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Chapter 1: Executive Summary I Chapter 2: Introduction I Chapter 3: Research Methodology, Sample Design & Sample Coverage I Chapter 4: Socio-Economic Impact of Road Crashes I Chapter 5: Gendered Impact of Road Crashes I Chapter 6: Psychological and Social Impact of Road Crashes I Chapter 7: Impact of Road Crashes on Adolescents I Chapter 8: Outcomes of the Insurance & Legal Compensation Process I Chapter 9: Interactions with Institutions I Chapter 10: Way Forward I Annexure & Appendix




The road crash fatality rate is three times higher in low-income countries than in high-income countries. In the last decade,1.3 million people have been killed and another 5 million have been injured in road crashes in India. 76% of people who die in road crashes are in their prime working-age i.e. 18 – 45 years (MoRTH, 2018). Vulnerable road users i.e. pedestrians, cyclists, two-wheelers, and other non-motorised transport are more at risk to road crash injury and account for more than half of all road crash deaths (WHO, 2018). These modes of transport are more often used by lower- income groups who bear a disproportionately larger burden of road crashes. It pushes the “non-poor” into poverty and already poor into debt. Road crashes deaths cause an immense financial loss to the families of victims, and a resultant deterioration in their standard of living accompanied with psychological suffering. Yet, the social and economic fallout from a road crash is understudied in India.




The present Traffic Crash Injuries and Disabilities: The Burden on Indian Society Report is commissioned by the World Bank under its proposed project ‘India State Program on Road Safety’ with the Ministry of Road Transport & Highways (MoRTH), Government of India (GoI) in association with the Save LIFE Foundation (SLF). This report seeks to document interlinkages between poverty, inequalities, road users, and road crash outcomes. It aims to capture the socioeconomic realities and nuances of road crashes at the sub-national level.
As part of the project, a detailed mixed-methodology study was conducted in 4 States across India to survey road crash victims/family members from Lower Income Households (LIH) and High Income Households (HIH), truck drivers and adolescents.
44%
of the households in rural areas reported at least one death after a road crash compared to 11.6% of households in urban areas.




75%
of poor households faced a decline in total household income after a crash compared to 54% in rich households.


66%
of the respondent truck drivers were not aware of third-party liability insurance.


3x
poor households were three times more likely to seek financial help than rich households.


2x
Within households, it is women who bear the brunt of caregiving activities, experiencing double burden of labour.


LIH>HIH
The post-crash impact was more severe for poor households in Low Capacity States compared to rich households in High Capacity States


75%
of victims from poor households were not aware of the legal compensation process.

Low
insurance coverage among poor households and delays in accessing compensation made recovery more difficult.


Poor
households experienced a decline in their quality of life, and mental and emotional stress after a crash


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Bihar Key Highlights (Download)


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UP Key Highlights (Download)


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Maharashtra Key Highlights (Download)


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Tamil Nadu Key Highlights (Download)
Based on the outcome of the crash, most of the victims that died belonged to low income households. For urban areas, 77.8% of the victims that died belonged to LIH and in rural areas, as high as 98.2% of the victims that died belonged to LIH.
Further, it can be observed that for both LIH and HIH, an equal proportion of female victims died in urban areas. Whereas, for males, the proportion of victims that died was higher for LIH in both urban and rural areas. 98.3% of the female victims that died in rural areas belonged to LIH.
Proportion of female victims that survived in urban areas was higher for HIH than for LIH. However, for rural areas, the proportion of female victims that survived was higher for LIH than HIH. The proportion of male victims that survived was higher for LIH in both urban and rural areas.


79.4% of LIH admitted that there was a decline in total income of the household due to the road crash, while 66.1% of HIH admitted to the same. Further, a larger number of cases of property sale, money borrowing, and relocation were observed in LIH than in HIH. Interestingly, a larger proportion of HIH reported OOPE than LIH. This can be due to the fact that HIH can afford better quality treatment than LIH.
Out of pocket expenditure (OOPE) is the payment made directly by individuals at the point of service where the entire cost of the health good or service is not covered under any financial protection scheme. The OOPE was about 2.5 times higher for LIH than for HIH. Total OOPE was INR 66,659 for LIH, and 27,083 for HIH. 82.9% of the LIH where the victim survived the crash admitted to paying OOPE, while 72.2% of the of the HIH where victims survived admitted to paying OOPE.




The total losses faced by 412 low income households and 115 high income households was INR 1,09,227 and INR 1,47,156 respectively. As HIH have significantly higher income than LIH, the loss of income was higher for HIH than for LIH. Loss of property and legal expenses accounted for about 6.3% and 3.8% of LIH losses respectively, and 19.4% and 4.7% of HIH losses respectively. The breakup of the losses is as follows:


As low as 10.7% of LIH and 21.7% HIH victims/family members availed motor vehicle insurance compensation. Among those that availed compensation, just 59.1% of the LIH victims, and 48% of HIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 12.6 months while HIH victims received it in about 17.6 months.


Among the 101 truck drivers surveyed in Bihar, a relatively high proportion of truck drivers (20.8%) were unaware that the attendant or khalasi is also covered under the motor third party liability insurance under the Motor Vehicles (Amendement) Act, 2019. There was also relatively less awareness about the time limit for filing cases for compensation, which is 6 months from the crash occurrence, and about the insurance company’s liability to designate an officer to assist claimants in the claim settlement process.


In the case of both LIH and HIH, the majority of the victims had a female family member as their caregiver (64.5% for LIH and 72.2% for HIH). Interestingly, there was a greater proportion of victims from LIH (8.9%) that took care of themselves post the crash than HIH victims (2.5%).


As high as 41.8% of the LIH victim’s household members admitted that their food consumption has decreased post crash, while 21.7% of the HIH victim’s household members admitted that their food consumption has decreased post crash.


37% of the victims from LIH admitted that their family/ household members developed health problems post crash, as opposed to HIH victims, where 16.9% of the victim household members developed health problems post crash


In Bihar, a higher proportion of LIH victims faced disabilities than HIH victims. 99 (42.3%) of the respondents from LIH, and 19 (17.6%) of the respondents from HIH reported a disability. Among them, 45.5% of LIH and 21.1% of HIH reported a serious disability.


In Bihar, 52.7% of LIH and 33.7% of HIH reported that the victim or a household member suffered from depression post the crash.


In Bihar, as high as 30.1% of the household members from LIH faced difficulty in sleeping, while 18.1% of the household members from HIH faced the same.


In Bihar, LIH on an average, took 88 more days than HIH to return to their previous occupation, with LIH taking an average of 134 days to return to their occupation and HIH taking 46 days for the same. Further, on an average it took LIH 40 days, and HIH 29 days to find a new occupation.
In Bihar, 51.5% of the LIH and 58.3% of the HIH claim that no FIR was filed for the road crash case that the victim was involved in.


Based on the outcome of the crash, most of the victims that died belonged to low income households. For urban areas, 56.4% of the victims that died belonged to LIH and in rural areas, 99.5% of the victims that died belonged to LIH.
Further, it can be observed that for both LIH and HIH, an equal proportion of female victims died in urban areas.Whereas, for males, the proportion of victims


83.8% of LIH admitted that there was a decline in total income of the household due to the road crash, while 64.4% of HIH admitted to the same. Further, a larger number of cases of property sale, money borrowing, and relocation were observed in LIH than in HIH. Interestingly, a larger proportion of HIH reported OOPE than LIH. This can be due to the fact that HIH can afford better quality treatment than LIH.




The total losses faced by 413 low income households and 101 high income households was INR 1,64,230, and INR 2,30,800 respectively. As HIH have significantly higher income than LIH, the loss of income was higher for HIH than for LIH. Loss of property and legal expenses accounted for about 8% and 5.8% of LIH losses respectively, and 12.3% and 1.6% of HIH losses respectively. The breakup of the losses is as follows:


As low as 7.5% of LIH victims, and 30.7% HIH victims/family members availed motor vehicle insurance compensation. Among those that availed compensation, just 41.9% of the LIH victims, and 38.7% of HIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 11.1 months while HIH victims received it in about 10.3 months.
Only 1.7% of LIH victims and 9.9% HIH victims/family members availed medical insurance compensation. Among those that availed compensation , 42.9% of the LIH victims, and 90% of HIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 3.7 months while HIH victims received it in about 4 months.
5.8% of LIH, and 10.9% HIH victims/family members availed life insurance compensation. Among those that availed compensation , 91.7% of the LIH, and 72.7% HIH received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 4.1 months, and HIH in 5.9 months.


Among the 106 truck drivers surveyed in Uttar Pradesh, 43.4% of the truck drivers were unaware that the attendant or khalasi is also covered under the motor third party liability insurance under the Motor Vehicles (Amendement) Act, 2019. As high as 45.3% of the truck drivers were unaware about the time limit for filing cases for compensation, which is 6 months from the crash occurrence. Further, as high as 55.7% of the drivers were unaware about the insurance company’s liability to designate an officer to assist claimants in the claim settlement process. 33% of the respondents were unaware that Motor Third Party Liability Insurance is mandatory, and that the Police can charge fines for uninsured vehicles.


In the case of both LIH and HIH, the majority of the victims had a female family member as their caregiver (68.4% for LIH and 87.8% for HIH). Interestingly, there was a greater proportion of male caregivers from LIH (27.9%) than HIH victims (12.2%). 3.7% of the victims took care of themselves in LIH, as opposed to 0% of the victims in HIH.


As high as 54.6% of the LIH victim’s household members admitted that their food consumption has decreased post crash, while 6.5% of the HIH victim’s household members admitted that their food consumption has decreased post crash.


As high as 55.2% of the victims from LIH admitted that their family/ household members developed health problems post crash, and 6.5% of the HIH victim household members developed health problems post crash.


In Uttar Pradesh, a higher proportion of LIH victims faced disabilities than HIH victims. 76 (37.1%) of the respondents from LIH reported a disability. Among them, 32.9% of LIH reported a serious disability (*Note: No HIH reported a disability).


In Uttar Pradesh, 62.6% of LIH and 19.4% of HIH reported that the victim or a household member suffered from depression post the crash.


In Uttar Pradesh, as high as 49.1% of the household members from LIH faced difficulty in sleeping, while 3.2% of the household members from HIH faced the same.


In Uttar Pradesh, LIH on an average, took 73 more days than HIH to return to their previous occupation, with LIH taking an average of 129 days to return to their occupation and HIH taking 56 days for the same. Further, on an average it took LIH 105 days to find a new occupation. (Note: No HIH shifted to a new occupation).
In Uttar Pradesh, 50.6% of the LIH and 50.5% of the HIH claim that no FIR was filed for the road crash case that the victim was involved in.


Based on the outcome of the crash, most of the victims that died belonged to low income households. For urban areas, 54.2% of the victims that died belonged to LIH and in rural areas, 100% of the victims that died belonged to LIH.
Further, it can be observed that 42.9% of the female victims that died in urban areas were from LIH and 57.1% of the female victims were from HIH. Whereas, for males, the proportion of victims that died was higher for LIH in both urban and rural areas, with LIH comprising 70% of the male victims in urban areas, and 100% of the male victims in rural areas. 100% of the female victims that died in rural areas belonged to LIH.


76.9% of LIH admitted that there was a decline in total income of the household due to the road crash, while 51.3% of HIH admitted to the same. Further, a larger number of cases of OOPE, property sale, money borrowing, and relocation were observed in LIH than in HIH.




The total losses faced by 415 low income households and 113 high income households was INR 1,89,621, and INR 1,62,907 respectively. As HIH have significantly higher income than LIH, the loss of income was higher for HIH than for LIH. Loss of property and legal expenses accounted for about 5.7% and 3.4% of LIH losses respectively, and 11.9% and 0.54% of HIH losses respectively. The breakup of the losses is as follows:


As low as 9.2% of LIH victims and 38.1% HIH victims/family members availed motor vehicle insurance compensation. Among those that availed compensation, just 55.3% of the LIH victims, and 76.7% of HIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 10.5 months while HIH victims received it in about 3.1 months.
Only 2.4% of LIH victims and 19.5% HIH victims/family members availed medical insurance compensation. Among those that availed compensation, 70% of the LIH victims, and 81.8% of HIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 3.4 months while HIH victims received it in about 2.4 months.
Only 2.7% of LIH victims/family members availed life insurance compensation. Among those that availed compensation, 81.8% of the LIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 4.1 months. (*Note: none of the HIH availed life insurance).


Among the 113 truck drivers surveyed in Maharashtra, a relatively high proportion of truck drivers (17.7%) were unaware that the attendant or khalasi is also covered under the motor third party liability insurance under the Motor Vehicles (Amendement) Act, 2019. 23% of the truck drivers were unaware about the time limit for filing cases for compensation, which is 6 months from the crash occurrence. Further, as high as 27.4% of the drivers were unaware about the insurance company’s liability to designate an officer to assist claimants in the claim settlement process.


In the case of both LIH and HIH, the majority of the victims had a female family member as their caregiver (73.4% for LIH and 79.7% for HIH). Interestingly, there was a greater proportion of male caregivers from LIH (23.9%) than HIH victims (17.7%).


As high as 34.6% of the LIH victim’s household members admitted that their food consumption has decreased post crash, while 29.9% of the HIH victim’s household members admitted that their food consumption has decreased post crash.


22% of the victims from LIH admitted that their family/ household members developed health problems post crash, and 24.1% of the HIH victim household members developed health problems post crash.


In Maharashtra, a higher proportion of LIH victims faced disabilities than HIH victims. 88 (30.3%) of the respondents from LIH, and 6 (5.9%) of the respondents from HIH reported a disability. Among them, 42% of LIH reported a serious disability (*Note: HIH did not report serious disability).


In Maharashtra, 40.2% of LIH and 3.4% of HIH reported that the victim or a household member suffered from depression post the crash.


In Maharashtra, as high as 24.4% of the household members from LIH faced difficulty in sleeping, while 6.9% of the household members from HIH faced the same.


In Maharashtra, LIH on an average, took 77 more days than HIH to return to their previous occupation, with LIH taking an average of 122 days to return to their occupation and HIH taking 45 days for the same. Further, on an average it took LIH 189 days, and HIH 84 days to find a new occupation.
In Maharashtra, 52.5% of the LIH and 75.2% of the HIH claim that no FIR was filed for the road crash case that the victim was involved in.


Based on the outcome of the crash, most of the victims that died belonged to low income households. For urban areas, 93.8% of the victims that died belonged to LIH and in rural areas, 80.2% of the victims that died belonged to LIH.
Further, it can be observed that 83.3% of the female victims that died in urban areas from LIH and 16.7% of the female victims that died in urban areas were from HIH. For males, the proportion of victims that died was higher for LIH in both urban and rural areas, with LIH comprising 100% of the male victims in urban areas, and 88.7% of the male victims in rural areas. 66.7% of the female victims that died in rural areas belonged to LIH, and 33.3% belonged to HIH.


59% of LIH admitted that there was a decline in total income of the household due to the road crash, while 47.6% of HIH admitted to the same. Further, a larger number of cases of OOPE, property sale, money borrowing, and relocation were observed in LIH than in HIH.




The total losses faced by 407 low income households and 103 high income households was INR 1,42,350, and INR 2,49,081 respectively. As HIH have significantly higher income than LIH, the loss of income was higher for HIH than for LIH. Loss of property and legal expenses accounted for about 14.2% and 4.3% of LIH losses respectively, and 16.1% and 4.6% of HIH losses respectively. The breakup of the losses is as follows:


28.5% of LIH victims and 32% HIH victims/family members availed motor vehicle insurance compensation. Among those that availed compensation, 75.9% of the LIH victims, and 66.7% of HIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 3.9 months while HIH victims received it in about 6.4 months.
17.4% of LIH victims and 16.5% HIH victims/family members availed medical insurance compensation. Among those that availed compensation , 88.7% of the LIH victims, and 94.1% of HIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 2.2 months while HIH victims received it in about 2.4 months.
A mere 2.5% of LIH, and 1.9% of HIH victims/family members availed life insurance compensation. Among those that availed compensation , 40% of the LIH victims, and 50% of HIH victims received the eligible compensation. In terms of time taken, LIH victims received their compensation in about 3.8 months, and HIH in about 5 months.


Among the 100 truck drivers surveyed in Tamil Nadu, half of the truck drivers were unaware that the attendant or khalasi is also covered under the motor third party liability insurance under the Motor Vehicles (Amendement) Act, 2019. As high as 55% of the truck drivers were unaware about the time limit for filing cases for compensation, which is 6 months from the crash occurrence. Further, as high as 45% of the drivers were unaware about the insurance company’s liability to designate an officer to assist claimants in the claim settlement process. 53% of the respondents were unaware that Motor Third Party Liability Insurance is mandatory, and that the Police can charge fines for uninsured vehicles.


In the case of both LIH and HIH, the majority of the victims had a female family member as their caregiver (81% for LIH and 67.7% for HIH). Interestingly, there was a greater proportion of victims from LIH (3%) that took care of themselves post the crash than HIH victims (1.6%). Also, a greater proportion of male caregivers for LIH than for LIH.


As high as 43.7% of the LIH victim’s household members admitted that their food consumption has decreased post crash, while 35.6% of the HIH victim’s household members admitted that their food consumption has decreased post crash.


34.3% of the victims from LIH admitted that their family/ household members developed health problems post crash, and 35.6% of the HIH victim household members developed health problems post crash.


In Tamil Nadu, a higher proportion of LIH victims faced disabilities than HIH victims. 47 (14.6%) of the respondents from LIH, and 4 (4.7%) of the respondents from HIH reported a disability. Among them, 29.8% of LIH reported a serious disability (*Note: no HIH reported a serious disability).


In Tamil Nadu, 40.8% of LIH and 50.7% of HIH reported that the victim or a household member suffered from depression post the crash.


In Tamil Nadu, as high as 32.7% of the household members from LIH faced difficulty in sleeping, while 38.4% of the household members from HIH faced the same.


In Tamil Nadu, LIH on an average, took 8 more days than HIH to return to their previous occupation, with LIH taking an average of 33 days to return to their occupation and HIH taking 25 days for the same. Further, on an average it took LIH 120 days, and HIH 60 days to find a new occupation.
In Tamil Nadu, 35.9% of the LIH and 15.5% of the HIH claim that no FIR was filed for the road crash case that the victim was involved in.

