Your insurance safety net following a road traffic accident

In a country where more than 500,000 road traffic accidents are reported each year the chance of being injured or killed in an accident are as high in South Africa as anywhere in the world. The best way to protect you and your family from the financial repercussions of road traffic accidents is to have adequate insurance cover in place.

“It is possible to take out a range of insurance policies that will perform following a road traffic accident – starting with your short-term personal lines policy to cover accidental damage to your vehicle and other vehicles– to personal accident policies to assist you financially in the event of death or permanent disability sustained by you or your family members,” says Karin Verster, senior manager at Acuideas. She advises consumers to understand the expenses that occur following a road traffic accident as well as the level of cover their existing ‘basket’ of insurance products offers.

The terms and conditions for the repair or replacement of your motor vehicle post-accident are set out in your personal lines: motor policy. Your policy will also indicate the insurer’s liability insofar towing your vehicle and providing a hire car until the repairs are completed. “A comprehensive policy should compensate fully for the damage caused by or to your vehicle following the accident, subject to the usual exclusions and excesses,” says Verster. “In the case you opted for a balance of third party policy you will not enjoy any cover for damage to your vehicle and will have to pursue the other driver’s insurer or make a civil claim to recover your losses, assuming you were not at fault of course”.

Far too frequently your post-accident costs will include medical expenses. Compensation for medical expenses following a motor vehicle accident can be provided by a mix of insurance products and / or state support via the Road Accident Fund (RAF). “Families that are members of a private medical scheme will be compensated for any post-accident medical expenses in line with the benefits and conditions stipulated by their medical aid,” says Verster. Members of medical schemes often face significant co-payments for large medical bills with the result they might choose to supplement their medical aid cover with gap cover or hospital cash back plans.

The onus of proof in claiming against the RAF lies with the claimant. For your claim to be successful you must be able to prove that another person caused or contributed to the accident; prove that the other person’s actions were wrongful; prove that injuries were sustained and / or that a breadwinner died; link the injuries or death to the accident; and prove that the damages claimed relate to the accident.

You must submit your claim to the RAF within three years of the accident (or two in the case of a hit-and-run claim) or from the date that a minor reaches the age of 18. You will have to attach a ream of documents in support of your claim, including the original accident report, an affidavit and medical records. The RAF will register your claim on its system and then complete an investigation to determine the validity, merits and quantum of the claim. (Full details for RAF claims procedures are available online at www.raf.co.za). Readers should note that plans to replace the current RAF with a new Road Accident Benefit Scheme are well-advanced, with draft legislation submitted to Parliament late in 2017. Until such time the proposed Road Accident Benefit Scheme Bill is signed into law the abovementioned steps will apply.

Another insurance option available to you pre-accident is to take out a personal accident policy. These policies vary from one insurer to the next insofar the amount of cover and conditions for the policy to pay-out; but they typically provide a ‘capped’ rand amount for you and any of your family members following an accident.

“In the event of death or disability your best protection would come from life insurance policies that include death and disability cover,” says Verster. Such policies provide for lump-sum pay-outs following the death or permanent disability of a policyholder which can be used to pay for post-accident lifestyle adjustments and invested to provide a monthly revenue stream. Verster adds that income protection policies are also useful should a breadwinner become temporarily or permanently disabled following an accident.

“Personal insurance remains your best defence against the financial implications of a road traffic accident,” concludes Verster. “You owe it to your family to review your insurance portfolio – interrogate each component of your portfolio to determine how it performs and how much it will pay-out following an accident – and plug any gaps that this interrogation reveals”.

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