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Undertakings for future medical expenses issued by the Road Accident Fund in terms of Section 17 (4) (a)
02 July 2018  | Dries Knoetze
 
It is necessary to first establish wat the purpose of these undertakings is before we deal with the how and why.

Section 17 (4) has been designed for the benefit of the Road Accident Fund and not for the benefit of the claimant and has the effect of eliminating the uncertainties and imponderables involved in having to adjudicate the final quantum (i.e. amount of be paid to the claimant) in respect of the damages pertaining to the future medical expenses.

These costs also include costs which a claimant might in future incur by appointing someone to assist him in his farming activities as a result of the injuries sustained in a collision and the services of a Pilates instructor. Thus from the above the scope of the undertaking is extremely wide and should you approached the offices of an attorney should you wish to claim in terms thereof.

The RAF may elect to furnish an undertaking to compensate a third party claimant for costs relating to future accommodation in a hospital or nursing home, or treatment of, rendering aa service or supply of goods to him or her arising in connection with the claim.

A third party will be for example a doctor, pharmacy or any other service provider who provides a service to the claimant in terms of injuries sustained and on the basis of the undertaking.

The undertaking relates solely to such treatment, accommodation, services and other consequential requirements reasonably required by the claimant because of the bodily injuries suffered, and apply only in respect of the reasonable costs thereof.  Payment by the RAF is deferred until the costs are actually incurred and upon actual proof thereof being furnished.

As such if a claimant obtains free medical assistance at a state owned hospital or clinic, the claimant or the service provider will not be able to claim in terms of the undertaking.

An undertaking does not only cover medical expenses but also extends to non-medical expenditures such as liability for the supply of goods or the rendering of services.

How to claim:

It is advised that you should submit your claim as soon as possible, the claim shall be set out in the form of an affidavit whereto the original account(s) for services rendered is attached to the affidavit.

All the accounts appendix to the affidavit must be specified, which means that the account must indicate exactly what services/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. Take note that it is not sufficient to only submit a receipt as proof that you have incurred an expense.

The following is very important:

1)    Before submitting your claim, make a copy of the all the documents which you intent to submit to the fund, including the letter referred hereunder and the proof of sending.
2)    Check the contents of each account that you intend submitting as a claim. Make sure that you have received the goods/services reflected in the account. If you are satisfied, you must sign all accounts that you are forwarding to the Fund for reimbursement.
3)    Write your Road Accident Fund Undertaking claim reference number, which will be made available to you by the Department, clearly on each claim.
4)    With your first claim, furnish the bank account details into which any monies are to be paid.
5)    Under cover of an ordinary letter, quoting the file reference number, as well as, marking your letter for the Undertakings Department, post your claims, together with any receipts as well as all other substantiating documentation, to the following address:

The Chief Executive Officer
Road Accident Fund – Undertakings Department
Private Bag X2003
Menlyn
0063

How long must you wait for payment?

It is advisable that you upon submitting your claim, provide the RAF with a period of at least 30 (thirty) days in which to settle your claim.

The undertaking indicates that your claim will be payable within a reasonable time period, I am of the view that a 30 (thirty) day period will be sufficient.

What if the RAF does not pay?

Take note that the RAF has a history of not making payments timeously, and as such and after the 30 (thirty) day period referred to above, urgently consult your attorney in order to have further legal steps taken against the fund.

General:

The Section does provide sufficient protection and cover for a person claiming future medical expenses and costs in terms of the undertaking. However due to the financial situation currently at the Road Accident Fund, the service provides, i.e. doctors and pharmacies refuse to accept the undertaking, which causes the claimant to settle the expenses and attempt to be reimbursed by the RAF.

It is advisable that you contact your attorney should you wish to claim against the Fund and that you must insure that all slips, invoices and proof of payments made for your medical expenses are available and kept save to use when a claim is lodged.

Reference List:

•    The Road Accident Fund Act, Act 56 of 1996
•    Lexis Nexis – RAF Practitioner’s Guide, Issue 35 – H.B. Klopper
 
 
 
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Tags: RAF