Pursuant to the law on health insurance, November 14, 2008;

Pursuant to the law on road traffic, November 13, 2008;

Pursuant to the law of railways on June 14, 2005;

Water Transport Law base on 15 June 2004;

Pursuant to Decree No. 62/2009/ND-CP dated 27/7/2009-Government's detailed rules and instructions for the implementation of some articles of the law on health insurance, Contact the Ministry of health, Ministry of finance instructed the payment procedure consultation fees, cure for health insurance participants were traffic accidents are as follows : article 1. General principles 1. Health insurance participants were traffic accidents, while not yet have enough bases to determine the cause of a traffic accident is caused by violations of the legislation on the traffic of that cause, cure the sick, visit enjoy medical insurance mode according to the regulations.

2. When there is enough bases to determine the cause of a traffic accident is caused by violations of the legislation on the traffic of the person causing the accident or traffic accident cases but not paid by the health insurance fund, the accident did not enjoy medical insurance mode and are responsible to reimburse in full the expenses the doctor, cure for health insurance fund.

3. cases are entitled to medical treatment mode of health insurance under the provisions that do not identify violations of traffic law as defined in article 2 of this circular: a) children under the age of 14;

b) elderly people from 80 years of age.

Article 2. The sequences, procedures and responsibilities in determining violations of traffic law 1. For health insurance participants were traffic accidents: health insurance participants were traffic accidents when hospital treatment, in addition to the present procedure for medical examination and treatment for health insurance under the common regulations, to provide for the medical facility, healing the information relevant , including: first and last name; date of birth; place of residence; time, where the accident occurred and the cause of the accident (if available).

The case of the comatose accident, do not provide the information on the relative or the person who brought the victim to the institution responsible for providing the information that you know about traffic accidents occurred with respect to the accident.

The case has had one of the documents stipulated in article 3 of this circular, the accident or relatives who suffered the accident must immediately provide the basis of examination and treatment to make the payment of the base doctor, cure health insurance according to the prescribed regimes.

2. for medical facility, the person receiving healing accident: patient establishments, daily, General healing list health insurance participants were traffic accidents treatment, cure or emergencies during the day (according to the model in annex No. 1 attached to this circular) to turn to the social insurance agency or insurance agency employees social standing in the base doctor, healing.

3. for the social insurance agency: a) within 2 working days, counting from receipt of the list of people who have health insurance cards were traffic accidents caused by the base doctor, cure moved to the social insurance agency, is responsible for sending the text recommended to verify violations of traffic law of the accident to the police force traffic or criminal investigation police about social order (hereafter referred to as public safety agencies) of the site of traffic accident (according to the model in annex No. 2 attached to this circular).

Case of accident or accident relatives who have provided the base doctor, cure or the social insurance agency in one of the documents stipulated in article 3 of this circular or in case of the accident were the social insurance agency earlier had written verification requirements shall not send the verification proposal text.

b) case after 3 months from the date of the social insurance agency to send the verification proposal text as defined in point a of this paragraph but still have not received the notice of the police or get the message yet or do not verify the status law on traffic violations , the social insurance agency made settlement costs of examination and treatment was used as for the case of an accident does not violate traffic laws.

Article 3. Pursuant to the payment or non-payment of the cost of medical examination and treatment regimes for health insurance participants were traffic accident social insurance agency based on one of the following documents in order to decide the payment or non-payment of examination fees treatment for health insurance participants were traffic accident: 1. A copy thereon resolved traffic accident by the police.

2. A copy or extract of the part a of the conclusions of the investigation of causes of traffic accident confirmation of police agencies accepting, resolving traffic accident.

3. A copy or extract of the part of the final court hearing traffic accidents (with confirmation of a court) by accident or relatives who provide accident.

Article 4. The payment of the cost of hospital treatment in case of violation of the laws on traffic accidents When there is enough bases to determine the cause of a traffic accident is caused by violations of the legislation on the traffic accident's causes, social insurance agencies make payments as follows : 1. where the victim is still being treated at the base hospital, healing: the social insurance agency for direct notification to the person of the accident or the relatives of the victim (father, mother; your wife or husband; offspring from age 18 and up) know about the accident violated the law on traffic and not health insurance fund payments costs of examination and treatment.

2. in case of the accident took out the Institute: social insurance agency made cost recovery consultations, healing that health insurance funds paid under the provisions of article 5 of this circular.

3. in case of the accident fatality: social insurance bodies perform payment consultation expenses, medical facility with healing, healing according to the mode of health insurance (no cost recovery consultations, healing has paid for this case).

Article 5. Cost recovery consultations, healing by the health insurance fund has paid 1. The social insurance agency has the responsibility to notify the victim or relatives who know the accident results identify the violation of traffic laws on the police and requests the victim or relatives who suffer accidents are responsible to reimburse the Fund for health insurance medical expenses healing, which the social insurance agency paid (according to the model in annex No. 3 attached to this circular).

2. After 30 days from the date the refund request text, if the victim or relative who had an accident does not reimburse the cost of the social insurance agency continues to have text urging execution.

3. the following case 3, from the date of sending the notice and urge as defined in paragraph 2 of this Article but who suffer accidents or relatives who were still not refundable and accidents, the social insurance agency under social insurance report superior to general social insurance reporting Vietnam.

4. The end of the financial year, Vietnam General social insurance expenses examinations, cure for health insurance participants were traffic accidents but not recovered is sent to the Ministry of health, in coordination with the Finance Ministry and the Prime Minister allowed the settlement to fund health insurance for the account is not obtained.

Article 6. Effect 1. This circular effect since July 26, 2011.

2. Annul paragraph 3 article 8 joint circular No. 03/2009/TTLT-BYT-BTC on August 14, 2009 the Ministry of health, Ministry of Finance shall guide the implementation of health insurance when this circular effect.

Article 7. Implementation 1. Social insurance allocation Vietnam issued synthetic forms, reporting on the case of irrecoverable costs specified in clause 3 5 of this circular and guide the social insurance organization levels done.

2. where the health insurance participants were traffic accidents before the day this circular effect but is still being treated at the base hospital, cure shall follow the provisions of this circular.

In the process if there are obstacles, the proposal reflects the timeliness of the Ministry of health, the Ministry of finance to study the resolution./.