A motor policy pays for the car. The Road Accident Fund pays for the person. The two clocks, the RAF 4 form, and the line a brokerage must not cross.
The file rarely opens with a claim form. It opens with a voice note at half past six in the morning from a client's daughter: there was a crash on the way to Durban, her father is in hospital in Pietermaritzburg, and the bakkie is on a flatbed somewhere. Your brokerage owns one part of what follows and must stay out of another part almost entirely. Getting that boundary right in the first conversation decides whether the family later thanks you or complains about you.
This is the compensation question every short-term desk in South Africa eventually fields, and most brokerages answer it from memory. The statutory framework is narrow, the time bars are unforgiving, and none of it sits inside a short-term policy.
The motor policy you placed responds to damage: the vehicle, the towing, the excess, the third party's property if the liability section applies. That claim is yours to run, and the claim notification and follow-up work is ordinary intermediary service.
Bodily injury is a different system. The Road Accident Fund is a statutory scheme funded by a levy on fuel. It compensates people injured, and the dependants of people killed, where the loss was caused by the negligent or otherwise wrongful driving of a motor vehicle. It is fault-based: if nobody else was at fault, there is generally nothing to claim. And under section 21 of the Road Accident Fund Act 56 of 1996, the injured person's common-law claim against the driver or owner who caused the harm is abolished to the extent that the Fund covers it. Clients regularly assume they can simply sue the other driver. In most crash scenarios, they cannot.
| What the client lost | Where it is claimed |
|---|---|
| Vehicle damage, write-off, towing, storage | The motor policy you placed — not the Fund |
| Damage the client caused to someone else's property | The liability section of the motor policy |
| Hospital and treatment costs after the crash | Medical scheme in the first instance; the Fund is claimed against, and past expenses already paid by a scheme have been litigated repeatedly |
| Future medical treatment | The Fund, typically by way of an undertaking rather than cash |
| Loss of income while off work | The Fund, capped at the amount the Act sets and adjusts over time |
| Pain, suffering, disfigurement | The Fund, only where the injury is assessed as serious |
| Funeral costs and loss of support after a death | The Fund; plus any funeral or life cover held |
Two lines on that table are worth saying out loud to a client. Personal injury is not covered by a comprehensive motor policy unless personal accident cover was actually bought. And general damages — the money most people mean when they say "compensation" — are not automatic.
Four periods matter, and a brokerage that knows them is far more useful than one that offers sympathy.
Those two dates are the ones families lose. A claim lodged in month thirty-four is alive; a claim first mentioned to an attorney in year four is usually dead, whatever the merits. If you diarise nothing else about a serious injury on your book, diarise the anniversary of the crash.
Since the amendments that took effect on 1 August 2008, general damages are payable only where the injury is assessed as serious. The assessment is done by a medical practitioner on the RAF 4 form using the American Medical Association's guides to permanent impairment. Thirty percent or more whole-person impairment qualifies. Below that, the practitioner applies the narrative test: serious long-term impairment or loss of a body function, permanent serious disfigurement, severe long-term mental or behavioural disturbance, or the loss of a foetus.
The Fund reviews the report and may reject it with reasons, or send the claimant for a further assessment at its own expense. A rejected assessment is not argued in court — it goes to an appeal tribunal convened by the Health Professions Council of South Africa. Courts have also held that the RAF 4 may be filed after the three-year lodgement period has run but within the five-year period, which is why an early lodgement matters more than an early medical report.
None of this is your work. It is the reason a client with a fractured wrist and a client with a spinal injury will have very different conversations, and knowing that stops you from setting an expectation the Fund will not meet.
An RAF claim is not a financial product. Your FAIS licence does not extend to it, your professional indemnity cover almost certainly does not contemplate it, and quantifying a client's likely payout is not intermediary service — it is an opinion you are not licensed, insured or qualified to give.
What you may safely do is give factual information: the Fund exists, these are the time limits, a claim may be lodged directly with the Fund at no cost with assistance from its own staff, an attorney is the alternative and attorney fees in these matters are regulated. What you should not do is estimate an amount, advise whether to accept an offer, or steer the family to a particular attorney in exchange for anything. Referral arrangements in personal injury work are heavily contested territory; a brokerage that takes a cut of a claim it introduced has bought itself a problem far larger than the commission.
Two further cautions. First, the treatment of past medical expenses already paid by a medical scheme has been through several rounds of litigation and remains unsettled — never tell a client what the Fund will or will not pay there. Second, whatever you do say, keep it. If the conversation happens on WhatsApp, the thread is your record of the factual information you gave and the referral you made, which is exactly what you want on file if the family later argues that the brokerage handled their claim.
This is the kind of file where a shared record beats a personal handset. Working the conversation in a shared inbox means the thread, the case number and the dates sit with the client record rather than with whoever was on duty that morning; ORIS classifies inbound messages and flags the urgent ones, holds AI-suggested replies as drafts for a human to approve rather than sending sensitive answers on its own, and keeps the audit trail that shows who said what and when. For the ordinary damage claim alongside it, the claim follow-up cadence is what stops the family chasing you. If you want to see how that looks on a real book, book a demo.
Not as a rule. A comprehensive policy responds to the vehicle and to third-party property damage; injuries to the driver and passengers fall to the Road Accident Fund, to a medical scheme for treatment, and to any personal accident or income protection cover the client actually holds. Check the schedule before answering — some products bundle a small personal accident benefit, and clients rarely remember buying it.
Generally not for the losses the Act covers: section 21 abolished that common-law claim against the driver and owner to that extent. Where a loss genuinely falls outside the scheme, a client should take legal advice rather than rely on anything the brokerage says, and you should be explicit that you are not giving that advice.
Yes, the Fund entertains claims where the driver or owner is unidentified, but on a two-year clock rather than three, and the regulations add requirements — including showing that reasonable steps were taken to identify the driver. Report it to the police immediately and get the family to an attorney early, because these claims fail on process more often than on merit.
No. Lodging and running the claim is either the claimant's own job — the Fund assists claimants directly and free of charge — or an attorney's. Doing it for them blurs your licence, exposes the firm if a deadline is missed, and is not covered by your professional indemnity. Hand over the facts, not the file.
Treat it like any other client record and keep it under your normal FAIS retention rule, at least five years from the end of the relationship. The thread proves what factual information you gave and that you did not advise on the injury claim, which is the exact allegation a disappointed family makes years later when the compensation is smaller than they hoped.
Shared WhatsApp inbox, client records, follow-ups and opportunities for the whole brokerage. 15-minute demo.
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