Claims Procedure

The claim process can be divided into 3 stages:

1. Pre-submission
2. Submitted
3. Litigated – Medico-Legal

presubmit Pre-submission
During this phase of your claim all of the basic information is gathered to satisfy the Road Accident Fund that there is in fact a claim. If there is insufficient information supplied with your initial claim documentation, then the Road Accident Fund will be entitled to object to the validity of your claim which will lead to delays.

presubmit Submitted
This is the phase during which your claim has been submitted to the Road Accident Fund and they are permitted a grace period of 120 days within which to investigate your claim. The case load of the claims handlers at the Road Accident Fund is such that seldom are they able to investigate your claim within the time allocated.

presubmit Litigated – Medico-Legal
Once the 120 days have elapsed, a summons may be issued and delivered to the Road Accident Fund informing them that you intend proving your claim in court.

If your injuries are serious your attorney will probably make appointments for you to be assessed by various medical experts in order to properly quantify your claim. The medical experts will prepare medico-legal reports which, together with your documentation, form the basis of your claim. The Road Accident Fund has the right to have your injuries assessed by experts of their own. The reason for this is to ensure the objectivity of the reports – it often happens that the experts differ in their opinions in many respects. The parties and their experts then meet to discuss possible areas of agreement or compromise. This compromise then most often leads to a fair settlement of the claim.

Claims against the Road Accident Fund are seldom heard in court, the cases are taken up to, in most cases, the day of trial when the Road Accident will make an offer to settle the claim. After negotiation between claimants’ attorneys and the attorneys acting for the Road Accident Fund, most matters become settled.

Ho Long will it take to finalize my claim ?

Simple Claims

A simple claim that involves straightforward accident circumstances – for example a car collides with you from behind while you’re stationary at a robot – and uncomplicated injuries that heal pretty quickly with no serious after effects can be finalised in between 9 and 15 months.

Complex Claims
A complex claim can take anything between 2 and 6 years (and sometimes even longer) to finalise.
The reason for the huge variance is that the Road Accident Fund claims handlers are often overloaded with claims. A summons then has to be issued and a court date for hearing obtained. In most (99%) of the claims on which summonses are issued a settlement is reached and no trial actually takes place. The court process serves as a legal method of finalising the matter.

The reasons for the time delay can be any of the following:

  • Difficulties obtaining the necessary information with which to lodge your claim, e.g.
    • Attorneys are dependent on various third parties for the information required to submit a claim - doctors, physiotherapists, hospitals, police, metro police, claimants, witnesses, pension funds, executors of deceased estates.
  • Dispute surrounding how the accident happened.
  • Dispute surrounding the amount of compensation.
  • Court process, e.g.
    • It takes approximately 18 – 24 months between starting a case in the High Court (claims of R100,000 and bigger) and being on trial for the first time.
    • Youthful age of accident victim.

Often, in the case of young children with mild to moderate brain injury, quantification has to be delayed because the damage often only presents itself when developmental milestones are delayed.

Contact Details

Phone Phone: (012) 809 1588
Fax Fax: (0) 86 603 0097
WWW Link Website: www.claims4u.co.za
Email Email:info@claims4u.co.za
Address: Block 2, Lombardy Business Park,
Cnr Cole & Graham Rds, Lombardy , Pretoria