ROAD ACCIDENT FUND CLAIMS

When compiling a breakdown of medical expenses, the opinion of your medical professional/s is critical, because the RAF will consider all medical reports and recommendations from a professional such as a Medical Specialist, Surgeon or Physical therapist.

It is also important to note that once the case is settled by the RAF, you will receive an agreed lump sum (or monthly payout when the new bill comes into effect). This means you will no longer be able to claim any further funds. That is why calculating future medical expenses upfront is critically important.
When reviewing calculations for determining future expenses, we realise it is not an easy exercise. Simplifying this process by giving you one calculation would do you a gross injustice and you should seek the assistance of a legal advisor to ensure the calculations you use are 100% valid.

As of 31 October 2018, the maximum amount that you can claim from the RAF for loss of income or earnings is capped at R276,928 per year (payable in a lump sum). Also, this value is adjusted on a quarterly basis for inflation.

Because the RAF needs to make an informed decision about the compensation you are due, your evidence at this stage is very important because the onus is on you to provide enough evidence of your income.

If you are employed and have a payslip, calculating loss of earnings is straight forward and would be calculated using evidence of at least three month’s payslips, prior to your accident.

Make sure you provide detailed evidence of your past earnings including:

• Employment history such as your employee contract
• Proof of income such as payslips for salaried employees
• Proof of overtime missed, here you need to prove that overtime would be available to you and that you had a track record of doing overtime in the past

Past loss of earnings calculation

Past: average monthly take-home salary multiplied by the period of absence.

Future: average monthly take-home salary multiplied by the period of absence plus inflation adjustment.

How to demonstrate loss of earnings if you are self-employed

If you do not have formal employment the process is a bit more complicated. If you have a bookkeeper or accountant, you can provide detailed profit and loss accounts for at least 3 years prior to your accident.

Startup companies that do not have sufficient history of earnings or informal businesses who operate without bank accounts or verifiable tax and business records, makes it difficult to provide enough evidence in a claim against the RAF for loss of earnings.

Your claim will also be affected by the way your business is structured: for example if you are in business partnership, the loss is linked to your share of the profits, not the business profits. 

The upshot is this, if your claim is to succeed you must clearly demonstrate that the profitability of your business was, or is, negatively affected due to the injury sustained in the road accident.

The following documents will assist your claim:

• Personal tax returns
• Comprehensive financial statements prepared by a professional bookkeeper or accountant
• Copies of orders
• Invoices and receipts
• Bank statements
• Details of past and future contracts.

Claims which resulted in death for past and future loss of support

If you are the dependent claiming loss of support, the onus is on you to substantiate your claim with detailed records. You are entitled to claim for loss of support if the person killed in a road accident was the main income provider in your household, but only if it resulted from someone else’s negligence. If you are claiming after the RABS comes into effect, you will be able to claim regardless of who was at fault.

Note that claims are limited to a maximum amount of R160 000 adjusted quarterly for inflation. You are also entitled to claim for funeral costs.

Documents you will need to provide in your claim

• Certified copy of the deceased’s identity document
• Death certificate
• If the person died immediately, no medical report is required. If death happened after the accident date, you will need to submit the medical report from the treating medical practitioner
• Copy of post-mortem report if available
• Marriage certificate, if you are the spouse of the deceased
• An unabridged birth certificate, if you are the child of the deceased
• Financial statements, salary slips or income tax returns providing proof of the deceased’s income
• Proof of funeral costs

A contested or opposed divorce means that you and your spouse cannot reach an agreement regarding how to end your marriage or the terms and conditions of your divorce. Contested divorces can drag on for years, causing emotional draining and financial loss to all involved.

In South Africa, a marriage can be dissolved even when one of the parties does not wish to get a divorce and this can happen if one party believes that there has been an “irretrievable breakdown of the marriage relationship and that no reasonable prospects exist of restoring the relationship.

Steps that need to be taken in a contested divorce are as follows:

• Summons will be issued and served on the Defendant by the Plaintiff;
• The Defendant will have to serve and file his/her Notice of Intention to Defend;
• The Defendant has 20 days to serve their plea. The Defendant must either deny or admit all the material facts alleged in the Particulars of Claim and must clearly state the nature and grounds of their defence. Should the Defendant fail to deliver their plea, the Plaintiff may deliver a Notice of Bar wherein the Defendant is awarded 5 days in which do serve and file his/her Plea. If the Defendant fails to do so it will result in the case being set down without further notice to the Defendant and judgment will be taken without consideration of the Defendant’s case;
• If the Defendant has a counterclaim, they must deliver a counterclaim together with their plea.
• If the Plaintiff intends to defend the counterclaim, the Plaintiff must deliver a plea to the counterclaim within 10 days. Once this is done the pleading are closed;
• Once pleading are closed, the parties will deliver their discovery documents. This is where each party demands to see the documentation and other materials that they would like to use at the trial;
• Before obtaining a trial date, a pre-trial conference will be held. This is a semi-informal conference that will be conducted by the presiding officer in order to narrow the issues in dispute;
• Once a pre-trial conference has been held, the Plaintiff will apply for a trial date. The Registrar will allocate a date and the Plaintiff will proceed to set the matter down for hearing;
• The trial proceedings will then take place where each legal representatives is given an opportunity to address their case and present necessary evidence in support thereof;
• Judgment will be handed down by the presiding officer. This order can include a cost order if such order is requested and motivated by the successful party.

Contested divorces can be very complicated especially when there are minor children and/or large asset values involved. At Chininga Attorneys Inc. we have the requisite skills and experience to assist you through a turbulent divorce process.

Personal injury claims in South Africa are more common than you think. The Health Department in Gauteng alone paid more than R1 billion to settle medical negligence cases since 2015. So, if another party directly caused your injury, then you can make a claim against them for compensation. Injuries that people are claiming for range from slip and fall at shopping centres, restaurants or places of business, motor vehicle accidents, medical negligence, whiplash and many more.

Basically, if you get injured and can prove another party was negligent, then you have a case. And you are not restricted to bodily injury. Personal injury claims also cover psychological injury, injury to your rights and reputation, as well as to your property.

How to Claim from personal injury?

There are many personal injury cases which are settled by insurance companies and even without an insurance company, by the organisation, before even getting to court. You would need to find out if the person at fault is insured, get the insurance company’s details as well as their policy number. You would then need to notify the insurance company that you intend to make a claim.

The same process applies to if you are making a claim against a government department – you will notify them of your intention to claim and submit everything to them as per their requirements.

You can file a third party claim directly with the insurance company of the person who is at fault or you can submit a claim directly to the Road Accident Fund (RAF) in the case of a motor vehicle accident – however you cannot claim from both for the same injury.

Usually the insurance company will provide you with a claim form and detail of the various documents they require from you such as:

• Identity verification
• Police case number
• Affidavit letter from you detailing your account of the event
• Witness statements
• Video or photographic evidence
• Evidence of medical invoices and medical reports
• Evidence of salary/income if you are claiming loss of earnings

If your claim is rejected or negotiations break down, get the personal injury lawsuit process started immediately with your lawyer.