THE NATIONAL COUNCIL FOR PERSONS WITH PHYSICAL DISABILITIES IN SOUTH AFRICA

10 April 2005

Dear Mr Cronin

COMMENT ON THE ROAD ACCIDENT FUND AMENDMENT BILL 2005

Thank you for the privilege of again commenting on the RAF Amendment Bill.

The RAF should be guided by the Batho Pele - Putting People First principles, an initiative aimed at enhancing the quality and accessibility of government services by improving efficiency and accountability to the recipients of public goods and services.

This means that the following eight service delivery principles must be implemented :

* Regularly consult with customers;

* Set service standards;

* Increase access to services;

* Ensure higher levels of courtesy;

* Provide more and better information about services;

* Increase openness and transparency about services;

* Remedy failures and mistakes and

* Give the best possible value for money.

The fact that a large number of people involved in road accidents become disabled, requires that all legislations and guidelines like the Integrated National Disability Strategy (INDS) which is also enshrined in the Constitution of South Africa be observed.

In The Constitution of SA, Act 108 of 1996, Chapter 2, Bill of Rights, Section 10 Human Dignity, reads as follows: "Everyone has inherent dignity and the right to have their dignity respected and protected.

The current Amendment Bill does not comply with either the Batho Pele principles, the INDS or Section 10 of the Bill of Rights. The opposite seems to be true: the safeguard of the RAF and its current incompetence of dealing with claimants which it was designed to assist many years ago.

Zachie Achmat said: "We believe that the personal crises faced by many of our families, friends, nurses, doctors, colleagues and their children should be turned into discomfort and a crisis for the politicians and bureaucrats who continue to deny our people medicine."

Is the road taken by the TAC the road which should be taken by Road Accident Victims?

OBJECTS OF THE BILL

The Memorandum, which accompanies the Bill, states that the proposals are aimed at "improving the governance of the Fund" and will "improve the financial sustainability of the Fund".

Governance

To address governance the Bill seeks to empower the Minister of Transport to appoint the Chairperson and Vice Chairperson of the Board of the Fund and, with the concurrence of the Board, to appoint the Chief Executive Officer of the Fund. The executive committee of the Board is to be abolished. Good governance is the core of transparency and accountability. Limiting the Board to Chairperson and Vice-Chairperson and abolishing the Executive Committee effectively limits the process of good governance.

Financial Sustainability

To achieve savings "a monetary limit" on general damages and future loss of income or support is proposed along with "a method for determining tariffs for payment of medical expenses". The Fund’s current statutory liability to pay successful claimants their costs is to be repealed.

As against this, the Bill proposes that the current cap on passenger’s claims be abolished and that the Fund be liable, on a no fault basis, to "compensate a provider of emergency medical treatment directly". It is our view that the benefits to claimants of these proposals are more apparent than real. This will be dealt with in the body of this comment.

It is noteworthy to note that, to improve the financial sustainability of the Fund, the proposal is to limit compensation paid by the Fund and not to increase the sources of income of the Fund or to look at factors which are risk factors increasing the financial obligations of the Fund.

Claimants on funds very rarely, if ever, have legal or medical expert assistance in processing their claims. Recently the Legal Resources Centre launched proceedings aimed at obtaining a court order compelling the Compensation Commissioner to perform the very functions for which the office was created. The Legal resources Centre has stated that investigations conducted by them reveal a reserve of R11 BILLION in the coffers of the Compensation Commissioner.

Effects of the Savings

The clear intention of the proposed legislation is to remove claimants’ attorneys and their medical and other expert advisors from the system and to develop a tribunal for the assessment of damages controlled by the Fund, itself. Surely this goes against a person’s freedom of choice.

The delays and inefficiencies in the office of the Compensation Commissioner have received considerable publicity of late, as well as the failure on the part of the Commissioner to pay suppliers and/or providers. A recent newspaper article reported that at any one time there are 100 000 pieces of unopened mail in the office of the Compensation Commissioner and only two members of staff to process the backlog.

The failure in the Compensation Commissioners office to process claims has resulted in lengthy delays in finalising claims against the Road Accident Fund and, often, a claimant’s only remedy is to proceed to court and subpoena the Commissioner to attend the trial. Often it is only this drastic step that forces a response from the Commissioner’s office.

Road accident victims, in terms of the proposed legislation, will be in a far worse position. Before they even qualify for compensation they will be obliged to traverse a minefield of technicalities, prove fault on the part of a motorist and quantify their damages. The vast majority of claimants will not be represented. A claimant will still have to prove fault and thread his or her way through extremely complicated and technical procedural requirements in order to qualify for compensation. Were it not for attorneys, medical experts, etc, the claimant (the victim) would be at the mercy of the Compensation Commissioner and we all know where that would leave the claimant: in dire straits, deep in debt, house bound, poverty, etc.

The proposed amendment to section 19 will entitle the Fund to interrogate each and every claimant on any aspect of the claim and, if, in the opinion of the Fund, a claimant "fails to respond truthfully and to the best of his or her knowledge to questions put" compensation will be denied. Words fail to express adequately the injustice and inequity of such a proposal, which flies in the face of every basic tenet of fairness, access to justice and equality. How can skilled officials question someone that is unskilled in the technicalities of the RAF? This is discriminatory to say the least.

The Fund’s current culture, even with attorneys representing claimants, is to take technical points, delay settlement of claims and payments and consistently make initial offers and tenders that bear no relation to the fair and reasonable value of the claim in terms of the current legislation. Where claimants have attempted to claim direct the Fund has raised prescription when the claim is not settled within the prescribed periods. To compound matters, the inefficiency of the Fund remains a serious issue. There is little in the current practice that gives any comfort to future claimants, who will be obliged to claim, unassisted.

The inability of the Road accident Fund to administer undertakings has been well ventilated before this committee, as has the general failure of the Fund to perform many of its functions with any degree of acceptable efficiency. This is in terms of a dispensation, which permits a claimant to have legal representation.

A notice published in the Sunday Times of 23 January 2005 by the interdepartmental portfolio committee, invites stakeholders to participate in consultations regarding possible and changes to the current Road Accident Fund Act with a view to devising a new system of compensation for road accident victims.

This process clearly relates to the SATCHWELL COMMISSION’S report. It is understood that cabinet has, in principle, approved the philosophy of the SATCHWELL COMMISSION recommendations and, to this end, appointed an inter-departmental committee, to work in conjunction with a panel of suitably qualified experts, to advice on the implementation of the recommendations.

The reality is that, under the proposed amendments without legal assistance, the vast majority of claimants will be denied meaningful compensation. The "financial sustainability of the Fund", will indeed be improved (if only in the sort term) but at what real cost? At the cost of the claimant which goes against Section 9 and 10 of the Bill of Rights.

 

THE BILL

Amendment of Section 4 of Act 56 of 1996

The Bill seeks to expand the powers of the Fund to include the power to sub-contract its functions, currently the responsibility of the Fund, either to the private sector or another organ of state.

Amendment of Section 10 of Act 56 of 1996

Provides for the disbanding of the executive committee and limits the term of office of Board members. The proposed amendment limiting the term of office of Board members to three years militates against long term planning and continuity on the part of the Board.

The amendment further empowers the Minister to appoint the Chairperson and Vice-Chairperson of the Board (as opposed to the Board, itself).

Why is there no mention made of having a person with disability on the Board?

Substitution of Section 17 of Act 56 of 1996

This section is the core of the Act and determines the liability of the Fund to compensate claimants. Radical amendments are proposed.

1 General Damages and the Nature of the Injury

The amendment seeks to exclude payment of general damages (pain and suffering, loss of amenities of life, impairment, disfigurement, disability and shock) to victims who have not suffered "a serious injury". A cap of R100 000.00 is imposed in respect of a victim who suffers a serious injury.

If one applies the proposed definition of "a serious injury" to the Road Accident Fund’s own current guidelines for the calculation of general damages, all but approximately 6 of the listed injuries will qualify for compensation. This means that more than 80% of road accident victims will be disqualified from receiving compensation for pain and suffering, loss of amenities of life, disability, disfigurement and shock.

The definition of "a serious injury" leaves much to be desired. The Minister is empowered to "prescribe" other serious injuries. No regulations have, as yet been produced. It is clear that the intention is to limit payment to those claimants with an objectively discernable catastrophic injury. Many injuries, which would not fall into the definition of "total disablement", can result in a claimant’s lifestyle and ability to earn being severely impaired. If the proposed amendment is adopted, thousands of seriously injured claimants will suffer.

The Bill proposes that "assessment of serious injuries" be based on a "prescribed method" adopted after consultation with "medical service providers". It is not clear whether these are the same "providers" as referred to in section 26.

What is of concern is the establishment of "provincial medical panels consisting of a representative of the Fund". To make assurance doubly sure, it is proposed that "the Fund set up a peer review panel to oversee assessments by panels…"

What is contemplated is the establishment of medical tribunals, controlled by a review panel "set up" by the Fund, the very body against whom the claim is made. In addition, amendments proposed to section 26 empower the Minister to further "make regulations regarding-

(e) the resolution of disputes about the assessment of the nature of an injury"

No indication is given as to the nature of the regulations, but it is assumed that these will attempt to prescribe in-house mediation and other procedures, which will exclude a claimant’s constitutional right to have access to the courts in order to enforce a right.

Such a system of assessing the "nature of an injury" cannot be perceived to be independent, impartial or fair.

The abolition of the Fund’s current statutory obligation to pay a successful claimant’s party and party costs in addition to the capital merely emphasises that the new system of dispute resolution intended by the Bill excludes claimants’ lawyers, claimants’ independent medical and other expert advisors and the courts. The constitutionality of this is questioned.

The proposed payment of general damages limited to R100 000.00 in a lump sum will not begin to address the immediate needs of those few accident victims who do qualify for the payment, particularly as the clear intention is to pay future loss of income by way of instalments over the rest of a claimant’s life (to age 65 or death). Both the lump sum payment and the instalments will be further subject to apportionment in the case of contributory negligence.

2 Future Loss of Income or Support

The Bill proposes that the Funds liability "to compensate the third party for future loss of income or support as contemplated in section 17(4)(b) shall not exceed R160 000.00 per year".

The Fund’s liability to compensate a claimant ceases upon the death of the claimant or when the claimant turns 65, whichever occurs first. In the case of loss of support it ceases when the deceased spouse would have turned 65 and/or if the surviving spouse should remarry or, in the case of a child, when that child attains the age of 21.

The wording of the proposed section indicates that the intention of the amendment is to pay future loss of income and support in instalments not exceeding R160 000.00 per annum. What is not clear is whether these annual payments will be spread over 12 months or paid quarterly or in one payment.

The common law tenet that loss of support cease on re-marriage is archaic and discriminatory, as is the current practice of applying a contingency deduction for re-marriage. In terms of the proposed legislation, many widows will find themselves in the position of never being financially able to resume a new life. In terms of the Bill, surviving dependents will be required to re-apply, every year, for loss of support and, if denied fair support, be obliged to institute proceedings, time and time again, in terms of whatever system is prescribed to attempt to enforce their rights, most likely without support from a lawyer. Re-marriage will not be a financially sensible alternative.

There are many circumstances where children, in terms of the common law, legitimately require support beyond the age of 21. For example, those children who are brain damaged, ill or for any physical reason will never be independent. It is discriminatory to prejudice those dependants. If a dependant loses both parents, such dependant will require assistance, year after year, to process annual claims for loss of support.

Similarly, the provision that loss of support terminate, when the breadwinner would have turned 65 is artificial. Many breadwinners do not have the luxury of retiring at some arbitrary, albeit, widely accepted "retirement" age.

No Lump sums

As very few claimants will qualify for general damages, lump sum payments, in essence, will be done away with in terms of the Bill as presently drafted. The Portfolio Committee has already heard considerable evidence from a large cross-section of the public and stakeholders on this. Virtually every submission was against the payment of compensation in instalments.

The objections were broadly based on two grounds, namely, the Fund’s inability to administer claims and undertakings in terms of the current legislation and the devastating effect that the denial of lump sums will have on the lives of accident victims, particularly those who sustain serious, disabling injuries.

Future Medical Expenses

The right to claim future medical and related costs from the Fund is taken away from the claimant. Only the supplier or provider may claim. The Fund’s liability is further restricted to a "prescribed" tariff.

The proposed amendments, once again, impose huge additional, administrative burdens on the Fund. If the Fund has to review every claimant entitled to future loss of income annually (in addition to administering unsettled claims) and dealing with claims under the existing system (where there is already a substantial backlog which continues to grow) the additional cost to the Fund will be astronomical. Whatever savings the Fund hopes to achieve by eliminating attorneys from the system will be spent on medical panels, medical review panels and additional systems and staff.

In the case of passengers injured on duty, where under the current legislation their claims are limited to R25 000.00, claims from the Compensation Commissioner against the Fund will increase substantially, in respect of loss of income, past and future. Furthermore, it is apparent that the Compensation Commissioner will also be obliged to claim year by year in respect of future loss of income and support, thus materially increasing the administration functions of that office as well as the Road Accident Fund.

The stipulation that only providers can claim for costs incurred by a claimant will increase the volume of claims to be made on the Road Accident Fund dramatically. Instead of aiming at reducing administration the proposed amendments has the opposite effect.

No fault "golden hour" Medical Treatment

A restricted element of no-fault compensation has been introduced with a provision to pay "emergency medical treatment" irrespective of negligence or wrongfulness on the part of any person. The definition of "emergency medical treatment" limits liability to "reasonable and appropriate emergency treatment by a prescribed provider of such service in order to stabilize the emergency medical condition".

 

Amendment of section 18 of the Act of Act 56 of 1996

The cap on passengers’ claims is removed and fixed compensation of R5000.00 is proposed for funeral expenses. Clearly the writers do not know what a funeral costs.

At present, the majority of taxi passengers do not qualify for any meaningful payment as they are denied general damages (as a result of the absence of a taxi permit) and many are unemployed and/or unable to prove loss of income.

In other words, currently, passengers in taxis in a single vehicle accident or one caused by the sole negligence of the taxi driver are unable to access even the limited compensation of

R25 000.00. The stringent limitation on general damages will exclude most passengers travelling in taxis, which do have valid permits. Those passengers in "illegal" taxis will remain excluded from claiming general damages, in any event.

If the intention is to eliminate the unfair discrimination against passengers then the requirement of a taxi permit should also be abolished.

The most exposed class of motorist will be the taxi driver/owner. In the case of a single taxi accident, each and every passenger will have a common law claim against the taxi driver and/or owner for the balance damages suffered not covered by the proposed legislation. Currently, there is very limited cover available for the taxi industry in respect of passenger liability. Under the proposed legislation, the cost of this limited cover is likely to become unaffordable. The cost of full cover will be prohibitive. Even in collisions involving more than one vehicle the negligent driver (albeit 1% negligence) will be exposed to substantial common law claims, both from passengers in the vehicle driven by him or her and from the occupants of the other vehicle.

Government has confirmed its intention to proceed with the taxi re-capitalization scheme. Without sufficient protection from the Road Accident Fund and/or private insurers, owners of "new" taxis will be vulnerable to having their vehicles (probably their major asset) being attached for sale in execution to meet judgments obtained for personal injuries suffered by road accident victims.

Bus and other private passenger transport companies will be exposed to substantial common law claims and will be obliged to try to obtain suitable liability cover to protect them from claims arising from the negligence of their employees (if such cover can be found at an affordable cost).

The road transport industry will be obliged to take out additional insurance in order to protect their businesses from insolvency arising from a second’s inattention on the part of an employee. The tourism industry will be even more exposed.

The additional costs for cover will have to be passed on to the end user in order for those industries to continue to trade. The ripple effect will be considerable.

All commercially active road users will have to protect themselves, financially, from the risk of injury in circumstances where it will not be possible to recover in terms of the common law. Currently, because of the cover in terms of the Act, such protection is relatively affordable. If the current legislation is passed the cost of replacing the protection lost from private insurers is likely to be beyond the reach of all but the extremely wealthy.

 

On 6 April 2005 it came to the attention of this Council that the Department of Transport has yet again launched a further amendment proposal to the RAF Act in that the common law right to sue the wrongdoer for the balance of damages over and above the limited benefits to be provided by the Road Accident Fund, is now removed.

This makes the proposed 2004 amendments even worse for the victim (and we are all possible victims) as tragedy, hardship and poverty will await the seriously injured victim who will be unable to work as well as prior to the accident or at all.

Removal of common law rights is without doubt unconstitutional in principle.

The time has come for the RAF to humble themselves and request the victims of accidents and organizations of and for persons with disabilities to sit around a table and to grip with the real issues at hand:-

The cost after a road accident is immense and the trauma inconsolable. The added trauma of having to contend with bureaucratic process of the Road Accident Fund is totally discouraging. Where do the Batho Pele principles come in? Or do these principles not apply to the RAF?

 

Yours faithfully

DA Howitson

MISS DOROTHY-ANNE HOWITSON

VICE-CHAIRPERSON

 

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