How to claim from the Road Accident Fund

You claim from the Road Accident Fund by lodging a completed claim form, with medical and police documents attached, at an RAF office. If the driver who caused the accident was identified, you generally have three years from the date of the accident to lodge. If it was a hit and run, or the driver was never identified, you have only two years, and that shorter deadline is applied strictly.

The Fund is set up by the Road Accident Fund Act 56 of 1996. It compensates people who are injured, and the dependants of people who are killed, in road accidents caused by the negligent driving of another road user. It is funded by the fuel levy, so every time you fill up you are paying into it.

Start with the deadline

Nothing else matters if you miss the date.

• Identified driver: lodge within three years of the accident.
• Unidentified driver, including a hit and run: lodge within two years of the accident.

Lodging in time is not the end of it. A lodged claim still has to be taken further, and a summons generally has to be issued within five years of the accident date. If your claim has been sitting with the Fund for years with no movement, treat that as urgent, not as patience.

Time runs differently for children. A minor's claim generally does not start running until they turn 18, so a parent who missed the deadline for a child is often not out of options. If you are unsure where you stand, our prescription checker will walk you through the dates.

Who can claim

You can claim if you were injured because someone else drove negligently. That includes:

• drivers and motorcyclists injured by another road user
• passengers, including passengers in the vehicle that caused the accident
• pedestrians and cyclists
• dependants of a breadwinner who was killed, for the support they have lost
• whoever paid for the funeral

If you were solely at fault for the accident, you cannot claim general damages for your own injuries. If you were partly at fault, your compensation is usually reduced in proportion to your share of the blame rather than refused outright.

Passengers have the strongest position of anyone. Read Can I claim if I was a passenger in a car accident? if that is you.

What the RAF pays for

Broadly, four things:

1. Past and future medical expenses. Future treatment is usually covered by an undertaking, which is a written promise by the Fund to pay for that treatment when you actually need it, rather than a cash amount now.
2. Past loss of earnings while you were off work.
3. Future loss of earnings or earning capacity, if the injury has permanently changed what you can do for a living.
4. General damages for pain, suffering and loss of amenities of life, but only where the injury is assessed as serious.

It does not pay for damage to your vehicle. That is what your own short-term insurance is for, or a civil claim against the other driver. If your insurer has turned you down, see My insurance claim was rejected. What can I do?.

The serious injury test for general damages

General damages are only payable if your injury is assessed as serious using the process prescribed under the Act. A registered medical practitioner examines you and completes the prescribed serious injury assessment report. The Fund then decides whether it accepts that the injury qualifies. If it does not, there is a dispute process through an appeal tribunal.

This is why two people with what sounds like the same accident can end up with very different outcomes. It turns on the medical evidence, not on how bad the crash looked.

Documents you will need

Start collecting these immediately, because the older an accident gets, the harder they are to obtain:

• the police accident report and the case number (an OB or CAS number)
• your ID and, if you were driving, your licence
• hospital records, ambulance records and any medical reports
• proof of income: payslips, an employer letter, or bank statements if you are self-employed
• receipts for anything you have paid out of pocket
• names and contact numbers of witnesses
• photographs of the scene, the vehicles and your injuries
• for a fatal claim, the death certificate and proof that you depended on the deceased

Write down your own account of what happened while it is fresh. Memory fades and your statement may be tested years later.

What to do this week

If the accident was recent, these seven steps protect the claim.

1. Report the accident to the police if it has not been reported, and get the case number in writing.
2. Ask the hospital or clinic for a copy of your admission notes and discharge summary, or write to the records department for them.
3. Photograph your injuries now and again every week while they heal. Bruising disappears, and photographs are the only proof of how bad it was.
4. Ask every witness whose number you have for a short signed statement of what they saw, with the date.
5. Start a single folder for every receipt, sick note, prescription and appointment card.
6. Tell your employer in writing that you are off work because of the accident and ask for a letter confirming your dates and pay.
7. Work out your lodging deadline and write it somewhere you will see it.

None of this requires an attorney, and all of it is harder in a year's time.

Lodging the claim

You can lodge yourself. The RAF accepts claims directly from the public at its regional offices and hospital service points, and it costs nothing to do so. You complete the claim form, attach a medical report completed by the treating practitioner, attach your supporting documents, and lodge them. Keep a stamped copy of everything and keep your claim number somewhere safe.

If you use an attorney, they lodge on your behalf and usually work on a contingency basis, meaning no fee unless you succeed. Read How does no win no fee work in South Africa? before you sign anything. Under the Contingency Fees Act 66 of 1997 the agreement must be in writing, the success fee cannot exceed double the normal fee or 25% of the award, whichever is lower, and that cap does not cover disbursements such as expert reports.

A worked example

Thandi is a 34 year old shop assistant. A bakkie runs a red light and hits her car side-on. She breaks her right wrist, needs a plate inserted, and is off work for ten weeks. The bakkie driver is identified and the police open a case.

The figures that follow are illustrative only, made up to show how a claim is put together. They are not a prediction of what any claim would pay.

• Past medical expenses: the ambulance, the casualty visit, the operation and six physiotherapy sessions. Say these come to R48 000, part paid by her medical aid and part by her. Both parts can be claimed.
• Past loss of earnings: ten weeks off at her normal pay, which her employer confirms in a letter. Say R28 000.
• Future medical expenses: her surgeon says the plate may need to be removed in a few years. Rather than paying cash for that now, the Fund would typically give an undertaking to cover it when it happens.
• General damages: whether Thandi receives anything for pain and suffering depends entirely on whether her injury is assessed as serious on the prescribed form. A healed wrist fracture may not qualify. A wrist that leaves her with permanent loss of function might. Nobody can tell her the answer before the assessment is done.

Thandi's deadline to lodge is three years because the driver was identified. If the bakkie had driven off and was never traced, she would have two. Our RAF claim range calculator shows illustrative bands only, and it is not a prediction of Thandi's outcome or yours.

Realistic timeline

Lodging is quick. Everything after it is slow.

• Gathering documents: weeks to months, depending mostly on how quickly the hospital releases records.
• Lodging: a day, if your file is complete.
• The Fund's investigation: the Fund has a period after lodging to investigate before summons may be issued, and the merits investigation often runs well beyond it.
• Medico-legal examinations: often the longest stage, because several specialists have to examine you and report.
• Settlement or trial: months to years. Many claims settle shortly before a trial date.
• Payment: the Fund has a further period to pay after settlement or judgment, and it is frequently slower than that.

How long does a RAF claim take? sets out each stage in more detail.

Common mistakes and what they cost

• Waiting until you have recovered before lodging. Recovery can take longer than the deadline. A prescribed claim is worth nothing.
• Throwing away receipts. Every unproved expense is money you cannot claim.
• Not reporting a hit and run to the police. Without a police record an unidentified driver claim is very hard to prove, and you only have two years.
• Settling before your doctors know where you will end up. Once you accept, you cannot come back for more.
• Signing a fee agreement without reading it. The cap under the Contingency Fees Act only protects you if you check the agreement complies with it.
• Assuming the Fund will pay for the car. It will not. Claim that from your insurer separately, and watch the insurer's own time limits.

Your rights and the Fund's rights

You have the right to: lodge without an attorney; be given a claim number; dispute a serious injury rejection through the appeal tribunal; issue summons if the Fund does not settle within the period the Act allows; and recover a costs contribution if you succeed.

The Fund has the right to: investigate the merits before paying; require you to attend examinations by its own experts; reject a serious injury assessment it does not accept; argue that you were partly at fault; and pay future medical expenses by undertaking rather than in cash.

If you cannot afford an attorney

Lodging with the Fund yourself is free. If your injuries are modest and liability is clear, that is a genuine option. If your injury is serious, most people use an attorney on a no win no fee basis. Legal Aid South Africa can be reached on 0800 110 110 and applies a means test.

Nobody can tell you upfront what your claim is worth. How much is a RAF claim worth? explains what drives the number.