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ADRES triplica los pagos por atención de accidentes sin SOAT en 2025 y refuerza controles a IPS
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La Administradora de los Recursos del Sistema General de Seguridad Social en Salud (ADRES) giró $49.000 millones en abril de 2025 por concepto de atención a víctimas de accidentes de tránsito en vehículos no identificados o sin Seguro Obligatorio de Accidentes de Tránsito (SOAT). Con esta cifra, el acumulado entre enero y abril alcanza los $167.000 millones, lo que representa 3,6 veces más que los $46.000 millones pagados en el mismo periodo de 2024.
Durante el mes de abril se radicaron 34.862 reclamaciones nuevas por parte de las Instituciones Prestadoras de Servicios de Salud (IPS), por un valor total de $79.012 millones. Estas cifras muestran una disminución del 20,9 % en el valor reclamado y del 19,3 % en el número de reclamaciones respecto a abril de 2024, cuando se presentaron 43.214 reclamaciones por un valor de $99.827 millones.
Disminución atribuida a una mayor eficiencia en auditorías
La reducción en el volumen y valor de las reclamaciones está relacionada con el fortalecimiento de los procesos de validación por parte de la ADRES, en colaboración con las firmas auditoras contratadas para revisar la información reportada por las IPS. Esta mejora ha permitido una mayor eficiencia en la gestión y control de los recursos del sistema.
De las nuevas reclamaciones registradas en abril, el 46,2 % (16.118 casos) correspondieron a vehículos no identificados, con un valor total de $31.264 millones. Esta cifra representa una disminución del 37,6 % frente al valor reclamado por esta causa en abril de 2024, cuando alcanzó los $50.115 millones.
Por otra parte, el 45,9 % de las reclamaciones nuevas no incluyó información sobre el tipo de vehículo involucrado. En el 54,1 % restante que sí reportó esta variable, se encontró que el 96,0 % de los casos correspondió a accidentes con motocicletas.
Top cinco de IPS según el valor de reclamaciones nuevas
En abril de 2025, la IPS Clínica Cali, ubicada en el Valle del Cauca, lideró el listado de instituciones con mayor valor reclamado ante la ADRES por atención a víctimas de accidentes de tránsito. La entidad presentó un total de 3.361 reclamaciones, por un monto acumulado de $9.938 millones, equivalente al 12,6 % del valor total nacional.
Le siguió Especialistas Asociados S.A., en el departamento de Córdoba, con 1.579 reclamaciones que sumaron $4.719 millones (6,0 % del total nacional). En tercer lugar se ubicó la Clínica Medical S.A.S., en Bogotá D.C., que presentó 639 reclamaciones por un valor de $1.643 millones (2,1 %).
El cuarto lugar fue ocupado por Fabilu Ltda., también en el Valle del Cauca, con 2.240 reclamaciones por un monto de $1.623 millones (2,1 % del total). Finalmente, Inversiones Médicas Valle Salud S.A.S., con sede en el mismo departamento, radicó 217 reclamaciones que ascendieron a $1.549 millones, equivalentes al 2,0 % del total nacional.
Más de 25.000 personas resultaron afectadas solo en abril
Las cuentas nuevas radicadas ante ADRES en abril de 2025 correspondieron a la atención de 25.038 personas víctimas de accidentes de tránsito. De ellas, el 61 % fueron hombres (15.262 personas), el 32% mujeres (8.018 personas), y el 7 % restante (1.758 personas) no presentó información registrada sobre el sexo.
Estas cifras evidencian no solo la magnitud del reto que representa la atención a víctimas de siniestros viales sin cobertura de SOAT, sino también la necesidad de continuar fortaleciendo los procesos de auditoría, identificación y respuesta institucional para garantizar el uso adecuado de los recursos públicos en salud.
Descargue aquí el boletín técnico de la ADRES:
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