I was sitting in the back of a taxi when it was hit by another vehicle from behind a year ago. I recently discovered that my back pain is due to nerve damage. Can I submit a third party claim?

The long answer

Thank you for your email asking if you can apply for third party insurance for an accident a year ago in which the taxi in which you were traveling was hit from behind, you were sitting in the last row and were thrown from your seat by the impact, and only after a year afterwards did the doctor discover that the back pain you have been suffering was caused by nerve damage due to the accident. The accident was reported to the police, and you have the case number.

Yes, you should certainly be able to apply for compensation from the Road Accident Fund (RAF). Third party claims form part of Personal Injury Law for people who were injured in motor vehicle accidents, provided that you were not solely responsible for the accident.

Moonstone.co.za explains that the RAF provides cover to all users of South African roads for injuries or death from motor vehicle accidents. The RAF’s main source of income is the fuel sales levy, which is decided by the National Treasury and is presently about !0% on every litre of fuel sold to motorists.

You have three years to submit a claim to the RAF if you know who the driver is, and two years if you don’t. As the accident happened a year ago, and was reported to the police, and you have the case number, you should certainly be able to submit a claim for the medical expenses you have already incurred.

You can also claim for expected future medical treatment expenses from the RAF if you can prove that future medical expenses are likely, which would involve your doctor’s reports.

The RAF says that “…all medical 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 is 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.”

“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 Fund’s offices as indicated on the form.” When the claim has been investigated and settled, the RAF will pay by Electronic Funds Transfer (EFT) into your bank account. The RAF says it will also send a letter to tell you which claims have been admitted and how the money paid was worked out; which claims required further explanation, and which claims have been rejected.

The RAF also needs the following information (on the 2022 RAF form):
 Date of Accident
 Time of Accident
 Place of Accident – Street, Town, Province, Postal Code
 Name and address of police station where the accident was reported
 Contact details of SAPS station
 Attach SAPS Accident Report and Name of Investigating Officer
 Attach a docker Accident Report Number (AR number)
 Case Number (CR number

Sadler.co.za says that you need the following to make a claim:

 Receipts, accounts and vouchers to prove medical claims and expenses.
 A medical report and a letter from your doctor stating the amount you will pay
in the future for medical expenses as a result of the accident.
 A letter from your employer stating the amount you lost as a result of unpaid
wages.
 A written letter that permits the hospital to hand over your medical records to
the RAF.
 A sworn statement and statements from any witnesses to the accident.

They say that:
“You must provide details of the accident to the RAF on a statutory accident report form (RAF 3) together with information of witnesses which the RAF may request.
It’s important to make sure that all the documents are filled in correctly. It’s recommended to make copies of all your documents in case there’s an administration error.”

“Once you have completed all the necessary forms and accompanying documents, you must submit the documents in hard-copy, and faxed documents require the originals to be furnished. Emailed documents won’t be accepted.”

The RAF says that there are Information Officers at all branch offices of the RAF to assist claimants free of charge. However, they say that a claimant may still decide to employ a lawyer and the lawyer would be entitled to charge a fee for professional services rendered. The Law Society of South Africa (LSSA) says that there may be a difference of opinion between you and the RAF as to whether you are entitled to be compensated (the merits of the case) and, if so, what your claim is worth. The RAF also has to be satisfied that your injury is ‘serious’ before you are entitled to be paid for pain and suffering.
If you employed a lawyer, most law firms would only charge on ‘success’ I.e. once the RAF had paid.

Claimhelp.co.za says that you should try to have as many of the following relevant documents as possible on hand, when you see a lawyer:
 Identity document
 Documentation of the accident and damage caused
 Registration number of the car that caused the accident
 Police case number
 Personal details of the driver or the owner of the car
 Personal details of any witnesses to the accident
 A hospital patient number (if you have one)

If you need a lawyer and cannot afford one, you could approach Legal Aid for help. It is a means-tested organisation that must assist people who cannot afford a lawyer. I will include their contact details at the end of this letter. I don’t know if you belong to a medical aid scheme or not, but what moonstone.co.za says is that as the RAF Act currently stands, it does not exclude benefits that a victim of a motor vehicle accident has received from a medical scheme for past medical expenses. They say that usually, a medical scheme will cover the initial medical expenses of members who are injured in road accidents, and once the RAF has settled the claim – which can take years – the medical scheme will be reimbursed for medical expenses that the RAF has covered.

Moonstone.co.za says, however, that the RAF has not processed claims for any medical scheme members since 12 August 2022, after RAF CEO Letsoalo issued a directive to all the RAF claims offices, instructing RAF staff to halt the processing of all RAF claims from medical scheme members injured in road traffic accidents. This directive has been challenged in court as unlawful.

There is now a new draft Bill – the Road Accident Amendment Bill – put out by the Department of Transport in September last year. One of its proposed changes is that the RAF would not be obliged to pay a third party’s compensation or benefits if the third party belonged to a medical scheme or insurance which covered their treatment for injuries resulting from the accident.

The medical schemes are obviously against this, saying that if the Amendment Act is passed, medical schemes will have to charge more and members will be paying twice – once through their medical scheme and once through the fuel levy. As far as the general picture of the RAF goes, it’s also worth knowing that in spite of ongoing efforts by the new RAF board of 2019 to turn it around, the RAF has been in severe financial and operational difficulties for years. This has meant that it has taken a very long time to process and settle claims - a person could easily wait for five years to have a claim settled – and the RAF owed R16.2 billion to claimants for settled claims in 2020.

But on the bright(er) side, News24 reported in September 2024 that the fund had implemented its 2020-2025 Strategic Plan, which set out a roadmap for stabilising the fund: the RAF has been working to meet key targets including settling claims within 120 days, reducing the backlog of claims older than three years, and cutting legal costs.  According to the 2023/24 financial report, the fund has achieved its target of settling claims within 120 days. Also, the number of settlements through agreements (rather than going to court) increased from 58% in the 2015/16 financial year to 82% in 2023/24. This improvement has helped to reduce the burden on the courts and curb legal expenses.

But, says News24, the RAF is still in debt – it had a shortfall of R1.6 billion for the 2023/24 financial year. The reason for the ongoing deficit, said the fund, was that the fuel levy had not increased in three years, plus an increase in claims liability and inflation. 

These are the contact details for Legal Aid:
Tel: 0800 110 110 (Monday to Friday 7AM - 7PM) 
(Please Call Me) 079 835 7179
email: communications2@legal-aid.co.za

Wishing you the best,
Athalie