Road Accident Fund Home Care: A Guide for Claimants and Attorneys 

/ Nursing Services of South Africa/

Every year, thousands of South Africans survive road accidents that leave them with injuries requiring long-term care. Traumatic brain injuries, spinal cord damage, severe orthopaedic trauma, and complex wounds each create a care need that doesn't end at hospital discharge. For many survivors, that need extends for years. For some, it is permanent. 

The Road Accident Fund exists, in part, to fund that care. The RAF is legally required to cover the reasonable and necessary costs of home nursing, caregiving, physiotherapy, and occupational therapy for any person injured through the negligence of another party on a South African public road. That entitlement exists regardless of the claimant's medical aid membership, income, or province of residence. 

The problem is that too many accident survivors never access it. Families manage without professional nursing because they do not know the RAF covers it. Attorneys navigate documentation requirements without a care provider experienced in the process. Medical aid schemes fund interim care without recovering costs from the RAF because no one joined the dots. Nursing Services of South Africa exists, in part, to close exactly these gaps. 

The gap isn't legal - it's operational. The legal framework is clear. What's missing is the knowledge of how to initiate, document, and manage a home care claim - and that gap is where care the RAF should fund goes unclaimed. 

What the RAF covers for home-based care 

RAF-funded home care covers the full scope of reasonable and necessary nursing and rehabilitation services in the patient's home, including: 

  • 24-hour live-in or shift-based nursing for patients with traumatic brain injuries, quadriplegia, paraplegia, or other complex conditions requiring continuous clinical oversight 

  • Wound, stoma, and catheter care performed by registered nurses according to the patient's clinical plan 

  • Medication administration and management - reducing the risk of error and hospital readmission 

  • Physiotherapy at home - mobility rehabilitation, pain management, and muscle re-education delivered in the patient's own environment 

  • Occupational therapy - home environment assessment, adaptive equipment training, and functional rehabilitation towards daily independence 

  • Personal and hygiene care - bathing, dressing, grooming, continence care, and feeding assistance 

  • Paediatric home nursing - specialist care for children injured in road accidents, with plans adapted to developmental needs 

The specific care package is determined by clinical assessment, not a standard template. NSSA conducts a detailed nursing assessment of each patient before placing staff, and that assessment forms the evidentiary basis of the care component of the RAF claim. 

How the RAF funding process works 

Accessing RAF-funded home care requires documentation that is accurate, clinically grounded, and aligned with what the Fund - and, in contested matters, the courts - will accept. NSSA supports every stage of that process: 

Step 1: Clinical needs assessment. A senior nurse or clinical case manager assesses the patient at home, documenting the injuries sustained, the functional limitations that result, and the nursing and care interventions required. This assessment is the foundation of the care plan and the RAF claim documentation. 

Step 2: Care plan and cost structure. NSSA produces a detailed care plan with itemised costs structured at accepted RAF tariff rates. This is the document your attorney or case manager submits in support of the future medical expenses component of the claim. 

Step 3: Interim funding. Where the RAF claim has not yet settled, interim care is often funded through the patient's medical aid. NSSA provides the billing documentation and clinical reports the scheme requires. Once the claim settles, the medical aid recovers those costs from the RAF. 

Step 4: RAF Undertaking. In serious injury cases, the RAF may issue a written Undertaking to fund ongoing future medical and care costs after the main claim settles. Once an Undertaking is in place, NSSA invoices the RAF directly for care provided - removing the financial burden from the patient and ensuring continuity of care. 

Step 5: Ongoing documentation. NSSA provides monthly progress reports, updated care plans, and itemised invoices throughout the placement. Legal teams receive proactive communication about any changes in the patient's condition that affect the claim. 

What attorneys and case managers need from a care provider 

For the legal team managing a RAF claim, the home care provider they recommend carries professional accountability. A provider that cannot document its placements, verify its staff credentials, or produce billing records that withstand scrutiny creates problems for the claim and for the client. 

What attorneys and case managers should require: 

  • Full SANC registration verification for all nursing staff placed in claimant care 

  • HPCSA registration for doctors and allied health professionals 

  • Accurate, itemised invoicing at accepted RAF tariff rates 

  • Monthly clinical progress reports suitable for inclusion in legal files 

  • A B-BBEE compliance certificate and full vendor documentation pack - relevant for any public procurement dimension of the case 

  • A dedicated case contact with consistent availability for legal team enquiries 

  • NSSA provides all of the above as standard, with care costing structures aligned to the tariff frameworks the Fund and the courts apply. 

What claimants and families should know 

You do not need to wait for your RAF claim to settle before accessing professional home care. Interim arrangements can be established immediately through your medical aid or through private funding, with the costs recovered from the RAF settlement when the matter concludes. 

Contact NSSA directly- you do not need a referral, and the initial conversation is at no charge. We will assess your needs, explain the funding options, and begin the placement process. Our team works to place staff quickly once a booking is confirmed, drawing on a pool of vetted, SANC-registered nurses and carers. 

The RAF entitlement is real - but it does not claim itself 

The gap between what RAF claimants are legally entitled to and what they actually receive is not primarily a legal gap. The legal framework is clear. The gap is operational: families and even legal teams who do not know how to initiate, document, and manage a home care claim leave care that the RAF should fund unclaimed, and patients who should be receiving professional nursing support manage without it. 

NSSA bridges that gap. We do not just place nurses - we support the full process from clinical assessment to ongoing documentation, so that the care the patient needs is the care the claim funds, and the care the claim funds is the care the patient receives.