What began as a criminal case over a fatal road accident in North Macedonia is drawing politicians and diplomats into an already difficult relationship with neighbouring Bulgaria, as a 23-year-old dual national says travel restrictions are preventing her from obtaining medical treatment abroad.
KOCANI, North Macedonia, Sept 28 (BalkanView) – A trial over a road accident that killed one person has become an increasingly sensitive issue between North Macedonia and Bulgaria, after the injured woman accused of causing the crash said she was being prevented from travelling abroad for medical treatment.
Iva Mihaylova, 23, a citizen of both countries, is standing trial at the Basic Court in the eastern North Macedonian town of Kocani over an October 2025 collision in which one person was killed and several others, including Mihaylova, were injured.
She denies responsibility for the crash. No final judgment has been reached.
But nearly a year after the accident, the case has moved beyond questions of traffic reconstruction and criminal liability.
Bulgarian politicians have attended court hearings, Bulgarian media have closely followed the proceedings and Sofia has raised concerns about Mihaylova’s ability to obtain medical treatment.
Mihaylova, who identifies as Bulgarian, says the restrictions imposed during the criminal proceedings prevent her from travelling to Bulgaria or another country for treatment she says is unavailable in North Macedonia.
Before Monday’s hearing, she went further.
“The state has been holding me hostage for almost a year,” Mihaylova told reporters, according to Bulgarian broadcaster bTV.
The allegation has intensified attention on a case unfolding against the backdrop of already strained relations between Sofia and Skopje.
A fatal crash and competing accounts
At the centre of the case is still a road accident.
Mihaylova is charged with a serious road-traffic-safety offence following the October 2025 collision.
The prosecution’s reconstruction has placed responsibility on her, while the defence disputes that account.
That has made expert testimony increasingly important.
At Monday’s hearing, the court continued questioning experts who reconstructed how the collision occurred. Bulgarian National Television said it had obtained a technical reconstruction of the accident, while the defence is seeking consideration of an international expert assessment involving specialists from several countries.
At an earlier hearing, a prosecution-appointed expert said Mihaylova’s vehicle had crossed about 90 centimetres into the opposite lane.
The defence contests the prosecution’s version of events.
The court will ultimately have to determine the cause of the collision and Mihaylova’s criminal responsibility.
The medical dispute
Running parallel to the criminal trial is a second question: whether restrictions imposed on Mihaylova are preventing her from receiving necessary medical care.
Her identity and travel documents were confiscated following the accident, preventing her from leaving North Macedonia.
Mihaylova says her condition has deteriorated and that doctors in Skopje have concluded that the intervention she requires cannot be performed in the country.
Her lawyers have repeatedly sought permission for her to travel for treatment, but those requests have been rejected.
Bulgarian authorities have become involved in trying to arrange treatment. Bulgarian media reported earlier this year that her medical records had been reviewed by specialists in Sofia and that a Bulgarian hospital had indicated it could provide treatment.
Mihaylova’s defence argues that the restrictions should therefore be modified to allow her to travel without undermining the criminal proceedings.
The North Macedonian court has so far maintained the restrictions.
Bulgarian politicians enter the courtroom
The case has attracted attention in Bulgaria partly because Mihaylova holds Bulgarian citizenship and identifies as Bulgarian.
Bulgarian lawmakers have travelled to Kocani to observe proceedings and have publicly raised questions about her treatment.
That political dimension became more visible on Monday when Bulgarian lawmaker Angel Georgiev, chairman of a parliamentary committee dealing with Bulgarians abroad, was denied entry into North Macedonia while travelling to attend the hearing.
Bulgarian media reported the incident extensively.
The circumstances surrounding his refusal of entry were disputed, adding another bilateral element to a case that began with a traffic accident.
Bulgaria’s Foreign Ministry has also previously followed Mihaylova’s case and provided assistance connected with her efforts to obtain treatment.
For Sofia, that creates a consular issue involving one of its citizens.
For North Macedonia, however, Mihaylova is also a North Macedonian citizen facing criminal proceedings before a domestic court.
Claims of political pressure
Mihaylova’s Bulgarian lawyer, Nikolay Dimitrov, has questioned whether political considerations have influenced the handling of the case.
The defence points particularly to the repeated refusal to allow Mihaylova to travel despite the medical documentation it says demonstrates the need for treatment abroad.
No evidence has publicly established that the court’s decisions were motivated by Mihaylova’s Bulgarian citizenship or ethnic identification.
Those allegations therefore remain claims by the defence and some Bulgarian political figures rather than established findings.
That distinction is important in a bilateral relationship in which disputes involving identity can quickly acquire political significance.
Could the case reach Strasbourg?
Mihaylova’s defence has raised the possibility of eventually taking the case to the European Court of Human Rights.
That would be a separate process from determining responsibility for the crash.
Any application to Strasbourg would generally require the relevant domestic remedies to be exhausted first, subject to the admissibility rules of the European human rights court.
There has been no international judicial finding that North Macedonia violated Mihaylova’s rights.
For now, the case involves a defendant who suffered serious injuries and wants to travel abroad for treatment, and a domestic court maintaining restrictions while a criminal trial over a fatal accident continues.
The legal question is therefore becoming intertwined with a politically sensitive one: whether those restrictions remain proportionate given Mihaylova’s medical circumstances.
Another sensitive issue between Sofia and Skopje
That question carries additional weight because of the broader relationship between Bulgaria and North Macedonia.
The neighbours have spent years disputing questions of history, language and identity, as well as the treatment of people in North Macedonia who identify as Bulgarian.
Those disputes have also become entangled with North Macedonia’s efforts to advance its European Union accession negotiations.
Mihaylova’s case is legally separate from those disagreements.
But her dual citizenship, her Bulgarian identity and Sofia’s involvement have made it increasingly difficult to keep the criminal proceedings isolated from the wider bilateral relationship.
Two questions remain distinct.
The first is whether Mihaylova bears criminal responsibility for the October 2025 crash. That is for the Kocani court to determine on the basis of evidence, expert testimony and applicable law.
The second is whether the restrictions imposed while the case proceeds are compatible with her medical needs and whether arrangements can be made for treatment abroad without compromising the trial.
How North Macedonian institutions handle that second question may determine whether Mihaylova’s case remains primarily a fatal road-accident trial — or develops into another dispute between two neighbours whose relations are already burdened by far larger disagreements.