Claims & compensation

Something happened to you, somebody else caused it, and you are out of pocket, injured or both. That is the whole of this category. The law calls it delict, which simply means a wrong that entitles you to compensation. This page tells you which route your situation takes, because a car accident, a rejected insurance claim, a botched operation and a dog bite all end in compensation but travel by very different roads.

What this area of law covers

Three separate systems sit side by side here.

The first is the Road Accident Fund, created by the Road Accident Fund Act 56 of 1996. If you were injured in a road accident caused by someone else's negligence, you generally cannot sue that driver directly. You claim from the Fund instead. It has its own forms, its own rules on medical evidence, and its own deadlines.

The second is the ordinary law of delict, which applies where no special statute takes over. Slip and fall in a shop, a dog bite, a falling branch, defamation, or a professional who got it badly wrong. You prove that the other party owed you a duty, breached it, and that the breach caused your loss.

The third is contract and consumer law. A rejected insurance claim is a contract dispute governed by your policy and by the Short-term Insurance Act 53 of 1998 or the Long-term Insurance Act 52 of 1998, with the Financial Advisory and Intermediary Services Act 37 of 2002 covering the advice you were given. Faulty goods and unfair contract terms fall under the Consumer Protection Act 68 of 2008.

Medical negligence sits inside delict but behaves like its own field, because proving that treatment fell below the standard of a reasonable practitioner requires expert evidence.

Where to start, by problem

If you were injured in a road accident, start with how to claim from the Road Accident Fund. Then read how long does a RAF claim take so your expectations match reality.

If you were a passenger, read can I claim if I was a passenger in a car accident. Passengers are usually in the strongest position of anyone in the vehicle.

If the accident was partly your fault, read can I claim from the RAF if the accident was partly my fault. Partial fault reduces a claim. It rarely destroys it.

If you want to know what a claim is worth, read how much is a RAF claim worth and what can I claim for in a personal injury case. The second one matters even in a non road claim, because it lists the heads of damages you can actually recover.

If an insurer rejected your claim, read my insurance claim was rejected, what can I do, then how to complain to the ombudsman for short term insurance. The ombud route is free and it is where most rejected claims are resolved.

If you are worried about running out of time against an insurer, read how long do I have to claim from an insurance company. Policies contain their own short time bars that are much shorter than the ordinary three years.

If you were hurt by medical treatment, read what is medical negligence and how do I prove it. A bad outcome is not the same as negligence, and the guide explains the gap.

If you fell or were injured on someone's premises, read can I claim if I slipped and fell in a shop.

If a dog bit you, read how to claim compensation for a dog bite. South African law treats the owner of a domestic animal unusually strictly.

If somebody damaged your reputation online, read can I sue for defamation on social media.

If you bought something faulty or want to cancel a purchase, read what is the Consumer Protection Act cooling off period.

If you cannot pay an attorney upfront, read how does no win no fee work in South Africa. Contingency fees are legal here, and they are regulated, with a cap on the percentage.

The deadlines that catch people out

Three years for most damages claims. A delictual claim generally prescribes three years from the date the claim arose, or from when you knew, or reasonably should have known, both the identity of the wrongdoer and the facts giving rise to the claim. That second part matters in medical negligence, where the harm may only surface later.

Road Accident Fund claims. Lodge within three years of the accident where the driver who caused it is identified. Where it was a hit and run and the driver or vehicle cannot be identified, you have two years, and you should report the accident to the police at once, because that record is usually the main evidence that an unidentified vehicle was involved. The two year rule ends more valid claims than any other deadline in this category.

Claims against organs of state. If your claim is against a government department, a provincial health department, a municipality or the police, you must give written notice of the intended claim within six months of the debt arising, and then issue summons within the ordinary period. Miss the notice and you need condonation before you can proceed at all. Almost every public hospital negligence claim runs into this.

Insurance policy time bars. Policies usually require you to report an incident within days, and then give a short window after a rejection to object, and a further short window to issue summons. Those periods come from the contract, not from the Prescription Act, and they are much shorter. Read the rejection letter for the dates.

Consumer Protection Act periods. The cooling off right after direct marketing, the quality warranty on goods, and the window after a failed repair each run for their own fixed period. The consumer returns calculator works out which applies.

Once summons is issued, prescription stops running. That is why an attorney will often issue summons before finishing the medical reports.

What it costs, and what is free

The full picture is on what does claims and compensation cost.

Lodging a Road Accident Fund claim yourself costs nothing. The Fund provides the claim form and you may submit it without an attorney. The National Financial Ombud Scheme South Africa handles complaints against insurers, banks and credit providers free of charge, and it is the first stop for a rejected claim. The Motor Industry Ombudsman of South Africa and the Consumer Goods and Services Ombud handle consumer disputes at no cost. The National Consumer Commission takes Consumer Protection Act complaints. The Office of the Health Ombud receives complaints about health establishments, and the Health Professions Council of South Africa handles professional conduct complaints, although neither pays you compensation. The Small Claims Court is free for smaller damages claims. Legal Aid South Africa applies a means test.

Personal injury attorneys often work on contingency, so you pay nothing upfront and a regulated percentage on success. Read that agreement carefully, particularly the definition of success and how disbursements such as medico legal reports are treated.

The mistakes that cost the most

Not reporting the accident to the police. For a hit and run especially, a police report made promptly is close to essential.

Accepting the first offer. Insurers and the Fund settle early and cheaply where a claimant is under financial pressure. Once you sign a full and final settlement, the claim is over even if your injury worsens.

Waiting to see how the injury turns out. Prescription does not pause while you recover. Lodge, then quantify.

Missing the six month notice against the state. People spend a year gathering hospital records and only then discover the notice period ran out months ago.

Talking to the other side's insurer without advice. A recorded call in which you say you were fine, or apologise, becomes evidence about both fault and injury.

Treating an ombud complaint as optional. It is free, it often works, and it is far cheaper than litigation. Use it before you sue.

Losing the proof. No photographs of the wet floor, no incident report at the shop, no vet or medical records after a dog bite. The evidence disappears within days.

The tools on this site that help here

• RAF claim range gives a broad, heavily qualified indication of what a claim looks like at four injury levels, shows the maximum contingency fee on that figure, and works out your lodging deadline.
• Prescription checker works out when your claim prescribes, including the Road Accident Fund periods and the shorter rules for claims against the state.
• Consumer returns checks whether you can return goods or cancel a purchase, and by when.
• Small claims court checks whether your claim fits the free route, where no attorney appears and no costs order can be made against you.
• Court fees gives a rough cost band for suing in the District, Regional or High Court.
• Letter of demand for damages sets out what happened, why the other party is liable and what each item of loss cost you.
• Insurance claim rejection appeal letter asks the insurer for full written reasons and answers the ground of rejection, before you go to the ombud.

When you need an attorney

Get one for any serious injury claim, meaning a fracture, a head injury, a permanent disability or an injury that keeps you off work. The value turns on expert reports you cannot obtain yourself, and the difference between a self lodged claim and a properly quantified one is usually far more than the fee. Get one for any medical negligence claim, because you need an independent expert in the same discipline before you can even say whether there is a case. Get one for any claim against an organ of state, because of the notice requirement. Get one when the injury or loss is close to a prescription date, since issuing summons stops the clock. Get one when an insurer has rejected a large claim on non disclosure or a policy exclusion and the ombud has not resolved it. Get one when the other side has already instructed lawyers or is offering a settlement you cannot evaluate. And get one before you sign any full and final settlement or contingency fee agreement.

For smaller consumer and insurance disputes, use the ombud schemes first. LawMatch is not a law firm. This page is general information about South African law, not legal advice about your situation.