Rules the fund cannot reject or refuse to accept claims that substantially comply with the Road Accident Fund Act but not with a 2022 RAF board notice.
The Road Accident Fund (RAF) has received another legal setback, with a high court judgment dismissing with costs the fund’s special plea – and ruling that the RAF is not entitled to reject claims that substantially comply with Section 24 of the Road Accident Fund Act.
The special plea was in response to applications by 16 claimants whose claims submitted on different dates were rejected by the RAF because they did not comply with RAF Board Notice 271 of 2022 and the new RAF 1 form.
In a judgment handed down in the Eastern Circuit High Court in Thembalethu last week, Acting Judge SST Kholong found that all 16 claims substantially comply with Section 24 of the act and thus substantially comply with the procedural requirements for a validly lodged claim in this section of the act.
Kholong further ruled that the lodged documents for the 16 claimants provided the RAF with sufficient information to enable the fund to investigate and consider the claims.
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“This court finds that defendant [RAF] is entitled to refuse to accept claims which do not comply with Section 24.
“This court also finds that defendant [RAF] is not entitled to reject claims which substantially comply with Section 24 given [the] peculiar circumstances of each case if the facts of the matter looked upon as a whole objectively leads to a finding of substantial compliance with Section 24.
“Consequently, any ancillary directives or regulation cannot as a matter of law trump application of that provision,” he said.
“It is this court’s conclusion therefore that the [RAF’s] special plea for all 16 plaintiffs [claimants] in these actions falls to be dismissed.”
RAF head of corporate communications McIntosh Polela said on Monday the RAF is appealing the judgment.
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Rejection letters
Acting Judge Kholong said that while the 16 different plaintiffs instituted proceedings independently, the legal representation for each of them and the RAF in each of the applications is the same, and the parties accordingly agreed that the special plea raised in each of these matters be heard first and consolidated together before the merits in each separate case are considered.
Kholong said essentially in all of these cases, the RAF in the rejection letters stated: “To administer claims effectively and efficiently the Road Accident Fund (RAF) pursuant to section 4(1)(a) of the Road Accident Fund Act, 1996 (the Act) published the stipulated terms and conditions upon which claims for compensation shall be administered (the terms and conditions) in Board Notice 271 of 2022 which was published in Government Gazette No. 46322 on 6 May 2022. The terms and Conditions, read with section 24 of the Act, stipulate what documents must accompany the claim documentation when submitting a claim for compensation.”
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He said the RAF, in each instance, proceeded to object to the validity of the claims submitted in accordance with paragraph 24(5) of the act and stated that they “do not accept the documentation presented/posted/emailed … as a valid claim for the purposes of lodgment in terms of the Act and accordingly return the documents”.
Kholong said it was on this basis the RAF applied its special plea to be upheld and the claims by the 16 claimants to be dismissed with costs.
He said the 16 rejection letters are premised on largely the same principles: non-compliance with Section 24 of the Road Accident Fund Act.
It was common cause between the parties that the documents outstanding are not documents prescribed by Section 24 of the Road Accident Fund Act but are only documents required in terms of RAF Board Notice 271 of 6 May 2022.
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Board notice can’t trump an act of parliament
Counsel for the 16 applicants and claimants said that a full bench of the Gauteng Provincial Division reviewed and set aside Board Notice 271 of 2022, but an application for leave to appeal that judgment is still pending.
The applicants did not attack the validity of the board notice in these proceedings and accepted its validity, but they specifically requested the court to consider the documents that they submitted and to make a ruling on whether providing those documents constituted substantial compliance.
Counsel for the claimants said the documents supplied by the 16 claimants to the RAF substantially comply with the requirements of Section 24 of the Act, and that the board notice, being an internal board notice, can never trump the provisions of an act of parliament.
Acting Judge Kholong said it follows from a number of previous judgments he had referred to that in circumstances where there is no fraud or misrepresentation, the objects of the RAF, as contemplated in Section 3, must be given effect in circumstances where there is loss or damage wrongfully caused by the driving of motor vehicles.
He ruled that the purpose of Section 24 of the act is to place the RAF in a position where it can evaluate the merits of the claim to be instituted against it and establish whether the claim is valid or open to opposition.
Kholong added this because the RAF, as a creature of statute, must give effect within permissible limits to the object of the act.
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“There is therefore no basis to reject a claim or refuse to accept a claim for purposes of proper investigation purely because information relevant to quantum of damages is considered by the RAF to be incomplete, especially in circumstances where claimants, as in some of these cases, face the real prospect of their claims facing prescription.
“Nor [do] RAF administrative arrangements on processing or investigation of claims justify dilatory tactics to otherwise valid claims,” he said.
Kholong found that the submitted claims of all 16 claimants substantially complied with the requirements of Section 24 of the act, having submitted the RAF 1 form and accompanying medical report with clinical notes for the RAF to assess and properly investigate the merits of the claimants’ claims.
“To require proof of any other income ‘if applicable’; payslips pre and post accident; medical accounts; confirmation of disability grant; itemised tax invoice and proof of payment of medical expenses is not in this court’s view a valid reason to refuse even the first step of the claim, assessment of the merits,” he said.
This article was republished from Moneyweb. Read the original here.
