RAF Online Questionnaire

Contact Details

Name*

Phone Number*

Date of the Accident

When was the accident?

More than 3 years ago?
Less than 3 years ago?

How old were you when the accident happened?

More than 18 years old?
Less than 18 years old?

Have you already claimed from the RAF?

Yes
No

Are you more than 21 now?

Yes
No

Claimed

Have you already claimed?

Yes
No

Do you have a claim reference number from the RAF?

Yes
No

Did you do a direct claim or did you use an attorney?

Direct Claim
Attorney

Do you want to leave your attorney?

It is very important that you are sure you want to leave your current attorney. If you do not wish to leave your current attorney we recommend you rather contact them.

Yes
No

Please provide your reference number

If you have a reference number but do not have it with you now, you can leave this blank. However, we request you have it available for when we call you back.

Please provide your reference number

If you have a reference number but do not have it with you now, you can leave this blank. However, we request you have it available for when we call you back.

Please provide the reason you want to leave your attorney

Who

Who was in the accident?

Me
Someone else

Is the person alive or did they die in the accident?

The person is alive
The person died

Did they support you finacially?

Must have had a real reason to support. Parents -> child; children -> elderly parents; Spousal support; uncles/aunt if parents have died (legal guardians). Support should be well established before the accident.

Yes
No

Please provide details about how they supported you.

Is the person older or younger than 18 years old?

Older than 18 years old
Younger than 18 years old

Is the person able to contact us directly?

If the person is not able to contact us because their abilities are impaired due to the accident, please select "no".

Yes
No

Responsibility

Were you (or person that died) the driver, passenger, pedestrian?

Driver
Pedestrian
Passenger

Who was responsible for the Accident?

Me / person that died
Other person
Both
Not sure

Who was responsible for the Accident?

Me / person that died
Other person
Both
Not sure

Was there another vehicle involved?

Yes
No

Nature of Injuries

Were you taken to hospital after the accident?

Yes
No

Please describe your injuries

Please note that we are not able to assist in all cases, in particular, if the injuries are not severe enough. If you were not taken to hospital from the accident, we might not be able to assist. If your injuries were not severe you may wish to call the Road Accident Fund directly on 0860 23 55 23.

Unfortunately, we cannot assist you with your matter, as your claim has expired. We can only help in very specific circumstances. You may wish to call the Road Accident Fund directly on 0860 23 55 23.

Unfortunately, we cannot assist, if you have an attorney and you wish to stay with them. We suggest you contact your attorney directly or you may wish to call the Road Accident Fund directly on 0860 23 55 23.

Unfortunately, we cannot assist you until you have your RAF reference number. Please call the Road Accident Fund directly on 0860 23 55 23 and get your reference number, then contact us again.

Unfortunately, we cannot assist you with your matter unless you received financial support from the person that died; and, this support was a legal requirement and well established before the accident. You may wish to call the Road Accident Fund directly on 0860 23 55 23.

Unfortunately, we cannot assist you further if you are contacting us for someone else that is able to contact us themselves. Please have them contact us directly.

Unfortunately, we cannot assist if you were responsible for the accident. The Road Accident Fund Act does not allow claims where the claimant was 100% responsible for the accident. If you wish, you may wish to call the Road Accident Fund directly on 0860 23 55 23.

Unfortunately, we cannot assist if you were responsible for the accident. If there was no other vehicle involved in the accident it is assumed the driver was 100% responsible for the accident. The Road Accident Fund Act does not allow claims where the claimant was 100% responsible for the accident. If you wish, you may wish to call the Road Accident Fund directly on 0860 23 55 23.