Cashless Treatment Of Road Accident Victims Scheme, 2025: Know Your Rights

The Ministry Of Road Transport And Highways has notified Cashless Treatment Of Road Accident Victims Scheme, 2025, which ensures cashless treatment of victims of the accident during the golden hour and contains provisions for creation of a fund for treatment.

In accordance with section 162 of the Motor Vehicles (MV) Act, 1988 the Ministry of Road Transport and Highways (MoRTH) has launched a Cashless Treatment of Road Accident Victims Scheme, 2025 for the cashless treatment of victims of road accidents caused by the use of motor vehicle(s) on any category of road.

In accordance with section 164B of the Act, MoRTH has set up the Motor Vehicle Accident Fund (“Fund”) to provide for, inter alia, the treatment of victims in accordance with the scheme framed under section 162 of the Act. For the implementation of the Scheme, two accounts of the Fund, namely, 1) the Account for Insured Vehicles, and 2) the Account for Uninsured Vehicles or Hit and Run Motor Accident, shall be utilised.

Eligibility criteria

Any person being a victim of a road accident caused by the use of motor vehicle (“road accident”) on any road, who has sustained injuries requiring hospitalisation, shall be entitled to the benefit of cashless treatment under the Scheme in accordance with these Guidelines. In this regard, “motor vehicle” shall have the same meaning as defined under sub-section (28) of section 2 of the MV Act, 1988.

A victim of a road accident shall be entitled to cashless treatment for an amount for such period as specified in the Scheme.

The benefits under this Scheme shall take precedence over any other benefit scheme for the same or similar purpose or for medical treatment of the Central Government or the State Government or UT Administration.

Those victims whose first hospitalisation takes place after the lapse of 24 hours from the time of accident shall not be considered eligible under the Scheme.

Designated hospitals

The treatment shall be provided through designated hospitals under the Scheme including empaneled hospitals under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), compliant with the guidelines issued by National Health Authority (NHA) in respect of this Scheme, which shall be deemed designated for the Scheme.

Hospitals which are not empaneled under AB PM-JAY will be designated as per the guidelines and procedure issued by National Health Authority (NHA).

Hospitals which are not designated under the Scheme will also be allowed to provide treatment for stabilization of road accident victims on registration on the Transaction Management System (TMS) of NHA through the Health Facility Registry (HFR) ID.

The designated hospitals shall follow the guidelines issued by the National Health Authority (NHA) on patient admission, pre-authorisation, claims settlement and other matters related to hospitalisation and medical treatment of victims of road accidents.

Hospital claim settlement

Subsequent to the discharge of victim from the Scheme, the hospital will be required to submit the claim for payment to the concerned State Health Agency (SHA) on the TMS portal. All requisite documents, as mandated by NHA or SHA, shall have to be submitted along with the claim for payment by the designated hospital.

Where the location of the road accident and the hospital where treatment is being provided are in different States/UTs, the claim for payment shall be submitted to the SHA of the State/UT in which the treating hospital is situated, and such SHA may seek necessary information from the officials of the district in which the accident took place.

The SHA concerned shall approve the claim for payment, in full or in part, or reject the claim, in full or in part, provided reasons for rejection of the claim are provided to the hospital.

The Motor Vehicle Accident Fund Trust referred to in the Central Motor Vehicles (Motor Vehicle Accident Fund) Rules, 2022 may specify the drawing limits for the agency designated by the Central Government to make payments to hospitals against claims approved by the SHA. The limits may be reviewed periodically by the Trust after evaluating the volume of cases for that particular State / UT.

In cases where the TMS ID is timed out due to lack of response from the police officials, the cost of stabilisation treatment shall be paid to the hospital under this Scheme. However, for cases which were flagged as life threatening by the hospital administrator, the cost of actual treatment administered up to the extended period of 48 hours under the specific set of conditions outlined in para 6.7, subject to coverage under this Scheme, shall be paid to the hospital if the TMS ID is timed out due to lack of response from the police officials.

During police verification, in case it is found that victim is not a road accident victim, the victim shall be liable for bearing the entire cost of treatment and the hospital shall be informed and alerted to the police verification details through the linkage of eDAR with the TMS of NHA.

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