The following are entitled to make a claim
A person who sustained a bodily injury in the accident (except a driver who was the sole cause of the accident);
A dependent of a deceased breadwinner;
A close relative of the deceased who paid for the funeral; and
A claimant under the age of 18 years must be assisted by a parent, legal guardian or curator ad litem.
See the Claims procedure section for detailed information on submitting a claim.
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 must be finalised within 5 years from the date of accident;
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 must be finalised within 5 years from the date of accident;
Claims in terms of an undertaking certificate issued in terms of section 17(4)(a)(ii) of the Act must be lodged and finalised within 5 years from the date on which services were rendered to the injured.
The claimant or a representative and/or the supplier can submit claims in terms of the undertaking.
In the event of the supplier, written request is required before the assessed liability can be reimbursed.
Subject to the terms and conditions of the undertaking certificate, the injured, or the supplier, may claim the costs of accommodation in a hospital or nursing home or treatment of or rendering of a service or supplying of goods to the injured;
Where emergency medical treatment is provided to the injured (that is treatment to save the injured’s life or a bodily function) the Fund’s liability to compensate the injured or the supplier, as the case may be, is determined in accordance with a prescribed tariff; and
Where the treatment provided is of a non-emergency nature the Fund will compensate the reasonable necessary costs of the treatment to the injured, or the supplier, as the case may be.
No specific form needs to be completed.
All accounts (tax invoices), must be fully specified. This means that the account must indicate exactly what service/treatment has been received. It must also reflect the date of the service or treatment, as well as the name and physical address of the service provider. It is not enough to only submit a receipt as proof that you have incurred an expense.
Check the contents of each account, which intended for submission as a claim.Make sure that the goods/service reflected in the account has been received.
If satisfied, sign each account, that has been submitted to the Fund for reimbursement.
Write the Road Accident Fund claim reference number and/or Link number as quoted in the undertaking document, clearly on each claim.
Post claims, together with any receipts as well as all other substantiating documentation, to the following address:
The Chief Executive OfficerRoad Accident Fund – Undertakings Department38 Ida StreetMenlynPretoria
The Chief Executive Officer
Road Accident Fund –
38 Ida Street
Always bear in mind that you remain personally liable towards the service provider, and that you have to pay the account rendered by that service provider. In the event that you require the Fund to pay the service provider direct, you must give such authorization in writing.
This will depend on the type of the claim which is submitted as indicated below:
A tax invoice for medical expenses
A Service contract, certified copy of the employee’s ID and proof of the costs being incurred for a domestic worker, caregiver and/or gardener
Details of the vehicle that is being used to transport the injured including the name of the owner and driver, purchase price of the vehicle, type, make and model of the vehicle, Distance traveled and tax invoice from the service provider.
4. Proof of the costs of special school fees, transport to and from the school and hostel fees before the accident together with the current costs (Tax invoice)
5. Approved building plans of the house before the accident, photos of the areas which need to be altered and at least 2 fully specified reasonable quotes for the proposed building costs.
If you already have a savings, transmission or cheque account you do not have to open another account.
If it is the first time that you are claiming the bank indemnity form must be completed by yourself, and taken to the bank to verify the bank account detail. The original form must be returned to the Funds offices as indicated on the form.
If you cannot afford a bank account you can furnish the Fund with written authorization to make payment into another person’s bank account on condition that the person also provides his written agreement that the money can be paid into his account. The bank indemnity form is still required with his details.
When specifically excluded in the undertaking, the undertaking does not cover the costs of any compensation to which you would be entitled in terms of the provisions of the Workmen's Compensation legislation, the Defence Force Act, 1957, (Act No 44 of 1957), or another Act of Parliament governing the said Force.
Yes, you can furnish authorization to the Fund to make payment of the costs directly to your medical aid or you can arrange with your medical to pay them back once the Fund has made payment to you.
Yes, if for example you were 20% to blame for the accident, the Fund will reduce your claims with 20% and pay you or the service provider 80% of the assessed costs you incurred.
If this situation applies to your case, we would like to urge you to plan ahead, before incurring any particular costs, so as to ensure that you will be able to pay for your own share of the costs from your own money, as the Fund will only reimburse you to the extent of its share.
Yes, on receipt of a written request from you the Fund may subject you to its internal policies to quantify the estimated future medical costs that you might require. Once the Fund and you have reached an agreement on the future amount the Fund can reimburse you or the service provider for 100% of the costs incurred up to the agreed amount that will be reflected in the revised Undertaking document.
The Road Accident Fund must be offered a reasonable period of time in which to assess its liability in respect of the claims lodged, enter the claims into the relevant computer system, perform the necessary enquiries, and thereafter arrange for Electronic Funds Transfer directly into your, or other nominated bank account.
You will be advised by way of a letter which claims have been admitted, how the amount of money paid into the bank account was made up, which claims require further explanation and which claims have been rejected as not being accident related or a claim in terms of the Undertaking.
Once you have specified quotations, contact the Undertakings Department by correspondence or per telephone, to find out whether the Fund regards the costs as both accident related and reasonable, and how much the Road Accident Fund will reimburse you, before you decide to incur said costs.
No, all that is required is that you must have incurred the obligation to pay the service provider. This means that a binding contract must have been concluded between yourself and the service provider. A quotation is therefore not sufficient proof that the costs have been incurred.
The Fund is prepared to pre-authorise any treatment that you might require. The Fund is prepared to pay doctors and hospitals directly, including often giving a deposit in advance of the treatment.
This would also assist you as you will have full knowledge, in advance of precisely what the Fund is covering. Any payment made by the Fund will not exceed the amount that would have in normal circumstances been paid to you.
Identity document of deceased;
Death certificate or post mortem report;
Documentary proof of marriage (if claim by spouse);
Full unabridged birth certificates reflecting the names of parents;
Proof of earnings of all parties involved;
Proof of reasonable funeral expenses.
The Fund employs Information officers at all branch offices of the Road Accident Fund to assist claimants free of charge. However a claimant may still decide to employ a lawyer. The lawyer will be entitled to charge a fee for professional services rendered.
The RAF must obtain documentation and information from the insured driver, witnesses and the SAP confirming the description of the accident as given by the claimant. It can happen that the RAF must appoint an assessor in order to trace the insured driver or any witnesses.
Once the merits have been confirmed the RAF must make a decision whether it can pay the claim or whether the claim must be repudiated.
If the RAF decides to pay out a claim, it must conduct a quantum investigation to ascertain the correct amounts to be paid. This involves verifying amounts claimed as for treatment given by hospitals, doctors etc. At this stage experts such as actuaries, medical specialists etc. can be appointed to assist in making valid quantum decisions.
If all information is available the claims handler will make an offer to the claimant/attorney. This offer must be verified and agreed upon by another person with the correct mandate before it can be sent out.
If the offer is not accepted negotiation can take place, which can lead to further experts being appointed. It can also lead to a court having to make a decision in the event of the parties not being able to reach agreement.
If the offer is accepted a discharge form will be issued which contains the amounts to which the parties agreed. Once the RAF has received the signed discharge form, payment can be made.
The RAF does not have any say as far as the amount payable by the claimant to the attorney is concerned. Some attorneys do charge their clients a deposit to cover expenses and some also require their clients to pay upfront for expenses as and when they occur.
The RAF makes a cost contribution to the attorney as far the attorney's dealings with the RAF isconcerned. The attorney can also serve a bill of cost on the RAF, which will lead to a bill being settled on party-party basis. It must be noted that this only covers the attorney's dealings with the RAF.
A claimant should discuss beforehand, with his attorney, how he would be billed. Some attorneys take a percentage of certain amounts paid out by the RAF, but once again, the RAF has no control over this.
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 discharge form, which contains the details of the amounts agreed upon.