Medical Treatment & Rehabilitation
Injured in a road crash?
Claimants who have been injured due to road traffic accidents are eligible for medical assistance.
- For the first medical review, Claimants must communicate medical appointments to the Fund, supported by an appointment card at least 2 weeks before the appointment date.
- Always inform the Fund of your next appointment immediately after consultation.
- A treatment authorisation will be issued by the Fund for your medical appointment.
- If on medical aid, the Fund will cover patient contributions only as a secondary insurer.
- The Fund will not cover medical aid tariff differences. However where your annual scheme benefit has been exhausted the claimant will inform the Fund in writing availing proof from the medical aid of such exhaustion and the duration of the same.
- The Fund will assist with transport, accommodation and meals for medical appointments in accordance with the Fund’s policy and as per the incidentals allocations in the medical offer.
- Where private or special transport is required, a medical motivation from a registered health practitioner should be submitted to the Fund and will be assessed accordingly.
- Where the claimant requires to travel with a caretaker for medical appointments, as may be medically motivated by the health practitioner, the Fund will cover incidental costs (transport, accommodation, meals) for both the claimant and the caretaker as per incidentals allocated in the offer.
- Meal allowance provisions will only apply where the claimant has to travel for 100km or more to seek medical interventions.
- For self-referrals, the Fund will cover medical costs only and will not cover incidental costs. In the case of a limited claim, the Fund covers the claimants’ medical costs only and does not provide for incidental expenses.
Application Of Workers Compensation Cover (WCC)
- WCC applies in all accidents occurring whilst on duty despite having an insurance cover.
- In the event a claimant gets injured in a road traffic accident while in the scope of work the employer is the primary insurer.
- The employer is liable for the claimants medical expenses (P75 000.00), Assistive devices (crutches, wheelchairs etc) as advised by the health practitioner (P10 000.00) and transport (P1 500.00) as per Section 28 of the MVA Fund Act No15 of 2008 and Regulation 5(a), (b) and (c).
- Where the employer has reached their full liability the Fund must be informed in writing before it can take over.
Loss of Income
Lost your ability to earn a living due to a road crash?
We provide for you during these difficult times.
- Severely injured claimants who cannot return to employment due to the nature of their injuries are eligible for Loss of Income, provided such loss is proven.
- You will be paid for the period of your loss only (as proven).
- If you have been offered an annual payment schedule, you are required to submit an affidavit confirming that you are still unemployed before disbursement of annual payments.
- All requests for extension of Loss of Income benefit must be accompanied by a medical report, proof of loss of earnings (letter from employer, bank statements) and sick leave
Lost a loved one as a result of a road crash?
We offer up to P7,500 to assist with funeral costs
- Claim form
- Police report
- Police statements (Investigating officer`s statements, driver, witnesses)
- Police sketch plan
- Death certificate/post -mortem report/death notification (Certified copy)
- Sworn affidavit for authority to claim from the deceased`s family (if Claimant is not the parent)
- Copies of IDs of the two witnesses in the sworn affidavit in F above (certified
- Proof of funeral expenses (quotations/Invoice+ Receipts)
Loss of Support
Lost a breadwinner due to a road Crash?
We lend a helping hand to support dependents of the deceased.
- Affidavits confirming socio-economic status of adult beneficiaries and that minor beneficiaries are still alive should be submitted to the Fund before disbursement of annual payments.
- A home visit will be conducted before annual payment can be disbursed.
- The Fund must be informed of any changes in guardianship of minor beneficiaries.
- Spouses must inform the Fund if their marital status changes i.e. if they re-marry.
- The Fund should immediately be notified of the death of a beneficiary. A certified copy of death certificate must be submitted to the Fund.
Giving the Fund any false information intentionally is viewed as an act of Fraud and a criminal act. The Fund reserves the right to take action against perpetrator.