The Road Safety and Insurance Fund Service (RSIFS) plans to establish an Emergency Medical Services Fund (EMSF) to cover treatment costs for road accident victims. The fund will be financed through contributions from insurance companies. A new directive, currently open for stakeholder feedback, proposes raising the maximum emergency medical expense per victim to 15,000 Br, up from the previous 2,000 Br.

Each insurance provider will be required to contribute three percent of their gross premiums from third-party auto insurance policies. The RSIFS will also contribute three percent of the funds collected from insurance providers.

The Ministry of Health (MoH) will oversee the fund’s utilisation. Once regional health bureaus have used 75pc of their allocated funds, they can request additional funding from the Ministry, which will assess and approve further allocations. The Ministry is also responsible for ensuring that the funds are used appropriately and in compliance with regulations. It provides guidance and support to regional health bureaus to ensure effective fund management.

Established by a Council of Ministers regulation in 2022, the RSIFS has recently introduced revised premium rates and higher compensation amounts to improve emergency medical services for accident victims. Premiums have increased by up to 150 percent, and a digital system for recording and reporting accidents is being implemented.

Hospitals and health centres providing emergency care to road accident victims are entitled to reimbursement for their expenses.

Unlike previous regulations, the new directive allows a medical professional or emergency medical coordinator to complete a Vehicle Accident Medical Evidence form in the absence of a police report.

Federal and regional authorities had struggled to coordinate emergency medical services for accident victims. The revised directive intends to address inefficiencies and improve service accessibility.

Chala Feyissa, lead executive of the Service’s post-accident report department, says that under the previous system, 18 insurance companies, including the Fund itself, were responsible for reimbursement. Payments required constant mechanisation to process claims for injuries of all severities. Emergency treatment was privately funded by insurance companies, but this approach proved insufficient.

One of the main problems was ensuring accurate accident reporting for reimbursement. The new directive allows hospitals to verify and administer treatment, with expenses later reimbursed by the Fund. However, if criminal activity is suspected, the federal police take over the case.

Last year, the Service paid 33 million Br to hospitals and health centres nationwide, covering 16,000 road accident victims. An additional 69 million Br in reimbursement requests from regional health bureaus are currently awaiting processing.

Degesew Derso, head of emergency and critical care services at the MoH, revealed that fewer than 750 health centres have received third-party insurance reimbursements out of 30,000 healthcare facilities nationwide.

He says that there is a mismatch between the low vehicle-to-population ratio, about one vehicle per 100 people, and its high rate of road accidents. The sub-Saharan Africa accounts for 90pc of the world’s road injuries.

Hospitals face reporting problems, often requiring police confirmation before processing accident claims, as vehicle accidents are frequently treated as criminal cases rather than civil incidents. These payment and reporting hurdles have made hospitals reluctant to accept third-party insurance patients.

In the 2023/24 fiscal year, the MoH spent 25 million Br to cover insurance services for 35,315 road accident victims. The Ministry reports that 14,320 cases in the past six months are still awaiting reimbursement.

The new directive mandates the digitalisation of third-party insurance payments. This year, the Service secured 2.4 billion Br through a digitised system, covering 510,000 vehicles under third-party insurance.

Assefa Addisu, advisor to the State Minister for Transport & Logistics, says that there is a need for a sustainable emergency treatment fund. He acknowledged that current hospital reimbursement mechanisms for accident-related treatments are inadequate.

He argues that there has to be a dependable resource mobilisation mechanism and the need for an organised fund to ensure reliable emergency care for both hospitals and patients.

Historically, third-party insurance payments were made to the RSIFS, which the MoH then disbursed to regional and city governments before reaching the healthcare system, a slow and cumbersome process.