Core Demand of the Question
- Discuss the limitations of cashless treatment schemes for accident victims.
- Suggest measures for its effective implementation.
|
Answer
India’s Cashless Treatment Scheme for Accident Victims, launched in May 2025, provides emergency medical care of up to ₹1.5 lakh for the first seven days post-accident. Introduced under Section 162 of the Motor Vehicles Act, the scheme aims to reduce accident-related mortality and out-of-pocket expenses.
Provisions of Cashless Treatment Scheme for Road Accident Victims
- Financial Coverage Limit: The scheme provides cashless treatment up to ₹1.5 lakh for seven days following a road accident, regardless of the victim’s income or vehicle ownership.
- Treatment at Designated and Non-Designated Hospitals: Victims may be treated at designated hospitals under the scheme. Non-designated hospitals can offer initial stabilization before transferring the patient to an empanelled facility.
- Hospital Empanelment by State Agencies: State Road Safety Councils (SRSCs), in coordination with the National Health Authority (NHA), are responsible for empanelling both public and private hospitals.
- Digital Claims Portal: Hospitals must submit claims through an online portal managed by the State Health Agency (SHA). Reimbursements are made based on predefined treatment package rates.
- Central Oversight Committee: A 17-member Steering Committee chaired by the Secretary, Ministry of Road Transport and Highways (MoRTH) oversees implementation and monitor progress.
|
Roadblocks to Cashless Treatment Scheme
- Delayed State-Level Implementation: Many states have not issued procedural guidelines or empanelled hospitals on time.
Eg. In Noida and Ghaziabad, hospitals were unable to offer the scheme even in June 2025 due to lack of state instructions.
- Low Hospital Empanelment: The number of participating hospitals, especially in the private sector, remains low.
- Unfeasible Reimbursement Rates: Low compensation packages discourage private hospital participation.
- Administrative Confusion: Overlapping roles between police, hospitals, and insurers cause confusion in claim processing.
For instance , even one month post-launch, hospitals in NCR reported the absence of clarity on billing protocols and hospital roles.
- Portal and Documentation Issues: The claim processing portal remains inefficient, leading to delays.
Eg. As of July 2024, over 500 hit-and-run cases had unresolved claims due to documentation errors and portal glitches.
- Coverage Inadequacy: The cap of ₹1.5 lakh for seven days often fails to cover critical injuries requiring longer hospitalisation.
Eg: The Supreme Court noted that the capped amount falls short of what is required for full trauma care in serious cases.
- Poor Public Awareness: Victims and even hospital staff are often unaware of the scheme’s existence and procedures.
Measures for Effective Implementation
- Issue State-Level Directives Promptly: Clear guidelines on hospital empanelment and billing must be issued at the state level.
Eg. In Indore, hospitals were given a three-day deadline to register under the scheme in June 2025.
- Expand Hospital Participation: Include both Ayushman Bharat and other private hospitals under the scheme.
Eg. The Haryana government broadened the list to include non-Ayushman hospitals to increase accessibility.
- Revise Reimbursement Rates: Payment packages should be adjusted to reflect actual treatment costs.
Eg. The Association of Healthcare Providers (India) has demanded rate revisions to attract quality private care.
- Improve Coordination Between Agencies: Define roles for the National Health Authority, Road Safety Councils, and insurers to avoid overlaps.
Eg. A 17-member steering committee led by the Road Secretary now monitors national-level implementation.
- Upgrade Claim Processing Portals: Digital platforms must be fast, transparent, and user-friendly.
Eg. The General Insurance Council has been assigned to address the portal’s inefficiencies and streamline workflows.
- Enable Interim Stabilisation: Victims should receive stabilisation treatment at any hospital, even if not empanelled.
- Strengthen Awareness Campaigns: Large-scale outreach is necessary to inform both citizens and medical staff.
Eg. Under the Rahveer Yojana in Haryana, the government uses FM radio and posters to promote scheme awareness and offers ₹25,000 for helping accident victims reach hospitals.
India’s Cashless Treatment Scheme has the potential to significantly reduce accident-related fatalities and financial stress for families. Its success now hinges on state-level coordination, fair reimbursement, infrastructure readiness, and mass awareness, aligning with the goal of inclusive and efficient emergency healthcare.
To get PDF version, Please click on "Print PDF" button.
Latest Comments