What You Cannot Claim from the Road Accident Fund?

The Road Accident Fund does not compensate every loss arising from a motor-vehicle accident. Under the Road Accident Fund Act (as amended), claimants cannot recover for pure emotional shock and trauma unless it produces a diagnosed physical injury, and “general damages” (non-economic loss such as pain, suffering, and loss of amenities of life) now sit behind a “serious injury” threshold under the amended section 17 framework. Other non-compensable items include depreciation on the vehicle itself, losses the claimant would have suffered regardless of the accident, and any portion of loss attributable to the claimant’s own contributory negligence. The headline exclusions every RAF claimant should know are: pure emotional shock with no physical injury, vehicle depreciation, and any loss unrelated to the accident.

The RAF Scheme at a Glance

The Road Accident Fund is a statutory insurer that compensates third-party victims of motor-vehicle accidents within South Africa. It is governed by the Road Accident Fund Act 56 of 1996, materially amended by the Road Accident Fund Amendment Acts of 2005 (which introduced the “serious injury” threshold) and 2010. The scheme responds to accidents, not to fault: it covers drivers, passengers, pedestrians, and cyclists, regardless of who caused the collision, and pays out of a fund collected through fuel levies and other statutory contributions.

Three headline heads of damage run through every RAF claim: past loss of earnings, future loss of earnings, and general damages. Each is governed by its own rules, its own evidence requirements, and its own set of exclusions. A claimant can be in scope for one head and out of scope for another on the same set of facts, which is why the exclusions matter as much as the inclusions when planning a claim.

What You Cannot Claim from the Road Accident Fund

The RAF Act draws sharp lines around which losses the Fund will pay for. The categories below are the most commonly excluded items across South African RAF claims:

• Pure emotional shock or psychological trauma without physical injury. The regime centres on bodily injury; a psychological condition with no underpinning physical injury falls outside the scheme. Trauma that flows from a confirmed physical injury is treated differently from trauma that stands alone.
• General damages without a “serious injury.” Under the post-2005 amendments, non-serious injuries cannot recover general damages (pain, suffering, loss of amenities of life). Claimants below the threshold are limited to past and future loss of earnings where supportable.
• Losses unrelated to the accident. The causal link must be demonstrated. Pre-existing conditions remain excluded except where they were aggravated by the accident in a medically attributable way.
• Vehicle value depreciation (“wear and tear”). The scheme addresses the reasonable cost of repairs, or in defined circumstances the market value of the vehicle, not the depreciation that would have accrued regardless of the accident.
• Property damage outside the limited categories the Act permits. Most personal property (clothing, electronics, items not falling within the scheme’s narrow property-damage provisions) is excluded.
• Losses the claimant would have suffered anyway. A causation-only exclusion: speculative losses, or losses disconnected from the accident, fall away even where the accident happened.

Burger Huyser Attorneys’ general litigation practice, run through Director Nadine Roesch-Prinsloo at the Roodepoort branch, fields these scope questions early in every MVA file, so the evidence-gathering effort is pointed at the heads of damage the Act actually supports.

Category-by-Category: What’s Excluded vs. What’s Included

The table below sets out the in/out line across the main RAF claim heads. It is a working map, not a guarantee — every claim turns on its own medical and actuarial evidence, and the precise scope can shift when the regulations or the case law are updated.

Claim head	What’s in scope	What’s out of scope
Medical / hospital expenses	Reasonable, accident-related treatment to date and into the future	Pre-existing treatment; treatment unrelated to the accident; cosmetic work beyond what’s medically required
Past loss of earnings	Lost income between accident and settlement, supported by employer / SARS records	Income the claimant would not have earned regardless; undeclared income with no paper trail
Future loss of earnings	Loss of future earning capacity proved by actuarial and medical evidence	Speculative future loss unsupported by medical opinion; loss the claimant would have suffered anyway
General damages (pain and suffering)	Available for claimants who meet the “serious injury” definition under the Act and any applicable regulations	All non-serious injuries under the threshold are excluded from general damages
Vehicle damage	Reasonable repair cost, or in some cases the market value of the vehicle	Depreciation; wear and tear; loss of use (commonly excluded); non-essential accessories unrelated to operation
Travel costs	Reasonable, medically-related transport, supported by medical certificate	General commuting unrelated to treatment; travel outside medical necessity
Domestic help	Medically recommended and prescribed care	General household help that would have been needed regardless

Contributory Negligence and Deductions That Reduce a Claim

An RAF award is reduced by the claimant’s percentage of fault. A claimant found 30% at fault typically recovers 70% of the assessed loss, after deduction. The Act also allows certain deductions even where the claimant’s fault is not the dominant cause, under the “unrelated contributory negligence” provisions — for example, where the claimant failed to wear a seatbelt or was not properly secured, or where conduct on the claimant’s side aggravated the consequences of the accident.

An RAF offer that fails to credit these deductions correctly is one of the more common litigation triggers. Disputes over the percentage split, the scope of the unrelated-conduct deduction, and the order in which deductions are applied all regularly reach the Gauteng Division of the High Court.

How the “Serious Injury” Threshold Works in Practice

Under the section 17 regime introduced by the 2005 amendments, claimants seeking general damages must prove a “serious injury” — a defined statutory concept covering long-term impairment, permanent disfigurement, severe emotional shock with a physical-symptom overlay, and other categories the Act and any applicable regulations specify. The assessment is a medical-actuarial exercise, run through a regulated methodology.

Claimants who fall below the threshold are limited to past and future loss of earnings only; general damages is no longer available to them, no matter how disruptive the injury has been. The interpretation has been heavily litigated and the relevant judgments remain the working authorities counsel uses to argue threshold disputes. Anyone whose claim sits close to the threshold needs medical evidence tailored to the regulatory criteria, not a generic treating-doctor report.

What the RAF Will Say No To (and Why That Often Becomes a Dispute)

A few categories regularly draw repudiation letters or partial offers that prompt litigation:

• Repudiation of claims where causation between accident and injury is contested
• Exclusion of treatment costs not on the scheme’s prescribed tariff
• Disputes over general-damages quantum even where the threshold is met
• Pre-accident earnings where the claimant was not formally employed
• Cases where the accident occurred outside South Africa’s borders — RAF jurisdiction is territorially limited

Each of these is a known flashpoint, and each can usually be challenged where the supporting evidence is well-prepared. The challenge is rarely the law; the challenge is the paper.

What Burger Huyser Does When a Claim Hits an Exclusion

When a head of damage falls outside the RAF framework, the matter does not necessarily end. Burger Huyser’s general litigation practice handles motor-vehicle-accident claims through a defined intake and resolution process: an initial scope check to identify which heads of damage are in scope and which are likely to be excluded; medical and actuarial coordination to support the in-scope heads, especially where the section 17 / serious-injury assessment is on the table; drafting and lodging the RAF claim and supporting medical and financial documentation; negotiating settlement, or, if the offer understates the claim or the matter has been repudiated, litigating through the Gauteng Division of the High Court for matters arising in Gauteng or the relevant provincial High Court division for matters arising elsewhere in South Africa. Fees are typically charged on a contingency basis, subject to the firm’s normal engagement terms and the legal-costs tariff the RAF applies. The same working approach is available through Director Nadine Roesch-Prinsloo at the Roodepoort branch and through the firm’s other Gauteng intake points at Linden (Randburg), Bedfordview, and Centurion.

Litigating an RAF Dispute in Gauteng

RAF matters originating in Gauteng begin with a direct administrative submission to the RAF — the standard claim form, supported by medical and supporting documentation, addressed to the Fund’s regional processing operation. Where the offer from the RAF is inadequate, or the claim is rejected outright, the matter is litigated in the Gauteng Division of the High Court, sitting at either Johannesburg or Pretoria depending on the originating branch and the location of the accident. Counsel briefed to argue causation or “serious injury” threshold disputes in this division are typically sourced from the Pretoria or Johannesburg Bar.

The exclusions covered in this article operate identically across South Africa because they derive from the national RAF Act; there is no Gauteng-specific carve-out for the section 17 serious-injury regime or for the property-damage and emotional-shock exclusions. For Gauteng-based claimants, Burger Huyser Attorneys’ branches are the practical intake points: the Roodepoort branch (16 Galena Avenue, Helderkruin, 011 668 0030) is the working director’s office for MVA claims, with the firm’s Linden HQ (49 First Avenue, Linden, Randburg, 011 888 0246), Bedfordview (45A Florence Avenue, 011 201 7190), and Centurion (012 644 4990) branches acting as alternative intake points closer to where the claimant lives or works.

Frequently Asked Questions

What does “serious injury” mean for a Road Accident Fund claim?

Under the amended RAF Act, claimants seeking general damages for pain, suffering, and loss of amenities of life must prove a “serious injury” — a defined statutory concept covering long-term impairment, permanent disfigurement, severe emotional shock producing physical symptoms, and other categories the Act and any applicable regulations prescribe. Claimants with non-serious injuries can still claim past and future loss of earnings, but not general damages. The interpretation is a medical, actuarial, and judicial matter and has been the subject of extensive litigation.

Can I claim for emotional trauma if I wasn’t physically injured?

Generally, no. The RAF regime centres on bodily injury; pure psychological harm with no underlying physical injury is typically excluded. Where a confirmed physical injury produces psychological symptoms, and where severe emotional shock is linked to a physical injury, the position is different. Medical documentation and legal advice are usually needed to draw the line.

Does the RAF pay for vehicle depreciation?

No. The scheme addresses the reasonable cost of repairs, or in defined circumstances the market value of the vehicle, but it does not separately compensate for depreciation or “wear and tear” on the vehicle.

Can I claim loss of earnings if I was unemployed at the time of the accident?

Past loss of earnings claims require actual past loss supported by documentation; claimants who were not earning at the time of the accident may still have a future-loss-of-earnings claim if the accident impacts residual earning capacity, but this must be medically and actuarially supported. Past loss of earnings is rarely available without an employment or self-employment record.

Will the RAF reduce my claim if I was partly at fault?

Yes. Under the contributory-negligence framework your award is reduced by your percentage of fault, so a claimant found 30% responsible would typically recover 70% of the assessed loss. The Act also permits certain deductions even where your fault isn’t the dominant cause, under the “unrelated contributory negligence” provisions.

Can I claim for damage to personal belongings in the vehicle?

Generally, no — the Act’s property-damage provisions are narrow and are largely limited to vehicles themselves. Compensation for clothing, electronics, and other personal items is typically excluded.

What if the accident was intentional?

Claims arising from accidents caused intentionally by the claimant are excluded. Where the accident was caused by the deliberate act of a third party, the scheme usually still applies because the scheme responds to motor-vehicle accidents as such, not to the fault of the parties.

If your accident-related claim has been rejected, underpaid, or you have been told that your loss falls outside the Road Accident Fund, get in touch with Burger Huyser Attorneys to have the file assessed. Director Nadine Roesch-Prinsloo and the firm’s general litigation practice handle motor-vehicle-accident claims from the Roodepoort branch (16 Galena Avenue, Helderkruin, 011 668 0030) and the firm’s other Gauteng branches — Linden HQ (011 888 0246), Bedfordview (011 201 7190), and Centurion (012 644 4990). Initial consultations confirm whether the heads of damage fall within the RAF framework and what evidence is needed to support each one.