The new rules put ambulance response, movement and hospitalisation timelines under tighter monitoring, with penalties for delays.

Every minute counts

Under the new service-level benchmarks, an emergency alert must be accepted within one minute, while the ambulance must begin moving within two minutes.

For an accident within a 10-km radius, the ambulance must reach the site within 10 minutes of the emergency ticket being accepted.

For crashes farther away, the permitted response time will increase proportionately.

The injured person should also reach the nearest hospital within one hour of the emergency alert being accepted — a timeline that focuses on the critical "Golden Hour" following a serious road accident.

Delays could cost up to Rs 10,000

The new norms come with financial penalties for missed deadlines.

A delay of more than one minute in accepting an emergency alert can attract a penalty of Rs 5,000 for every additional minute or part thereof.

The same penalty applies if an ambulance fails to start moving within the prescribed two-minute window.

Missing the 10-minute accident-site response target can lead to a penalty of Rs 10,000 per incident.

Ambulances will also not be permitted to reject emergency tickets. An on-road unit that refuses an emergency call can face a Rs 10,000 penalty.

Failure to ensure that an accident victim reaches the nearest hospital within one hour can also attract a Rs 10,000 penalty per incident.

GPS to track ambulance response

NHAI will use GPS data, its Care Dashboard and the NHAI Care app to monitor compliance with the new timelines.

The authority said delays in emergency response had been flagged by the Supreme Court Committee on Road Safety as well as a performance audit by the Comptroller and Auditor General (CAG).

NHAI has also identified poor GPS uptime and emergency-response units remaining offline on the Care app as key problems affecting the existing system.

Ambulances to remain online

The use of the NHAI Incident Management System Care System has been made mandatory for all on-road units deployed on NHAI projects.

Ambulances, cranes and patrolling vehicles are equipped with AIS-140-compliant GPS devices, while response teams have Android devices with IoT SIMs and the NHAI Care app.

Incident Managers can monitor vehicle movement and accident response through the Care Dashboard, allowing NHAI to track the response in real time.

Going offline could also attract penalties. Failure to use the Care app or maintain the required GPS system can result in a penalty of Rs 2,500 per day.

Equipment and mock drills mandatory

NHAI has also tightened requirements for ambulance readiness.

An ambulance found without prescribed equipment, medicines or required personnel, including a driver or Emergency Medical Technician, can attract a penalty of Rs 10,000 per inspection.

Each ambulance must conduct a daily dry run or mock drill of at least 5 km, unless it has already responded to an accident and travelled more than 5 km that day.

Penalties to be automatically deducted

The penalties will be calculated automatically through the NHAI Care System and deducted from payments due to ambulance service providers or agencies responsible for highway maintenance.

However, the total penalty imposed on a service provider has been capped at Rs 2.5 lakh per month.

NHAI has also said ambulances may be required to respond to accidents beyond their own project jurisdiction if a crash occurs on an adjoining National Highway stretch and no ambulance is available there.

Part of NHAI's zero-fatality push

The tighter ambulance norms are part of NHAI's broader road-safety efforts aimed at reducing deaths on National Highways.

The authority has identified 1,083 High Fatality Zones across 77 National Highways, covering 6,948 critical spots.

Its road-safety strategy includes engineering improvements, enforcement measures and strengthening trauma care and emergency response.

The new ambulance rules are aimed at ensuring that when a serious crash occurs, help is not just dispatched — it reaches the victim when every second matters.