Golden Hour scheme by Supreme Court: Hospitals bound to give cashless medical treatment to accident patients. Read all about the scheme!

Index

•    Synopsis 
•    Introduction
•    Constitutional Angle 

• Is the court stepping in due to government’s inaction ? 
  The ruling set to strengthen the right to life ?

•    Role Of Emergency Response 

• How many lives are lost due to delay in medical aid ?
• Accident/emergency Schemes of other countries 

•    Financial questions

• Who will pay for the treatment? Government or insurers ?
• Car insurance premium to go up after this ? 

•    Liability

• Will hospitals be legally bound to comply?
• Will this law protect those who come forward to help ?

•    Challenges

• How will compliance be enforced ?
• Should this be merged with Ayushman Bharat ? 
• What infrastructure related upgrades are needed for this to be successful in our country? 

•    Case laws 
•    FAQs
•    Conclusion

Synopsis 

Supreme Court has directed to implement the golden hour scheme by March 14th, 2025. In the light of this scheme, there are various different angles that need to be looked at. In this article, the focus will be on highlighting important questions related to these different angles. Angles about the role of emergency response, constitutional angle, questions regarding the finances, the angle of liability and lastly we will focus on the challenges that the scheme is going to face and how to combat those.

Important questions will be brought to the surface, questions like- is the court stepping in due to the governments inaction? Is the ruling set to strengthen the right to life? While looking at the history of emergency response, how many lives are lost due to delay in medical aid? What are the emergency schemes active in countries across the globe? Important financial questions also come in picture. In light of this golden hour scheme, Who will pay for the treatment and care of the injured, the government or the insurers? Will the car insurance premium take a hike after this scheme is fully functional? Also the concerns about liability will also be addressed, will the hospitals be bound to legally comply? Will this scheme protect the people who come forward to help? There are also a lot of questions about the challenges that will have to be tackled in order to fully make the scheme functional and beneficial for people. How is the government planning to enforce compliance? Is this scheme going to be, rather should this scheme be merged with Ayushman Bharat? And lastly what infrastructure related upgrades need to be equipped in our country for this scheme to be working efficiently?

Introduction

To introduce this golden hour scheme, it is an initiative that is aimed to provide immediate and cashless medical treatment to the victims of road accidents within the critical first hour- mentioned as the golden hour- which is followed after a traumatic injury. This. Is extremely important as or timely medical intervention profoundly increases the chances of the patient to survive.

This scheme was established under Section 162 of The Motor Vehicle Act 1988, this section makes it mandatory for the creation of a scheme for a cashless aiding of the victims of road accident during the golden hour or the first hour post the accident. The funding mechanism of this scheme is supported by the motor vehicle accident fund which is also outlined in section 162 b of the motor vehicle act 1988 which says to cover expenses that are related to the emergency medical care.

Even after the legislative provisions being in place since 1st April 2022, this scheme’s implementation has been consistently delayed. The Supreme Court has recognised the imperative importance of a timely medical intervention and in a judgement dated 8th January 2025 Supreme Court directed the central government to formulate and enforce a well functioning golden hour scheme by 14th March 2025.

Constitutional Angle

Is the court stepping in due to government’s inaction ? 
While delving into the constitutional angle, important questions that conquer the mind , is the Supreme Court stepping into this situation because the government was inactive regarding this matter? Of course accidents have been happening since the stone age but we have come a long way since the stone age and have set aside rules to help the case. The rules that either focus on averting the mishap or promoting a helping hand if a mishap has happened. Ever since the invention of wheels, road accidents have repeatedly hit the roads. However, laws have changed, people have changed but what has not changed are the roads. Ever since the accidents have started to happen, people have gone from helping the injured to being mere spectators to even worse—a camera person shooting content for their awareness pages, without lending a helping hand first. How did we— as a society, progress so downhill that the courts had to come up with schemes to make us ‘act’ like a Good Samaritan rather than us genuinely being one? May be we needed this push from the governing bodies to help us realise that helping people is not only legal but also moral. No matter the circumstances that led to the surfacing of this golden hour scheme, we should be glad that it is here now and it will work in making our society better.
The golden hour scheme that makes it necessary for immediate medical attention to be provided to the accident victims within the first hour after the incident, is a crucial step for reducing the severe injuries and fatalities. The Honourable Supreme Court gave a direction to implement this by 14th of March 2025 and the urgency of this initiative definitely underscores that the court intervened because the government was inactive. The golden hour concept has been recognised internationally for its potential to being a life-saving scheme but despite this, its implementation in India has been rather inconsistent.

Previous government's initiatives to bring the scheme into light and enforce it has faced many challenges which included lack of proper infrastructure, inadequate awareness in public and also insufficiency in training of the first responders. This mandate of the Supreme Court is a reflection of judicial intervention to expedite the golden hour scheme for nationwide enforcement, addressing the delays and focusing on the protection of citizens right to life.

The ruling set to strengthen the right to life ?
The next important question that I would like to highlight in this article is less of a question and more of a statement— the ruling set to strengthen the right to life? Why I say that it is more of a statement is because of the nature of the sentence, much like the nature of our society — which is well aware that right to life is not only important to a person in particular but recognising that we as a society have a right to life, is imperative. Because, then we are not only of help to ourselves but also to the fellow human beings next to us. This ruling will enforce the right to life that is given to us by our fundamentals, as a statement and as an example both.

To answer the highlighted question.Yes, this ruling strengthens the fundamental right to life as given under Article 21 of the Constitution. The timely medical aid will ensure that accident victims get proper and immediate care that will reduce the number of injured people and prevent many deaths. Why I mentioned earlier that the ruling is rather a strong statement, is because it states the obligation of the state and reinforces that it is the government's duty to provide for emergency healthcare to its domicile. This judicial safeguard is going to hold the authorities accountable for the lapses in their emergency response. This initiative is aimed at providing urgent medical attention regardless of the financial status of the victim which is a very progressive measure and we will be highly beneficial for the accident victims.

Role Of Emergency Response

How many lives are lost due to delay in medical aid? 
It is rather sad that the delay in getting the medical aid that is required by the victim, is a significant contributor to the mortality rates in India.

In the year 2023 India had reported and approximate number of 1,60,000 deaths because of road accidents, what was notable about this was that about 50% of these could have been helped if only a timely medical intervention was available to them within the first hour of their accident which emphasises the critical importance of  timely response.

There was a study which was published in The Lancet, it indicated that around 55% of cardiac related emergencies and stroke deaths in India are a result of delays in medical care. How sad is it to go through these numbers knowing that it could have been prevented if immediate attention was given to  these emergency cases.

In a data revealed from the registrar general of India it was seen that in the year 2022 45% of the 8.2 million deaths which were recorded happened without medical care which highlighted a  prominent gap in their timely access to healthcare.

These statistics call for an urgent need of initiatives like the golden hour scheme in order to make the emergency medical response team better and to reduce the preventable damage to the lives of accident victims.

Accident/emergency Schemes of other countries 
Many countries have implemented their different emergency response systems in order to provide a timely medical assistance.

United Kingdom has its NHS pathway, which is  a software that is used by National Health Service in England in order to manage public health calls for medical assistance including emergency numbers like 999 and non emergency services like 111.

This system guides the call handlers through a series of questions that give the handler the condition of the patient, which helps determine appropriate level of care that is to be provided to the patient. It ranges from self care advisory to dispatching emergency medical services.

It is utilised by multiple ambulance services across England and it is aimed to make sure that there is a consistent and efficient response in times of medical emergencies.

The global prehospital consortium, is an international collaborative that comprises of organizations which direct community  bystander driven emergency medical service programmes all across the 12 countries on 3 different continents which involves over 22,000  First responders.  The consortium focuses on giving training to  the lay person in order to act as first responders , particularly in the countries which have low and middle income. It helps to provide rapid care before a professional help can arrive and take it from there.

This was established in 2022, GPC has identified different priorities like the infrastructure, communication, education and financing in order to accentuate emergency medical services globally.

LFR international,  is a non governmental organization that is dedicated towards developing first lady person responder programmes in resource limited  Countries to improve pre hospital emergency care.

Financial questions

Who will pay for the treatment? Government or insurers? 
Under the golden hour scheme the treatment cost for the victims of the road accident during the first crucial hour will be covered by the motor vehicle accident fund, which was established under section 162B of Motor Vehicles Act 1988.  However,  this fund is Suppose to be financed through contributions from insurers, the central government and other designated sources.

Car insurance premium to go up after this ? 
Yes, the car insurance premium may see a hike as the insurers will contribute to the motor vehicle accident fund for cashless treatment. The Honourable Supreme Court's directive will increase insurers financial liability, potentially leading them to make adjustments to their premiums. However, the extent of this increase will completely depend on the government policies and the framework that is in place for the cost sharing with the insurers.

Liability

Will hospitals be legally bound to comply? 
Yes, the hospitals are going to be legally bound to comply with the golden hour scheme. The honourable Supreme Court direction ensures that all the hospitals whether they are government or private, they must provide an immediate cashless treatment to the victims of the accident. Non compliance with this order can lead 2 penalties or even legal consequences under the motor vehicles act 1988. In addition to this, hospitals cannot refuse treatment on the financial grounds of the patient. This scheme makes it mandatory for the treatment costs to be reimbursed through the motor vehicle accident fund which ensures that no financial burden on hospital is levied.  A regulatory mechanism is likely to be implemented to monitor with the compliance which will hold the hospitals accountable for providing an urgent medical aid without any bureaucratic delays.

Will this law protect those who come forward to help ?
Yes, this law will definitely protect the good Samaritans under the Good Samaritan guidelines issued by the Supreme Court in 2016, which is reinforced by the Motor Vehicles Amendment Act 2019. The individuals that are assisting accident victims cannot be compelled to disclose the personal details or face any legal harassment. Hospitals are to provide legal treatment without demanding any legal formalities from the helpers. The golden hour scheme aligns with these protections which encourages the bystanders to assist the accident victims without having any fear of police questioning or liability. In addition to this, any action taken in good faith for the sake of helping the victims is going to be legally safeguarded which will ensure that more people come forward to provide a timely aid in an emergency hour.

Challenges

How will compliance be enforced?
Compliance will be enforced through a regulatory scrutiny by the government and IRDAI. The hospitals will be mandated to report the cases and audits will then track if there was an adherence to the case or not. Non compliance filed result and penalties komal legal action and even license revocation.  A digital monitoring system and a grievance redressal mechanism might be on the way to get introduced in order to track accountability of the hospitals.

Should this be merged with Ayushman Bharat? 
Merging this scheme with the Ayushman Bharat could streamline the funding and execution while leveraging its current healthcare network and the digital infrastructure. However it looks like it might complicate the implementation due to eligibility restrictions. Instead of that, parallel yet integrated model could help ensure that universal accessibility is maintained while the scheme is focused on immediate accident care without any bureaucratic delays. 

What infrastructure related upgrades are needed for this to be successful in our country? 
Crucial upgrades will include ambulance expansion, more trauma care centres, trained paramedics and real-time GPS tracking for emergency responding. Hospital’s medical wards need to be better equipped with necessary equipment, staff and cashless transaction strategies in order to serve better. There is a need for public awareness campaigns and inter agency coordination amongst the hospitals, police and insurance companies, so that there is a seamless execution and quick deliverance of medical aid. 

Case Laws

1. Parmanand Katara v. Union of India (1989) 4 SCC 286
The Supreme Court, in this verdict held that every doctor, whether in a government or private hospital, has a duty to deliver prompt medical treatment to accident victims without waiting for legal formalities.
This case strengthened the Right to Life (Article 21) by assuring that no one should be denied emergency medical care due to any procedural delays.

2. Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996) 4 SCC 37
In this ruling, the Supreme Court held that the state will be responsible for providing the proper medical facilities and must also make sure that individuals are not denied emergency treatment due to a lack in infrastructure.
 This verdict reinforced that a failure to comply with this ruling and provide emergency medical aid amounts to a violation of Article 21, which will place a liability on the government.

3. Save Life Foundation v. Union of India (2016)
This case led to the issuance of Good Samaritan Guidelines, which protect the bystanders who help accident victims from the legal and procedural harassment.
This ruling encouraged participation of public in emergency care without having to fear the police interrogation or liability.

4. M.C. Mehta v. Union of India (1987) 1 SCC 395
Established the “absolute liability” principle, holding companies strictly accountable for harm faced due to hazardous activities, including road accidents caused by negligence.
This case fostered victims’ right to compensation in accidents involving corporate negligence.

5. Pt. Parmanand Katara v. Union of India (2004) 6 SCC 772
This case reiterates that the hospitals cannot refuse any treatment to accident victims on any financial grounds so that it causes delays due to police formalities, if so then it violates Article 21.
This case backed enforcement of immediate emergency care responsibilities.
To read another judgment related to necessity of immediate medical attention, click here.

FAQs

1. What is the Golden Hour Scheme?
It ensures cashless emergency treatment for road accident victims within the first hour of the accident, funded by the Motor Vehicle Accident Fund.

2. Who will bear the treatment cost?
The Motor Vehicle Accident Fund which will be financed by insurers, the government and other sources, will cover expenses.

3. Are hospitals legally bound to provide treatment?
Yes, all hospitals must provide immediate care or face legal consequences.

4. Will Good Samaritans face legal trouble?
No, Good Samaritan Guidelines protect bystanders from police or legal harassment for helping victims.

5. Will car insurance premiums increase?
Likely yes, because the insurers are required to contribute to the Motor Vehicle Accident Fund.

Conclusion

The golden hour scheme is a transformative step taken towards strengthening road safety and also emergency medical care procedure in India. by making sure a cashless treatment is provided for the accident victims within the first hour of the accident, the scheme uphold the right to life and also reduces the number of fatalities, preventing the number of victims and injuries that can be prevented. The legal obligation that falls on the hospitals for protecting the good Samaritans and the funding which is backed by insurers makes it sure that a smooth implementation of this scheme is experienced. However, a really strict compliance, monitoring, upgrades infrastructure and also public awareness is still needed for the scheme to be a success. While the insurance premium may rise, the long-term benefits are still out weighing the costs if this scheme is effectively executed, it can help save countless lives and reinforce India’s commitment towards accessible and immediate emergency help and support.