We all have so many questions when it comes to claiming after a car accident. Who do we call? Where do we go? What can we expect?
All these questions have been asked, and answered before.
The following answers are taken directly from the website of the Road Accident Fund (www.raf.co.za)
Who is entitled to make a claim?
The following people 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
- A parent, legal guardian or curator ad litem must assist a claimant under the age of 18 years.
What is the time period in which to submit 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.
Who is entitled to submit a claim in terms of the RAF undertakings?
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.
What are the steps taken from the time the attorney lodges a claim until its finalisation?
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 RAF Payment 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, RAF Payment can be made.
Does the actual claimant (Victim) have the right to know how much in total was paid to the attorney and to verify whether the “cut” that the attorney took is genuinely what is 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 discharge form, which contains the details of the amounts agreed upon.
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