Road Accident Fund (RAF) claimants are at their wits’ end when it comes to accessing the cover they require for their health needs. For those people living with disabilities, the struggle to access RAF funds for medical supplies, mobility aids and caregivers not only impacts their right to dignity but also their physical well-being.

One RAF claimant, Nonhlanhla Bakasa, said, “The thing that scares me the most is that medication and having the right assistive devices is not a luxury; it’s a need. Not having these things can be fatal. The struggle with RAF for every single claim is demoralising and I get extremely anxious at just the mention of their name.”

The RAF is a national public entity, funded by the levy on fuel used for road transportation, that makes compulsory social cover available to all users of South African roads. Its responsibilities include compensating people who are injured as a result of motor vehicles in a timely manner and actively promoting the safe use of roads.

Nonhlanhla Bakasa, Road Accident Fund claimant. (Photo: Supplied)

Bakasa is the coordinator of youth affairs at the National Council of and for Persons with Disabilities (NCPD), a non-governmental organisation with a focus on rights and opportunities for people living with disabilities. In 2002, when she was 12 years old, she was involved in a car accident that left her paraplegic. 

According to her settlement with the RAF, Bakasa has a 100% undertaking, meaning the fund is required to cover all costs related to her spinal cord injury. This includes treatment, medical supplies and modifications to her home that allow her to function.

But Bakasa and other claimants have told Daily Maverick that getting the RAF to fulfil its obligations is a difficult and time-consuming process.

“They were paying for a caregiver for me. They stopped paying for a caregiver out of the blue and I’ve not know why. Then they came back and they said, ‘Oh, we stopped the payment because we needed to come and check if you still needed a caregiver.’ I told them [my situation]… They paid for a few months and then they stopped again,” said Bakasa.

Alice Masapo, Road Accident Fund claimant. (Photo: Supplied)

Another RAF claimant, Alice Masapo, is fully dependent on caregivers due to a road accident in 2014 that left her quadriplegic. The RAF is required to cover the caregiver costs, but Masapo reports the salaries are “never paid on time”.

“The problem with not paying the caregivers [is] when you tell them that the salaries are not in yet, it’s really heartbreaking because these people have families to support,” she said.

“For my weekend stand-in [caregiver]… the RAF cut her salary in half without giving an explanation. I am forced to use my own money to cover the rest of the [salary] and at the moment I can’t anymore, so she’s only here during the day.”

Caregivers often leave their posts due to the RAF’s failure to pay salaries, according to Norman Themba Zwane, an RAF claimant with paraplegia. He finds it difficult to seek new carers on a regular basis.

“Presently, I’m 67 years old. When I got injured… I was 56. Now, because I need somebody to bathe me, the emotional issue about all this is getting somebody new, every time, to come in to bathe me… I keep telling [the RAF] that you don’t know the pain of going through that every time. I would sooner get the caregiver and keep her for as long as possible and be comfortable… But the rapid change that I’m forced to make makes me feel… so undignified,” he explained.

Nthabiseng Molongoana, Road Accident Fund claimant. (Photo: Supplied)

Read more in Daily Maverick: Bleeding Road Accident Fund prevents almost R2.7bn in fraudulent claims

Medical treatment and supplies

Nthabiseng Molongoana, director of the NCPD in the Free State, is another RAF claimant with a 100% undertaking. She has been living with quadriplegia since 1994, when a taxi in which she was a passenger had a head-on collision with another vehicle. She was 18 years old at the time.

“I have been a claimant of RAF since 2000 and I have spent the last 23 years struggling with claims for caregivers and medical supplies. Suppliers are not willing to assist because of non-payment of claims by the RAF,” she said.

Molongoana often resorts to paying for medical supplies out of her own pocket and sending claims to the RAF for reimbursement. However, these claims either take months to be paid out or are not paid out at all.

“I received a [wheelchair] cushion from CE Mobility in 2020 and to this day RAF has not paid the supplier. I am very worried that I will be liable to pay despite the purchase of the cushion being authorised by the agency,” she said.

Wheelchair cushions cost thousands of rand and are vital to someone in Molongoana’s position, as they are designed to prevent the pressure sores that can develop due to sitting in a wheelchair for extended periods. Once these sores develop, they run a high risk of turning septic, which can result in hospitalisation or death.

Masapo told Daily Maverick that she was supposed to receive medical supplies from the RAF every three months, including nappies, linen savers, incontinence pads and gloves.

“At the moment, it’s a struggle… I’m on my last [packet] of nappies and I’m already stressed,” she said. “You have to buy everything and [the RAF] never repays the money… At the moment, I’m no longer sending receipts because it’s useless — you never get refunded…

“I really hope they remember that they are dealing with people with disabilities. Already our lives are a struggle… but they are making it worse.”

Part of the problem is that the procedures for making expense claims to the RAF sometimes change without claimants being informed, according to Bakasa. She made the example of her claims for the cost of her chronic medication. This process used to require only receipts but now needs a copy of her prescription.

“I’ve been backdating all the slips that I have for a good year and a half or so… and I’m being told, ‘We can’t pay you back because you don’t have the prescription’… But how was I supposed to know?” she said. “I’ve been on this chronic medication since the very beginning… My medication costs — just the medication, not the medical supplies — almost R3,000 a month.

“One of my medications is for my bladder. If I do not have that medication, I become vulnerable to kidney infections. A paraplegic friend of mine, a few months before that, passed away from a kidney infection. That’s how dangerous this stuff is.”

Bakasa emphasised that her medication and medical supplies were not a want but a need. Without items such as incontinence supplies, she is unable to move freely or leave the house. She also described the ongoing struggle to secure RAF funding for the home modifications she required in order to function within certain parts of her house, such as the kitchen.

Currently, Zwane’s wheelchair, commode and crutches are all damaged. He said his attempts to secure assistance from the RAF to fix or replace these items have been unsuccessful.

“Central to the issues that I have is the lack of any communication… That actually touches everything else… When you try to communicate with the RAF, you eventually get the feeling that you’re talking to yourself. No one tells you, ‘Yes, you are correct’; ‘No, you’re wrong’… ‘We’ve changed the policy’ or ‘We have changed the people you can talk to’,” explained Zwane.

Other RAF claimants reported difficulties in communicating with the public entity, claiming emails were not responded to and calls were not picked up.

“There’s nothing that makes it so difficult as when you send emails to the Road Accident Fund [and] you never get a reply to the enquiries… As a result, you give up. But then… after you’ve given up, you ask yourself, what is my hope going to be?” said Molongoana. 

“Then you end up getting into debt with other people to cover what the Road Accident Fund should have covered… and then you spoil your relationships.”

The Road Accident Fund

The NCPD has attempted to engage with the RAF on behalf of claimants with grievances. However, Bakasa said that the organisation had yet to receive a satisfactory response from officials.

“As a claimant, trying to deal with the Road Accident Fund as an individual, you are extremely overwhelmed. So, once you get a number of us together, that really helps us to also know that we’re not going through this alone. Just as a support system, that’s one way that [the NCPD] has even assisted me personally,” she said.

According to McIntosh Polela, spokesperson for the RAF, the public entity engages with a wide range of relevant stakeholders, including claimants, when implementing its policies and processes.

“Claimants are urged to engage with the RAF Contact Centre, which together with the fund’s dedicated teams dealing with undertaking claims in process centres, have been tasked to address any challenges,” he told Daily Maverick.

When asked about the challenges claimants had faced in getting responses to their enquiries, he said the RAF had launched an “enhanced Contact Centre with the number 087 820 1111” and that the fund was on a “transformation journey” to make it easier for victims of road accidents to claim.

“This centre has been bolstered by an increased human resource capability of 300 staffers in order to improve the RAF’s responsiveness to claimants, part of the fund’s commitment to make 2023 the ‘Year of the Claimant’,” said Polela.

On the issue of caregiver salaries, Polela said there were efforts underway to “regularise caregiver pay runs”, adding that “to avoid further delays, caregivers are urged to submit all their time sheets and documents timeously and where necessary, escalate to the Contact Centre”.

The RAF faces an ongoing investigation by the Special Investigating Unit (SIU) into allegations of serious maladministration and improper or unlawful conduct by employees at the public entity. 

A progress update released on 29 November laid out various findings to date, including that RAF employees had made fraudulent bank account charges on the RAF system and redirected funds meant for service providers into their personal accounts. The SIU has found that just over R1.9-million was redirected to the personal accounts of employees.

Another finding was that the default court judgments issued against the RAF for costs and fees between 2018 and the second quarter of 2023 had reached a total amount of R4.7-billion.

At the time the progress update was released, the SIU had managed to recover more than R317-million erroneously paid to lawyers by the RAF. DM