Frequently Asked Questions
Claims
Who is entitled to lodge a claim?
The following are entitled to lodge a claim:
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A person who sustained a bodily injury in a motor vehicle accident (except a driver who was the sole cause of the accident);
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A dependant of a deceased breadwinner;
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A close relative of the deceased who paid for the funeral; and
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A claimant under the age of 18 years – who must be assisted by a parent, legal guardian or curator ad litem.
Click here for claims procedure for detailed information on submitting a claim.
What is the time period in which to submit a claim?
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Identified claims (claims where the identity of the driver or owner of the guilty motor vehicle is known) must be lodged with the Fund within 3 years from the date of the accident and summons must be served on RAF within 5 years from the date of accident;
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Hit and Run claims (claims where the identity of the driver or owner of the guilty motor vehicle is unknown) must be lodged with the Fund within 2 years from the date of the accident and summons must be served on RAF within 5 years from the date of accident.
Does the claimant (victim) have the right to know how much was paid to the attorney and to verify whether the fee that the attorney took is genuinely what was due to them?
The claimant does indeed have the right to know what amounts have been paid out. The claimant can ask to be furnished with a copy of the settlement agreement, which contains the details of the amounts agreed upon.
Accidents
What documents must I retain or obtain subsequent to a road accident?
Herewith a list of the documents:
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SAPS collision report (SAP 352) or Officer’s Accident Report (OAR)
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Witness statements taken by SAPS
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Hospital, medical, and / or clinical records
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Details of medical institutions attended and medical practitioners seen
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All hospital and medical accounts
What steps must I take subsequent to an accident?
The following steps must be taken subsequent to an accident:
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Report the accident to the SAPS immediately
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If the matter is not being investigated by the SAPS, attempt to obtain statements from witnesses ASAP
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Attempt to take photographs of the accident scene as the scene may change
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Attempt to take photographs of the damage to the vehicles and of injuries e.g. abrasions, severe bruising or cosmetic disfigurement
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Draw a sketch plan of the scene and make sure that it contains a fixed point so that it can be located easily
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Make sure that the treating doctor records the visit and gives a detailed account of injuries and treatment
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Take photographs of the end position of the vehicles as well as road markings, if any.
I have just been involved in a road accident, what do I need to do?
Record the following details:
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Full names of all drivers / pedestrians involved
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ID numbers
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Addresses (work and home)
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Telephone numbers (work and home)
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Vehicle registration numbers of all drivers, passengers and witnesses
You will also need to record the following:
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Descriptions of vehicles and drivers
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Details of police officials, traffic officials and ambulance officials
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Details of tow truck personnel
What recourse exists if a dispute arises regarding the assessment of the seriousness of an injury?
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The amendments provide for dispute resolution where the medical practitioner has assessed an injury as “not serious” or where the Fund has rejected a serious injury assessment report by a medical practitioner in terms of which the injury has been assessed as “serious”.
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A claimant wishing to lodge a dispute must do so within 90 days of being notified of the outcome of the assessment or being notified of the rejection of the serious injury assessment report by the Fund.
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The dispute must be lodged, on the prescribed form (RAF 5), with the Registrar of the Health Professions Council of South Africa (“the HPCSA”).
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The dispute will be determined by an appeal tribunal appointed by the Registrar of the HPCSA and will publish its findings within 90 days from the date that the dispute was referred to the Registrar.
Section 90(1)(b) of the National Health Act, 2003 (Act No. 61 of 2003), as revised from time to time.
Legal Questions
Do my injuries and/or losses qualify me to claim?
You can claim compensation for injuries caused by:
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Motor vehicle accidents
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Accidents in other forms of transport, such as aircraft, trains and boats
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Dog bites
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Defective products
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Negligently constructed infrastructure
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Accidents in public places, such as slips and falls
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Medical malpractice, negligent doctors or poor medical care
This is merely a list of examples. Your claim is not necessarily invalid if it is not specifically featured above. If you are unsure of your predicament it is advisable that you get a legal opinion as soon as possible.
You can also be compensated for loss of support when:
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The person on whom you or your family depended for financial support has been killed as a result of another person’s negligent actions or failures to act.
What kind of damages can I claim for?
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You can claim in respect of past and future financial burdens – including medical expenses, loss of income or earning abilities, funeral costs and loss of support.
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You can also claim for general damages if the injuries are considered of a serious nature, which means claiming for pain and suffering, emotional shock and psychological trauma.
Who will I actually be claiming from?
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Medical negligence cases: From State institutions or the relevant doctors’ insurers
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Motor vehicle accidents: From the Road Accident Fund, which gets its funds from a levy placed on fuel
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General personal injuries: From the relevant individual, company or public entity responsible or from the Workmen’s’ Compensation Fund if an occupational injury or disease has occurred.
How long will it be before I get results?
Every claim is unique, nonetheless it can be generally be said that it will take between 2 to 4 years to settle. You may ask why the estimated time period is so long.
Here are a few reasons:
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It is the nature of legal processes to be lengthy;
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There are no “short cuts” that can be taken;
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Medical conditions often need time to reach a steady state (maximum medical improvement) so that the long term effects can be properly assessed;
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Forcing hasty settlements will usually mean settling for less than what is a fair amount.
What is the procedure for claiming?
Below is a simplified overview of the procedure:
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During or after consultation, we establish the prospects of your claim and whether there is substantial supporting evidence
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We assist in determining and obtaining the necessary documentation
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We institute the legal action by issuing Summons
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We continue with the legal notices served on and by the opposing Attorneys
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We work on settling your claim out of Court
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If no out-of-court settlement is reached, we proceed to trial at the Courts.
Undertakings
Regarding emergency medical treatment, the RAF’s liability is determined according to a prescribed tariff applicable at the time.
Note that the RAF will not be liable for treatment that was excessive, experimental or unproven.
What if my medical aid has already covered some or all of the costs?
You will still be able to claim back for those expenses paid for by the medical aid. Your attorney receives the funds and thereafter transfers the amount to the medical aid.
What happens if I was also negligent on the day my accident happened?
You are still entitled to claim, however the amount claimed may be reduced in accordance with the percentage of your contributory negligence.
This percentage will be determined based on the degree to which your actions deviated from what the “reasonable person” would have done in the same circumstances.