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

VALUES

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 :

END