Dodgy claims robbing taxpayers of billions every year: actuary

 ·2 Mar 2024

Every year, around R3 billion is lost by the Road Accident Fund (RAF) as a result of paying out “opportunistic loss of income claims from individuals who suffered only minor injuries in a motor vehicle accident.”

This is according to research done by actuary and damages expert Gregory Whittaker for the Actuarial Society of South Africa (ASSA).

The research says that loss of income compensation from the RAF for non-serious injuries “is excessive,” highlighting that there has been a large increase in the number of these settlements made by the RAF over the years.

Source: Road Accident Fund Loss of Income Claims for Non-Serious Injury: A Local and International Comparison

“In the financial year ending 31 March 2008, the RAF made 5,957 individual claims payments in respect of loss of income, whereas in the financial year ending 31 March 2023, the RAF made 20,957 individual claims payments in respect of loss of income,” said Whittaker

Based on RAF data, R18.4 billion was paid out for loss of income settlements in the 2021/22 financial year, and of this total, roughly 14% went to individuals with non-serious injuries.

In the subsequent financial year (2022/23), the RAF paid out R22 billion for loss of income claims. Whittaker said that in the absence of exact figures (assuming that 14% of total loss of income claims was paid for non-serious injuries) this equates to roughly R3 billion over the past couple years for minor injuries.

The expert said that a key change introduced by the Road Accident Fund Amendment Act was to no longer allow compensation for non-pecuniary loss (general damages not quantifiable in monetary terms, such as pain and suffering) for non-serious injuries. 

However, this very same exclusion was not applied to loss of income claims from individuals who suffered minor injuries in a car accident – leading to people abusing the system.

This is seen in a recent trend where claims that were initially made for minor injuries prior to the Amendment Act have now transformed into claims that involve future loss of earnings due to minor to moderate head injuries.

Whittaker said that there are several measures that can substantially alleviate the fiscal pressure on the RAF, which has seen the deficit of the RAF grow from R3.8 billion (1994) to R344.8 billion (2022).

Recommendations

Whittaker recommends amending the RAFA Act to do away with the provision that allows individuals with minor injuries to submit loss of income claims.

“A simple amendment of removing compensation for non-serious injury and hence aligning this to the treatment of compensation for non-pecuniary losses would result in a saving to the fiscus of some R 3 billion a year in compensation payments,” said Whittaker.

The expert also urges legislators to address the “substantial mismatch” between compensation provided in terms of the Compensation for Occupational Injuries and Diseases Act (COIDA) and the RAF.

Lastly, he suggests the establishment of a central government body responsible for determining fair compensation to individuals, whether injured in a car accident or at their place of work, and how the compensation regime should function.


 Read: How fraudsters have been bleeding the Road Accident Fund for millions

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