In recent years, the Road Accident Fund (RAF) has attracted negative reviews, with many people alleging that it is difficult to claim from the Fund. However, since the introduction of its direct claims initiative, RAF direct claims have increased from 15 percent in 2011/12 to 37 percent in 2017/18.
“In truth, claiming directly with the RAF is a far simpler process than people tend to believe,” an RAF representative says. “It takes just three simple steps: gather the required documents; complete the submission form; and submit the form and documents at the nearest RAF office.”
Here are a few myths about the RAF.
Road-crash survivors and their families are often frustrated with the paperwork and processes involved post-injury. It is believed that the RAF contributes to this logjam. However, senior media manager Linda Rulashe points out that the RAF’s wide network of 100 Hospital Service Centres, five customer service centres, five regional offices, social media platforms, website and Call Centre are actually easy to access for information and assistance when lodging a claim.
In addition, staff members explain the claims steps when interacting with crash victims or their families at these touchpoints, and after the initial engagement, people are usually satisfied that they chose to claim directly.
Administrative claims process
Direct claims tend to be processed more promptly, because they don’t involve a trial. The Fund notes: “Claiming with the RAF is like any other insurance claim, as the administrative claims process can take some time.
“However, claiming directly tends to require less processing time as there is no lengthy litigation, which is common when a represented claim proceeds to court.”
Victims and their families still have access to great service. A claimant is consulted throughout the process and is constantly aware of the amount they are claiming.
“The RAF has a Direct Claim Management Policy in place that specifically provides for the management of disputes by direct claimants should a dispute arise. Direct claims improve service delivery through direct interaction between the RAF and the claimant, something which is not possible where the claimant is represented by an attorney,” the Fund says.
During a direct claim, the victim is constantly updated by the RAF on the status of the claim. Payment is also made in full to the claimant.
The Fund says: “Information shared by the RAF through its various platforms is simple to read and easy to digest. The anticipation of jargon is probably because of the perception of insurance processes, but RAF has ensured that information is accessible, with claims consultants on hand to assist when necessary.”
The organisation aims to make claims easy. All queries or clarification requests can be clarified via the RAF Call Centre, which operates from Monday to Friday between 07h45 to 16h00 on 0860 23 55 23. The Centre can assist in any of the 11 official South African languages.
There is also a belief that the RAF will settle for the lowest amount. However, claims are managed by the Direct Claim Management Policy and Standard Operating Procedure (the Framework) implemented by the RAF. It ensures that employees do not under or over-settle a claim.
“Where non-instances of compliance with the Framework are identified, they are dealt with and corrective action is taken in terms of the RAF’s Disciplinary Policy, where appropriate. In addition, the Framework provides for regional quality assurance teams to vet direct claim offers to ensure that they are complete and reasonable,” the organisation says.
The Fund also employs a number of actuaries who perform regular reviews of direct claim settlements. These are supplemented by quarterly reviews performed by an actuary. On a comparative basis, these reviews confirm consistent settlement values paid to direct claimants as compared to represented claimants.
For more information regarding direct claims via the RAF, visit the website at www.raf.co.za or phone the Call Centre 0860 23 55 23.