Over three quarters of a million people are killed and tens of millions injured on the roads in low income countries each year. Many, if not most, will come from poor households, particularly vulnerable to the risk of road trauma and its economic consequences. While road safety is traditionally focused on prevention activities, fair and timely compensation systems will help bereaved families and injured victims recover from the shock of a road crash. This scoping study is the Department for International Development’s first investment in documenting the role of the motor insurance industry in road safety. The study has focused on third party insurance and while compensation efforts are a main concern of the review, the motor insurance industry’s prevention activities are also covered.