ROAD ACCIDENT FUND PRESENTATION
South African Occupational Social Workers Association
Date: 17 August 2016
Suzanne Greef
Senior Learning and Development
Rebecca Moloto
Post Settlement Team Lead
RAF VISION MISSION & VALUES
To provide world class care to road accident victims to
restore balance in the social systemRAF Vision:
Mission is:
To provide appropriate
cover to road users
within the borders of
SA
To rehabilitate persons
injured, compensate
for injuries or death
and indemnify
wrongdoers as a result
of motor vehicle
accidents in a timely
and caring manner
To support safe use of
our roads
RAF LEGAL
MANDATE
Motor Vehicle Insurance Act 29 of 1942 was the first
compulsory motor vehicle insurance
Road Accident Fund Act, 1996 (Act No. 56 of 1996) was amended by the RAF Amendment Act, 2005 (Act
No. 19 of 2005)
Shaped by Constitutional Rulings and legal
precedents
National public entity (schedule 3A of the PFMA)
The RAF provides a social security safety net to the country and economy by making available compulsory social insurance cover to all users of South African roads
The RAF is responsible for providing compulsury
cover to all users with borders of South Africa
including foreigners
Citizens can claim directly from RAF
RAF Mandate
RAF MANDATE cont.
To protect wrongdoers and
their families from financial
ruin
To rehabilitate and re-integrate victims of road accidents back
into society from a health and
economic perspective
To provide health care to Motor
Vehicle Accident victims who have
suffered permanent injuries and
require medical attention for the rest of their lives
Socio-economic role of the RAF:
WHO CAN CLAIM
• Any injured person except the wrongdoer
or cause of accident
• A dependent of a deceased person,
except where the deceased is the
wrongdoer
• A close relative in respect of funeral
expenses.
• A parent or legal guardian of a minor
child.
• A foster parent in respect of past medical
expenses incurred by him/her.
• An executor of the deceased estate.
• A curator ad litem.
• RAF Form 1
• Accident Report (OAR)
• Affidavit by claimant
• Hospital records
• Certified ID copy
• Accident Report (OAR)
• Proof of earnings
• Proof of Medical expenses
• Death certificate or post mortem
report
SUBSTANTIAL
DOCUMENTS
CLAIM BENEFITS
• Benefits covered by the RAF
1. General Damages
2. Past and Future Hospital, Medical & Related Expenses
3. Past and Future Loss of Support
4. Past and Future Loss of Earnings
5. Funeral Expenses
Pain & Suffering, Disability, Disfigurement and Loss of
Amenities of Life
General Damages
Special Damages
WHY CLAIM DIRECTLY?
NB. A direct claim is submitted by a claimant without the assistance of a lawyer.
• Claims administered at no cost
• Direct contact with RAF consultants
• Speedy resolution of claims `
• Immediate funeral support to indigent families through our panel of funeral Parlours.
• Injured parties are referred to medical experts at no cost
• Issue interim Undertaking Certificate for serious injuries & rehabilitation
• We appoint and compensate caregivers to care for quadriplegics/paraplegic claimants
TIME PERIOD TO CLAIM
• IDENTIFIED DRIVER (Known driver)
• 3 yeas from date of accident
• Not applicable to persons under the age of 18 (minor) or
• Persons detained in a mental institution or persons under curatorship
• UNIDENTIFIED DRIVER (Unknown driver)
• 2 years from the date of accident
• Applicable to minors, mentally ill persons and persons under curatorship.
RAF’S COVERAGE THROUGHOUT SA
*Source: DoH National health Act 2003, Hospitals include: District, Regional, Provincial, Tertiary, Central Hospitals
Refer to Excel Spreadsheet for hospital names
Central: 0/0
Provincial: 1/1
Regional: 1/2
District: 2/11
Northern Cape
Central: 2/2
Provincial: 0/1
Regional: 3/4
District: 3/21
Western Cape
Central: 0/0
Provincial: 2/2
Regional: 1/3
District: 1/12
North West
Central: 0/0
Provincial: 2/2
Regional: 2/5
District: 7/30
Limpopo
Central: 1/1
Provincial: 2/3
Regional: 2/2
District: 0/46
Eastern Cape
Central: 0/0
Provincial: 2/2
Regional: 2/4
District: 9/18
Mpumalanga
Central: 2/4
Provincial: 3/3
Regional: 3/9
District: 2/11
Gauteng
Central: 1/2
Provincial: 2/2
Regional: 7/15
District: 0/38
Kwa-Zulu Natal
Central: 1/1
Provincial: 1/2
Regional: 2/4
District: 1/15
Free State
Hospital
Category
Total
Number
Current
Presence
Central 10 7
Provincial 17 15
Regional 48 23
District 202 25
Total 277 70
RAF OPERATING MODEL
Claims Origination Claims Determination Claims Litigation Claims Finalisation
Claims Processing Value Chain
Hospital service centres
Community service centres
Document Management
Validation, Verification & Registration
Mobile RAF
Medical
Represented claims
Direct claims
Summons administration
Internal law department (ILD)
Magistrate, high & district court litigation
Panel attorney management
Capital payment
Legal cost validation
Legal cost payment
Writs management
Judgement monitoring Claims file closure
Post Claims Settlement
Post claims management
Merits
RAF CUSTOMER ENGAGEMENT MODEL
CONCEPT BLUE PRINT
Road Accident Fund Victims
F2F Phone Electronic
Origination Center Operating ModelHospital Service
Centres
Community
Service Centres
Mobile Service
CentresContact Centre
Proactive Claim Origination and Servicing customers
Rehabilitation and Life-care
Mobile RAF
Information collection and provision throughout the claims lifecycle
Case
Management
ROAD ACCIDENT FUND STAKEHOLDER
NETWORK AND MANAGEMENT
14
Strategic Objective Performance Indicator
To meet and exceed the
expectations of our stakeholders
Satisfied stakeholders;
Minimum complaints;
RAF has a Stakeholder Relations Policy Place
RAF has entered into Memoranda's with various partners to ensure that seamless working standards and relations are in
place
RAF is extending its stakeholder footprint to include closer partnerships and co-operations with various organisations from NGOs, Private Companies, Special Interests Groups,
Communities, the Public Sector, etc.
RAF is championing RABS as a vehicle for further broadening stakeholder access to services.
RAF CONTACT DETAILS
• Call Centre : 0860 23 55 23
• Fraud Line : 0800 00 59 19
• Twitter : @RAF_SA
• Facebook : RAF SA Road
• Jeanette Maifadi Origination Manager :084 840 2155/084 313 0935
• Mmalemoko Sejeng Undertakings Manager :