QUADRIPLRGIC ASSOCIATION OF SOUTH AFRICA’S (QASA) SUBMISSION ON THE PROPOSED AMENDMENTS TO THE ROAD ACCIDENT FUND BILL
NOTE: Text in italics denotes an extract from the Road Accident Fund Amendment Bill; text in bold italics denotes a proposed amendment of same.
Section 17(1)(a) Provided that the obligation of the fund to compensate a third party for general damages, for pain and suffering, loss of amenities of life and disability, shall be limited in the amount of R100 000.00 in respect of each claimant and shall be paid by way of lump sum: Provided further that the Fund’s obligation to pay such compensation shall only extend to a third party who suffers a serious injury as contemplated in subsection (1A).
This provision is completely unacceptable to QASA, particularly in view of the fact that currently compensation ranges from between R700 000.00 and
R1 000 000.00 for a severe injury such as a spinal cord injury which results in quadriplegia.
The impact of permanent spinal cord injury causing paraplegia or quadriplegia is too severe to compensate with a mere R100 000.00 maximum.
This disability is life changing, and the consequences are life threatening in many ways; physically and emotionally/psychologically.
Families are broken up, in most cases careers changed and ended, journeys ended, the physical ability to perform menial daily personal tasks ended, mobility taken away, all as a result of paraplegic and quadriplegia.
R100 000.00 is no where near compensation for any of these consequences.
QASA supports the payment in a lump sum, but the amount proposed does not compensate the severity and extent of pain and suffering endured.
Our recommendation in the case of a spinal cord injury, rendering someone paraplegic or quadriplegic is a minimum of R 1 000 000.00
Section 17(4) Where a claim for compensation under subsection (1)-
(a) Includes a claim for the costs of future accommodation of any person in a hospital or nursing home or treatment of or rendering of a service or supplying goods to him or her, the Fund or an agent shall be entitled, after furnishing the third party concerned with an undertaking to that effect or a competent court has directed the Fund to furnish such an undertaking, to compensate the provider of such service or treatment directly, in accordance with the prescribed tariff contemplated in subsection (4A).
Section 17 (4A)(a) The liability of the Fund or an agent regarding the tariff contemplated in subsection (4)(a) and section 17(7) shall, in the case of compensation for-
(i) Public health care, be based on tariffs determined for providers of such services, and shall be prescribed by the Minister after consultation with the Minister of Health; and
(ii) private health care, be based on the National Health Reference Price List published by the Council for Medical Schemes, and shall be prescribed by the Minister after consultation with that Council
(b) The tariff contemplated in paragraphs (i) and (ii) shall be prescribed after consultation with medical service providers and shall be reasonable compensation, taking into account factors such as the cost of such treatment and the ability of the Fund to provide the compensation
The system contemplated above, where compensation is paid directly to the service provider at a rate prescribed by a set tariff, will result in providers being compensated for less than the full cost of the product or service, which in turn will disadvantage the third party who will not be able to afford the difference between the actual cost and the compensation, and therefore will no longer have access to such services or products.
There is a very good chance the supplier will not supply the very same essential product or service at the tariff prescribed.
This will have a substantial negative impact on the quality of life of the individual and their dependents, as it will affect all assistive devices and adaptations which may be required, as well.
This could also be life threatening in the case of someone with a spinal cord injury being paraplegic or quadriplegic
The method of determining the tariff is not adequately contemplated, and the concept of "medical service providers" is not adequately defined. The process does not allow for sector stakeholders who are not medical service providers to be involved in the setting of tariffs.
Many nursing homes, and homes accommodating paraplegics and quadriplegics will not accept a resident whose rental and costs will be paid directly by the RAF. Confidence in the RAF ability to pay and pay timeously is not good.
It is unsure how a tariff for a specialized piece of equipment for a quadriplegic and paraplegic will be prescribed.
It is recommended by QASA that the paraplegic or quadriplegic follow a procedure of submitting a quotation to the RAF for the service or product needed and the frequency thereof, which has been supported by a health professional after an assessment. This product or service is approved and funded within 30 days and paid to the victim, who then has the right to demand good product from the supplier and service back up and also good service from a nursing agency or accommodation provider.
The victim is at risk from suppliers, in the form of bad service, unreliable product and no-recourse , should the victim not be in a position to tender payment themselves.
QASA has no idea of what the tariff will be and this immediately puts the paraplegic and quadriplegic victim at risk. Ie. Bad service, unreliable and un-appropriate product to suit the tariff.
In the case of paraplegics and quadriplegics, all products and services received in order to complete daily living are essential, and can not be compromised by price, quality and service.
Medical Aid Tariffs are acceptable, building tariffs, architectural tariffs, equipment suppliers tariffs are acceptable as they are today.
Section 17(4) Where a claim for compensation under subsection (1)-
(b) Includes a claim for future loss of income or support the liability of the fund or an agent shall be limited to the amount specified in subsection (4B).
(4B) (a) The liability of the Fund 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.
(b) The liability of the Fund shall, in the case of future loss of income, cease upon the death of the third party or the attainment of the age of 65 years, whichever occurs first.
The above provision of R160 000 per annum is not linked to inflation. This will effectively result in the third party receiving less compensation per annum, and therefore does not compensate for loss of income or support, which would be linked to inflation.
If such compensation ceases to be paid on the death of the third party, the dependents of the third party are substantially disadvantaged.
It must also be acknowledged that in many cases, the death of the third party may be related to the injuries and subsequent disability sustained in the accident and thus the whole family unit has been and was compromised by the injury and has lost the benefit of the income should the victim have worked their whole life.
The provision can only be revised by regulation; in past instances, such revisions are made very seldom, as in the case of the R25 000.00 limit for passenger liability, which has not been revised for more than 10 years. Thus, QASA has no guarantee or confidence that the rate of R160 000.00 will be adjusted regularly to compensate for inflation.
QASA rejects the notion of a maximum of R160 000.00 per annum as spinal cord injury can paralyse those with skill and ambition and those with out.
Each persons’ potential must be assessed and a comparable career path and earning capability evaluated to correctly compensate this loss.
There is scant consideration for someone who takes entrepreneurial avenues or owns or owned their own business and the losses here.
R160 000.00 maximum proposed per annum severely compromises the lives of those victims who were earning more than this and were accustomed and financially committed to that lifestyle.
It again can create life threatening circumstances.
This maximum is way below an acceptable amount and will threaten the long term healthy and happy existence of a paraplegic or quadriplegic who did earn more or who had the potential to earn more, should they not have been a victim.
QASA rejects the proposed change of the payment ceasing on death, should the injury be any part of the cause of death.
This right of the income should exist until the age 65 whether the recipient is dead or alive, thus not compromising the existence of the family.
QASA will support further dialog or participation in the proposed changes, should the input be necessary.
QASA represents the needs of all paraplegics and quadriplegics in South Africa.
QASA runs a prevention of spinal cord injury programme in partnership with Arrive Alive, branded "BUCKLE UP – WE DON’T WANT NEW MEMNBERS"