Impairment, Sixth Edition.
To assess claims, the RAF use the so-called "Whole Person Impairment (WPI)" which is expressed as a percentage. The Minister of Transport set the threshold percentage at 30% which means a road accident victim must be assessed as being 30% Whole Person Impaired to qualify for an award of general damages.
This assessment can only be made by an appropriate medical specialist who has the requisite qualification from the AMA. The assessment is done after the accident victim has reached maximum medical recovery, meaning that the injuries have stabilised and have not notably improved or deteriorated for a period of several months prior to the assessment.
Examples of a serious injury that meet the 30% WPI threshold are:
- Permanent brain damage
The medical practitioner may submit an assessment testimony where a road accident victim is not rated as 30% WPI. In this case, there may be justification to still claim compensation for general damages.
What does the Road Accident Fund classify as a serious injury?
An injury is classified as serious for the following conditions:
- Long-term impairment or the loss of a body function
- Permanent, severe disfigurement
- A serious long-term mental or behavioural disturbance or disorder
- Lhe loss of an unborn child.
Medical conditions that do not fall under the serious injury classification include:
- Bruises and sprains
- Torn ligaments
- Loss of digits (fingers and toes)
- Superficial cuts and wounds.
What does "general damages' cover?
General damages are awarded for pain and suffering incurred where a person has:
- Lost an unborn child
- Sustained serious disfigurement, mental impairment or the loss of a bodily function
- Lost financial support if the deceased victim was the main income earner
- Lost earnings, where the person was unable to return to work.
Again, compensation is only awarded if the person involved in the road accident was not entirely negligent.
What medical expenses does the Road Accident Fund cover?
The RAF covers all past and future medical expenses that directly relate to the road accident where a person was seriously injured or died. The medical expenses must be proven by a suitably qualified medical practitioner to qualify.
A supplier of medical services such as a hospital, emergency service or doctor may also claim in the event the road accident victim is not able to pay. In this case, the road accident victim cannot claim medical expenses if the RAF has already paid out a claim to a medical supplier.
With regards to future medical costs, the RAF issues the road accident victim with an undertaking that any medical costs incurred in the future that are directly related to the injury caused by the accident will be covered.
All medical expenses are paid out by the RAF according to a prescribed tariff. The RAF assesses medical costs in terms of whether they were necessary and reasonable.
How does the Road Accident Fund pay out for loss of earnings?
The RAF covers past and future loss of income only if road accident victims are unable to return to work and fulfill their duties adequately as a result of their injuries. After the amendment to the Road Accident Fund Act, compensation is limited to a prescribed cap. This was determined as R160 000 at 1 August 2008 and adjusted quarterly for inflation.
If a person died as a result of the accident and was the main income earner (breadwinner), a dependent of the victim may claim from the RAF if they can prove past and future loss of support. Again, after the RAF Act was amended, compensation is limited to a prescribed cap which is adjusted quarterly for inflation.
Does the Road Accident Fund cover funeral costs?
The RAF compensates the dependents of a road accident victim who dies but again, only if the deceased was not entirely responsible for the accident. It's the mission of the RAF to support families of deceased road accident victims at a time of great loss and emotional suffering.
Dependents are supported through a Panel of Funeral Undertakers who are tasked with ensuring the deceased is given a dignified burial. The RAF only pays for the following funeral costs:
- Transporting the deceased body
- Storing the deceased body
- Providing a coffin or burial shroud
- Preparing the deceased body (including embalming)
- Issuing the death certificate
- Burial or cremation fees
- Equipment hired to lower the deceased body into a grave.
Dependents cannot claim from the RAF for the following costs:
- Family transport
- Funeral programmes.
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How does the Road Accident payment process work?
Compensation is determined by how much the injured victim is to blame for the road accident. Thus, the RAF apportions compensation for serious injury and general damages taking into account such issues as:
- To what extent the victim was negligent
- Whether the accident victim was wearing a seatbelt (motorcar driver or passenger)
- Whether the victim was wearing a safety helmet (motorcyclist or cyclist)
- Whether the pedestrian or bystander was negligent.
How to claim from the Road Accident Fund?
The more organised you are in terms of having the necessary documents together, the higher your rate of success claiming from the RAF. You need to ensure all documents are original hard copies. If the claim is submitted by fax or email, you must be able to provide the original hard-copy document when required.
Step 1: Gather all the documents needed to claim
The documents you need to claim from RAF are:
- The official RAF form (Form 1)
- The police report or case number of the accident
- Your personal details and the details of the person who caused the accident
- All medical documents that support your injury claim
- Witness statements from people who witnessed the accident
- Any motivating testimony from a medical practitioner or lawyer that can testify to your need to claim
- Information about any damage to the vehicle(s) and/or surrounding structures.
Step 2: Submit your claim
You can make a direct submission or employ the services of a legal firm that specialises in Road Accident Fund claims. The claim is lodged using a prescribed statutory claim form, called Form 1.
It provides the RAF with basic information on the claimant, the vehicles and all parties involved in the accident as well as the date and place of the accident, amounts claimed, supporting witness testimonies and the medical report from the assessing doctor.
Once the claim is processed, the legal proceedings begin and the RAF considers all the evidence presented. The RAF may require you to submit additional documents to prove aspects of the claim.
The information required by the RAF for a claim includes the following:
- Full details of the accident; where, when and how it happened
- Witness statements
- Police report
- Emergency services, hospital and medical records
- Invoices to support amounts claimed for medical costs.
After 31 July 2008, a Serious Injury Assessment Report (RAF 4) must be submitted to claim general damages that confirms the injury sustained is serious (according to the criteria set by the amended RAF Act). This assessment report can only be completed by a medical doctor with the requisite AMA qualification.
Step 3: RAF investigates the claim
Once a claim has been lodged and registered by the RAF, the process of investigating the circumstances of the accident, apportioning damages and reaching a settlement amount commences.
The RAF determines:
- If the claim is valid
- If the claim was submitted in time
- The degree of fault, blame or negligence of both parties (wrongdoer and victim)
- The amount of damage claimed is justified.
How to claim from the Road Accident Fund for a deceased victim?
If you have lost a family member who was the main income earner (breadwinner), you may claim from the Road Accident Fund for loss of support as long as you can prove the person was not entirely at fault for the accident. You may also claim for funeral costs, limited to what the RAF covers.
Follow the same procedure to claim using the RAF Form 1. The person lodging the claim needs to submit details of the accident, details of all parties involved, the police report or case number, witness statements if available, all medical costs incurred and proof of loss of income or support.
If the victim died immediately, it isn't necessary to submit a medical report. However, if the victim dies after the date of the accident, the RAF needs a supporting medical report to explain the injuries and cause of death.
For a deceased claim, the following certified documents are required:
- Identity document of the deceased
- Unabridged birth certificate, in the case where the claimant is a minor
- Death certificate and post-mortem report
- Marriage certificate, if applicable
- Invoice for funeral costs
- Salary slip, income tax returns or financial statement for proof of earnings.
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How to claim from the Road Accident Fund for a hit-and-run accident?
In the case of a hit-and-run accident, the driver at fault is unknown because he leaves the scene of the accident without identifying him/herself and providing contact details. You can still claim for past and future medical costs and general damages for a serious injury or death if the wrongdoer cannot be identified. Bear in mind, there is a time constraint and the amount payable is capped.
Follow the same procedure to claim using the RAF Form 1. The person lodging the claim needs to submit details of the accident, the police report or case number, witness statements if available, all medical costs incurred and proof of loss of income or support, if applicable.
When must a claim be submitted to 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.
The following timelines for a deceased claim apply:
- The claim must be submitted to the RAF within three (3) years of the date of the accident or the date of death, if the claimant was 18 years or older.
- If a claim is lodged on behalf of a minor who lost a parent(s) in a road accident, the claim must be submitted within three (3) years of the minor reaching the age of 18 years.
- In the case of a hit-and-run accident and there are no witnesses who can vouch for who was entirely to blame for the accident, a claim must be submitted within two (2) years of the date of the accident.
How does the Road Accident Fund payment process work?
Once the RAF has investigated a claim and arrived at a settlement amount, you should receive the payment owed to you within 14 to 28 days from the date of settlement. However, this timing is only a guide and it could take much longer to be paid out by the RAF due to certain internal procedural factors.
A claim may be taken to court if the claimant and RAF cannot settle on a compensation figure. This is either done through a court of law or an out-of-court settlement may be considered.
- Court settlement: The RAF claim is brought before a court of law and requires a judge to decide what payment is due
- Out of court settlement: Where the RAF claim is settled without the need to go to court; a popular option if a claimant wants to avoid taking the claim to court; however, he/she settles for a lesser amount.
As soon as the claimant and the RAF have reached a settlement amount, a discharge form is issued with a statement on the agreed amount. The payment is made once the discharge form is signed and lodged by both claimant and the RAF.
Compensation from the RAF is made directly into your cheque or savings account that's held with a registered bank in South Africa. The RAF needs an official letter from your bank that verifies you bank with the financial institutions and your bank details.
For claimants that don't have a bank account, the RAF will pay the compensation amount into another person's bank account. Again, it needs an official letter from the person's bank verifying the account details and a letter from yourself formally granting permission to the RAF to pay the amount owed into another person's bank account.
If you have claimed from the RAF through a legal firm, the payment goes directly to them. They then subtract their fees and pay over the balance into your personal bank account.
How long does the Road Accident Fund take to process a claim?
The RAF is burdened by a severe backlog and insufficient funding so the time it takes to investigate and payout compensation can take up to 3 to 5 years. The sooner you lodge your claim with the RAF, the sooner it will be investigated and processed.
Road Accident Fund latest news
In latest news, the Department of Transport announced that it intends starting the process to scrap the embattled RAF and replace it with a new fund. The current fault-based system administered by the RAF is deemed ineffective; with claims taking too long to pay out, high administration costs and claims often resulting in extensive and costly litigation.
The proposed scheme - dubbed the Road Accident Benefit Scheme (RABS) - will continue to supply a social safety net to those injured in road accidents and to the dependents of breadwinners killed in accidents. It will also continue to indemnify the wrongdoers who are responsible for road accidents from civil liability.
However, it's said the focus will shift from a fault-based system (which is an onerous process) to a no-fault scheme that's designed to remove the unintended negative consequences and financial burden on the family of wrongdoers. Unlike the RAF system, RABS payments will be made directly to claimants, medical and healthcare services provides.
The RABS is not a foregone conclusion as there has been a backlash to the proposed scheme and a concerted attempt to put the brakes on it. APRAV is a human rights organisation established for the Protection of Road Accident Victims in South Africa and, together with opposition parties, is currently fighting to stop RABS.
Chairman of the organisation, Pieter de Bruyn, says there is a "myriad of unconstitutional issues" related to the new scheme and that "authorities are lying to parliament and the public" about the cost of running both the RAF and RABS concurrently.
A sticking point of the new scheme is it will not cover victims who earn more than the national annual average income of approximately R220 000, and will have dire consequences for minors who lose a parent(s) in a road accident.
The road accident fund as we know it will soon be replaced by the road accident benefit scheme