FAQs

How much time is available to lodge a claim?
What is required for the first consultation?
How long will it take to finalise my claim?
How much will it cost?
Is the RAF bankrupt?

How much time is available to lodge a claim?

If the vehicle which caused the accident is identified (ie the driver or registration number of the vehicle is known), the claim must be lodged within three (3) years from the date of the accident, or the date of death of the deceased.  A minor (a person under the age of 21) can still lodge his/her claim at any time before reaching 22.  The three (3) year period will therefore not apply to minors.

If the vehicle is unidentified, the claim must be lodged within a two (2) year period after the date of the accident.  This is also applicable to minors, depending on the Act applicable.  Furthermore a claimant is required to lodge a comprehensive affidavit with the SAPS within 14 days of being able to do so, describing the accident and the vehicle in detail as far as possible to enable the SAPS to investigate.
What is required for the first consultation?

The claimant’s identity document, and generally as much information and documentation relating to questions of merits and quantum should be brought to the first consultation.

In particular as much as possible of the following information will be of assistance:

* date, time and place of the accident;
* registration numbers of motor vehicles involved in collision;
* full names and contact particulars of drivers of each of the vehicles;
* names and contact particulars of any witnesses;
* police station’s name and case number where accident was reported;
* accident report, if available;
* copy of registration certificate for own motor vehicle;
* full insurance particulars inclusive of policy number in regard to the damage to vehicle;
* copy of claim form that was submitted to insurance company;
* copy of any witness statements furnished to the SAP, if the claimant is in possession thereof;
* photographs depicting the damage to the motor vehicle;
* copies of any quotations and assessors reports in regard to the damage to the motor vehicle;
* copy of driver’s licence and identity document;
* medical accounts, doctors notes, radiologists reports;
* copies of any salary slips for the past year;
* full particulars of employer;
* name of the general practitioner who normally treats the claimant for general illnesses;
* names and contact particulars of all doctors and hospitals where the claimant obtained treatment for the injuries sustained in the collision;
* medical aid particulars;
* copies of all accident related medical vouchers;
* full particulars regarding any pre-existing medical condition together with the treating doctor’s contact particulars.

How long will it take to finalise my claim?

In terms of the Road Accident Fund Act, the RAF has one hundred and twenty (120) days to investigate the claim, after the claim has been lodged.  After this period the attorney can issue a summons whereafter the RAF will usually make a decision on whether to compensate the claimant or repudiate the claim.  If an amicable settlement cannot be reached with the RAF, the RAF will appoint its own attorneys to enter an appearance to defend, and the third party claim will proceed to trial.  If the merits of the matter are disputed and contentious, the merits and quantum will usually be separated and the matter will first proceed to trial in respect of the merits.  The matter will only proceed to trial in respect of the quantum once the merits have been finalised.  The waiting period for a trial date, in the High Court, is currently approximately 20 months.

In very serious cases, especially brain injuries, two (2) years must lapse before the claim can be quantified fully.  Should the person who suffered the brain injury be a minor, the claim will usually be delayed until the minor completes grade 5, to be able to ascertain the impact that the injury has on the minor’s schooling.

From the above it is evident that a claim can either be finalised within a four (4) month period after lodgment, or up to six (6) years later, depending on the circumstances of each matter.

Adams & Adams strives to finalise claims as quickly as possible and in the cases of most matters which proceed to trial, same are finalised 18-24 months from date of instruction.

How much will it cost?

Legal costs can be divided into two categories, namely party and party costs, and attorney and client costs.  In our legal system the successful litigant is entitled to recover the party and party costs from the other side.  Party and party costs do not cover all the costs of a matter, and are based on a tariff system laid down by a statutory Rules Board.

In most cases the majority of costs incurred is recovered from the RAF.

Any costs which are not covered in terms of the party and party scale will be attorney and client costs.  The attorney and client costs will be deducted from the quantum receivable from the RAF at the finalisation of the claim.  It is difficult to indicate the quantum of attorney and client costs, as this depends on various factors, for instance the complexity of the matter, the amount of work done on the file, whether the matter proceeded to trial or not, etc.

As expenses have to be incurred to prove a third party claim, Adams & Adams is willing to assist its clients with the expenses, and will pay them on the claimant’s behalf, subject to the levying of interest.  The majority of these expenses will, however, be recovered from the RAF at the finalisation of the claim.

In summary, the client need not lay out any money in advance and unrecovered costs will be deducted from the capital at the end of the matter.

Is the RAF bankrupt?

The RAF can be compared to an insurance company.  Most insurance companies will not be able to pay out all claims at once.  The RAF, however, receives money from a petrol levy on a daily basis, and pays out claims on a daily basis as well.  There is accordingly always an inflow and outflow of money from the RAF.  Furthermore, when calculations are done to establish whether the RAF can pay out outstanding claims, they include claims that may be invalid or claims that have not been quantified properly.

The RAF is a semi-state organisation, established in terms of an Act of Parliament.  The government is therefore responsible for the RAF, and should ensure its continued existence.  Government is in the process of re-evaluating the system to make it more equitable and affordable to all parties involved.

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What is an undertaking for future medical expenses?
Who receives an undertaking?
What does the undertaking cover?
What if a claimant was injured in the course and scope of employment?
How does a claimant get the most out of an undertaking?

What is an undertaking for future medical expenses?

An undertaking in terms of section 17(4)(a) of the RAF Act is a contract between the claimant and the RAF, in terms of which the RAF will reimburse the claimant for the reasonable medical expenses which he/she will have to incur due to the injuries sustained in the motor vehicle accident.
Who receives an undertaking?

An undertaking is usually furnished to people who will have to incur future costs for the injuries they sustained.  With an undertaking the RAF undertakes to reimburse a claimant’s reasonable future costs as and when they arise.
What does the undertaking cover?

The undertaking will cover reasonable future costs for the claimant’s injuries.  This means that excessive experimental or unproven types of treatment are not covered.  The undertaking can specify types of treatment only, or cover all treatment and equipment needed as a result of the accident.  A claimant may, for example, qualify for a prosthesis if he/she is an amputee, or a wheelchair if he/she has difficulty moving around, or modifications to a motor vehicle if the claimant is unable to drive a normal motor vehicle.

The undertaking does not cover costs for any illnesses, diseases or injuries that are not accident-related.  It also does not cover a claimant for the normal effects of ageing or the effects that other conditions may have on the injuries.

Click here for further information on the administering of undertakings.

What if a claimant was injured in the course and scope of employment?

The undertaking does not cover the costs of any compensation to which a claimant would be entitled to in terms of the provisions of the Workmen’s Compensation legislation or the Defence Force Act.  In such a case, a claimant must first submit all the specified accounts for the costs which have been incurred to the office that initially handled the claim, for consideration of their liability in terms of the provisions of the relevant legislation.  If that office repudiates liability for any of the claims lodged, the claimant may then proceed to lodge the repudiated claims with the RAF together with the letter of repudiation.

How does a claimant get the most out of an undertaking?

A claimant may contact the Undertakings Department of the RAF and discuss with a staff member any problem that he/she may have.  The Undertakings Department may also be able to advise a claimant of discounts that may be available and of quality services that may be offered by preferred service providers.
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How does the RAF pay future medical expenses and related bills?
How does a claimant know that he/she will be refunded if the costs are paid first?
How should a claim be lodged with the RAF?
How long does it take the RAF to process my claims?

How does the RAF pay the future medical expenses and related bills?

The RAF Act directs that a claimant must first incur the costs and submit the required proof thereof to the RAF, who will then, after determining its liability, pay such costs directly to the claimant.  Always bear in mind that a claimant remains personally liable to pay the account rendered by the service provider.  Should an apportionment be applicable to the claim, the RAF will reduce the claim with the percentage of the claimant’s negligence.  If for example the claimant was 20% to blame for the accident, the RAF will reduce the claim with 20% and pay the claimant 80% of the costs incurred.  If this applies to your case, you would need to plan ahead before incurring any particular costs, to ensure that you will be able to pay for your own share of the costs from your own money, as the RAF will only reimburse you to the extent of its liability pocket.

How does a claimant know that he/she will be refuned if the costs are paid first?

The Undertakings Department of the RAF may be contacted by correspondence or per telephone, to find out whether the RAF regards the costs as both accident-related and reasonable and how much the RAF will reimburse before a claimant decides to incur any costs.  In special circumstances, the RAF may be prepared to liaise on a claimant’s behalf directly with the service provider.  This may include the furnishing of a guarantee or express commitment on certain conditions to pay the service provider directly.
How should a claim be lodged with the RAF?

A claimant should submit any claims as soon as possible.  The original account(s) for services rendered must be furnished to the RAF. All accounts must be specified.  This means that the account must indicate exactly what service / treatment has been received, the date of the service / treatment, as well as the name and physical address of the service provider.  It is not good enough to submit only a receipt as proof that an expense has been incurred.

The following procedures are very important:

* Check the contents of each account you intend submitting as a claim.  Make sure that you receive the goods or services reflected in the account.  If you are satisfied, sign each account that you are forwarding to the RAF for reimbursement.
* Write your RAF claim reference number, which is quoted in your undertaking clearly on each claim.
* With your first claim furnish the bank account details into which any monies are to be paid.  The information required is the bank’s name, branch name, branch code, name of account holder, type of account and account number.
* Under cover of an ordinary letter, quoting the RAF’s file reference number as well as marking your letter for the Undertakings Department’s attention, post your claims together with any receipts as well as all substantiating documentation to the following address:
P.O. BOX 2743
PRETORIA
0001

How long does it take the RAF to process my claims?

The RAF must be offered a reasonable period of time in which to assess its liability in respect of the claims lodged, to enter the claims into the relevant computer system, to perform the necessary enquiries and thereafter to arrange for an electronic funds transfer directly into a claimant’s banking account.  The claimant will be advised by way of a letter which claims have been admitted, how the amount of money paid into the claimant’s bank account was made up, which claims require further explanation and which claims have been rejected as not being accident-related or claimable in terms of the undertaking.
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