Law Note: Cashless Treatment of Road Accident Victims Scheme, 2025

Bare Act : https://lawyerslibrary.in/books/ackz/

Table of Contents

Introduction

The Cashless Treatment of Road Accident Victims Scheme, 2025, notified by the Ministry of Road Transport and Highways on 5th May 2025, under the powers conferred by Section 162 and Section 215(4) of the Motor Vehicles Act, 1988, aims to provide timely and cashless medical treatment to victims of road accidents caused by motor vehicles. The scheme ensures immediate medical care, streamlined payment mechanisms, and effective monitoring to enhance road safety and victim welfare.

Key Provisions

1. Short Title and Commencement

Title: Cashless Treatment of Road Accident Victims Scheme, 2025.
Effective Date: 5th May 2025.

2. Definitions

Key terms defined under the scheme include:

Act: Motor Vehicles Act, 1988.
Designated Hospital: Hospitals or clinical establishments onboarded by the State Government with the National Health Authority (NHA) for cashless treatment.
Fund: Motor Vehicle Accident Fund as per the Central Motor Vehicles (Motor Vehicle Accident Fund) Rules, 2022.
National Health Authority: Entity under the Ministry of Health and Family Welfare responsible for implementing the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
Treatment Package: Standardized treatment protocols specified by the NHA.
Treatment Package Rate: Cost ceiling for treatments as determined by the NHA.

3. Eligibility and Coverage

Eligibility: Any person injured in a road accident involving a motor vehicle on any road is entitled to cashless treatment.
Coverage:
- Up to ₹1,50,000 per victim.
- Maximum treatment duration: 7 days from the accident date.
Non-Designated Hospitals: Treatment limited to stabilization, as per guidelines.
State Responsibility: Onboard hospitals capable of providing trauma and polytrauma care as designated hospitals.

4. Nodal Agency

Primary Nodal Agency: State Road Safety Council for each State/Union Territory.
Alternative Agency: State Government may designate another entity with Central Government approval.
Implementation Agencies: May be specified by the nodal agency as per guidelines.

5. Functions of Nodal Agency

Coordinate with NHA for portal utilization (onboarding hospitals, treatment, and payments).
Collaborate with State Health Agency to designate hospitals beyond AB-PMJAY empanelled ones.
Prevent fraud and misuse of the scheme.
Establish grievance redressal mechanisms.
Ensure timely payment disbursements to designated hospitals.
Undertake additional responsibilities assigned by the Central Government.

6. Treatment Packages

Treatment administered through predefined treatment packages.
Payments to hospitals based on treatment package rates set by the NHA.

7. Medical Treatment to Victims

Immediate Treatment: Designated hospitals must commence treatment upon the victim’s arrival.
Procedure: As specified by guidelines.
Referral: If facilities or expertise are inadequate, the hospital must refer the victim to another designated hospital, arrange ambulance transport, and update the portal.

8. Payments to Hospitals

Claim Process:
- Hospitals submit claims on the portal post-discharge with required documents.
- State Health Agency verifies claims, seeking additional information if necessary.
Approval/Rejection:
- Claims approved or rejected (fully/partially) with reasons recorded on the portal.
- Approved payments transferred to the designated agency/authority.
Payment Timeline: Within 10 days from approval, paid from the Motor Vehicle Accident Fund.

9. Guidelines

Central Government issues detailed guidelines for effective implementation.
In case of inconsistencies, the scheme’s provisions prevail over guidelines.

10. Scheme Monitoring Mechanism

Steering Committee:
- Composition:
  - Chairperson: Secretary, Ministry of Road Transport and Highways.
  - Members: CEO (NHA), Additional Secretary (MoRTH), Joint Secretaries (MHA, MoHFW, DFS), Secretary General (General Insurance Council), Deputy Director General (NIC), State Health Agency representatives (6 States/UTs on rotation), NGO representatives (3), and Director/Deputy Secretary (MoRTH) as Convenor.
- Meetings: At least twice annually.
- Functions: Monitor implementation, seek information from State Road Safety Councils or other entities.
State-Level Monitoring: By State Road Safety Council.
District-Level Monitoring: By District Road Safety Committee.
Nodal Authority: Ministry of Road Transport and Highways for guideline notifications and issue resolution.

Analysis

The scheme is a significant step toward ensuring immediate medical care for road accident victims, addressing the critical gap in timely treatment. By integrating with existing frameworks like AB-PMJAY and leveraging the NHA’s infrastructure, it ensures scalability and efficiency. The cap of ₹1,50,000 and 7-day treatment period balances accessibility with resource constraints, though challenges may arise in complex cases requiring extended care. The emphasis on designated hospitals and standardized treatment packages promotes consistency, while the grievance redressal and fraud prevention measures enhance accountability. The multi-tiered monitoring mechanism ensures oversight at national, state, and district levels, fostering effective implementation.

Conclusion

The Cashless Treatment of Road Accident Victims Scheme, 2025, aligns with the objectives of the Motor Vehicles Act, 1988, to safeguard victims and promote road safety. Its success hinges on robust coordination between Central and State Governments, efficient onboarding of hospitals, and adherence to guidelines. The scheme has the potential to significantly reduce mortality and morbidity from road accidents, provided implementation challenges like hospital capacity and timely fund disbursal are addressed.

Multiple Choice Questions (MCQs)

When did the Cashless Treatment of Road Accident Victims Scheme, 2025, come into effect?
a) 1st January 2025
b) 5th May 2025
c) 31st December 2024
d) 15th August 2025
Answer: b) 5th May 2025
What is the maximum amount of cashless treatment coverage per victim under the scheme?
a) ₹50,000
b) ₹1,00,000
c) ₹1,50,000
d) ₹2,00,000
Answer: c) ₹1,50,000
Which entity is primarily designated as the nodal agency for the scheme’s implementation in a State or Union Territory?
a) National Health Authority
b) State Health Agency
c) State Road Safety Council
d) District Road Safety Committee
Answer: c) State Road Safety Council
What is the maximum duration for cashless treatment under the scheme from the date of the accident?
a) 3 days
b) 5 days
c) 7 days
d) 10 days
Answer: c) 7 days
Who chairs the Steering Committee responsible for monitoring the scheme?
a) CEO, National Health Authority
b) Secretary, Ministry of Road Transport and Highways
c) Joint Secretary, Ministry of Health and Family Welfare
d) Secretary General, General Insurance Council
Answer: b) Secretary, Ministry of Road Transport and Highways
What happens if a designated hospital lacks the necessary facilities to treat a road accident victim?
a) The victim is discharged immediately
b) The hospital refers the victim to another designated hospital and arranges transportation
c) The hospital treats the victim regardless of facilities
d) The hospital seeks approval from the Central Government
Answer: b) The hospital refers the victim to another designated hospital and arranges transportation
Within how many days must the approved payment be made to hospitals from the Motor Vehicle Accident Fund?
a) 5 days
b) 7 days
c) 10 days
d) 15 days
Answer: c) 10 days
Which authority verifies the claims submitted by hospitals under the scheme?
a) National Health Authority
b) State Health Agency
c) State Road Safety Council
d) Ministry of Road Transport and Highways
Answer: b) State Health Agency

Frequently Asked Questions (FAQs)

What is the Cashless Treatment of Road Accident Victims Scheme, 2025?
The scheme, notified on 5th May 2025 under the Motor Vehicles Act, 1988, provides cashless medical treatment up to ₹1,50,000 for road accident victims for a maximum of 7 days. It aims to ensure timely treatment at designated hospitals and streamline payments through the Motor Vehicle Accident Fund.
Who is eligible for treatment under this scheme?
Any person injured in a road accident caused by a motor vehicle on any road is eligible for cashless treatment under the scheme, regardless of their background or status.
What is a designated hospital?
A designated hospital is a hospital or clinical establishment onboarded by the State Government in collaboration with the National Health Authority to provide cashless treatment to road accident victims.
Can treatment be availed at non-designated hospitals?
Treatment at non-designated hospitals is limited to stabilization purposes only, as specified by the scheme’s guidelines. States are encouraged to onboard trauma-capable hospitals as designated hospitals.
How are payments made to hospitals under the scheme?
Hospitals submit claims on the scheme’s portal post-treatment. The State Health Agency verifies the claims, approves or rejects them, and transfers approved payments to the designated authority. Payments are made from the Motor Vehicle Accident Fund within 10 days of approval.
What role does the National Health Authority play in the scheme?
The National Health Authority specifies treatment packages and rates, manages the portal for onboarding hospitals and processing claims, and collaborates with State Health Agencies to ensure effective implementation.
What happens if there is a grievance related to the scheme?
The nodal agency (typically the State Road Safety Council) is responsible for developing and maintaining a grievance redressal mechanism to address issues arising from the scheme’s implementation.
How is the scheme monitored?
The scheme is monitored at three levels:
- National Level: By a Steering Committee chaired by the Secretary, Ministry of Road Transport and Highways.
- State Level: By the State Road Safety Council.
- District Level: By the District Road Safety Committee.
What are treatment packages under the scheme?
Treatment packages are standardized medical treatment protocols specified by the National Health Authority. Payments to hospitals are based on predefined treatment package rates.
Can the State Government appoint a different nodal agency?
Yes, with prior approval from the Central Government, a State Government may designate an entity other than the State Road Safety Council as the nodal agency for the scheme’s implementation.