It is common place that there is huge confusion about who can lodge a Road Accident Fund claims for damages, and what criteria is used.
Essentially the adopted standard of evidence that is required by the RAF after the recent legislative changes, is that there should be minimum whole person impairment (WPI) rating of 30% for a claim to be entertained by the RAF.
This WPI rating is a scoring system developed and propagated globally by the American Medical Association, in its 6th Edition of the guides. The RAF, along with multitude of international organizations have adopted these guidelines and frameworks as the gold standard.
Road accident fund claims criteria
The actual final WPI score that is given to a specific patient for specific impairments, is done only by a duly qualified medical doctor or consultant that has been certified in the AMA Guides (6th Edition).
Why does a doctor or any other consultant need to be certified to be able to complete the rating?
Due to the highly technical nature and the specific process and assessment criteria that is used to provide a final WPI, the specific training and certification is a must. The rating given by someone that is not certified in the Guides, may result in unnecessary disputes, legal costs and very often denied claims by the RAF.
The claims from the RAF are related to key areas: direct damages, and consequential damages. The direct damages are fairly easy to document and have settlements reached, if contrasted to the indirect and / or consequential damages that are claimed and disputed.