Medical Assessment

partners logo

Medico-Legal Cover following a Motor Vehicle Accident (MVA)

  1. Compensation for MVA or MVA-related compensation is only admissible if there is recorded medico-legally sound clinical evidence of any trauma that was present immediately following the incident; or sound clinical evidence that the event has the potential to develop pathology related to the MVA or MVA-related event at any time during the lifetime of the policyholder
  2. The post-MVA or MVA-related medico-legal evidence includes clinical evidence that may not yet be immediately evident, but may be the cause of future health impairment or functional disability (e.g. vertebral degeneration of the spine – slipped disc, chronic neck-pain, and chronic headache, etc)
  3. By virtue particularly of the frequently long-term pathogenesis of Central Nervous System/Neurological/Mental/Cognitive Pathology consequent upon an  MVA or MVA-related event it  is critical that medico-legal evidence is recorded, confidentiality ensured  and securely archived  at the time of the event -  e.g.:
    • Psycho-trauma & post-traumatic-stress disorder
    • Major depression due to guilt over, or loss of life, of co- occupants
      of the vehicle
    • Delayed cognitive disorder(brain damage)
    • “Flashback Syndrome”
    • Vehicular phobia
    • Delayed-onset epilepsy
    • Motor dysfunction (muscle weakness, etc)
    • Functional loss (physical or mental) required for normal daily
      activity or continued income generation
  4. Employer/Employee: Recorded clinical evidence essential to Disability Compensation (Employee Benefit, Income Protection Insurance, etc) in employees driving/operating vehicles integral to the occupation for which he/she was employed

Policy Benefits

Medico-legal Report

  1. Access to a base-line medico-legal clinical assessment within 72 hours following a motor vehicle accident (MVA) or MVA-related accident
  2. Unless hospitalized, the base-line medico-legal clinical assessment will be scheduled anywhere in South Africa (unless otherwise agreed) and paid for by medworx
  3. Optional alcohol/illicit substance blood level determination (as evidence of Sobriety/non-abuse)
  4. Optional glucose blood level determination (legal extenuating circumstances in diabetics
  5. In the event of emergency hospitalization for an MVA or MVA-related accident,the relevant base-line medico-legal clinical record will be sourced by medworx
  6. The base-line medico-legal clinical assessment includes defined base-line plain-X-ray radiology and optional blood level evaluations as above
  7. Hospitalized, Specialist Referrals and Diagnostic procedures: Where relevant the medworx base-line medico-legal clinical record will ensure inclusion in the report (defined limitations will apply)
  8. Medico-legal documents are scrutinized for content and accuracy
  9. Medico-legal documents are archived by medworx for the lifetime of the policyholder

Emergency Ambulance Transfer

Medical Assessment

Specialist Referral

  1. In the event that the examining practitioner is of the opinion that the injury requires specialist out-of-hospital attention, the practitioner will refer the policy holder to the relevant specialist at the nearest Private Professional Facility (if the policyholder has relevant medical aid benefits) or nearest  State Professional Facility Hospital( if the policyholder does not have relevant medical aid benefits)
  2. The fee for specialist professional services and/or hospital and/or casualty treatment is not covered by the policy
  3. Cost of emergency medication and travel is not covered in these cases 

Applicable MVA/ MVA-related Policy Cover

Where the policyholder is:

Motor-vehicle-related accident (MVA-related) Policy Cover

1. Where the policyholder is:

  • The victim of an accident inflicted by a motor vehicle
  • And where the policy holder is a pedestrian, bystander, spectator or in other circumstances where injury is inflicted by a moving vehicle is considered likely


NOTE:

The above document has been compiled for illustrative purposes only



Disability Assist
Compensation
Medical Assessment

Disability Care

Although it’s something none of us like to think about, we may, through an accident, be placed in the position of no longer being able to work permanently or temporarily and support ourselves or our loved ones.

Compensation

We provide victims of the motor vehicle accidents in South Africa with immediate access to an effective Road Accident Fund (RAF) claims management system, with 100% of the recovery paid back to you and your family.

Medical Assessment

Compensation for MVA or MVA-related compensation is only admissible if there is recorded medico-legally sound clinical evidence of any trauma that was present immediately following the incident.