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pareek.prashant
Hello All,
I need some advise regarding payment during my hospitalization. In my offer letter HR mentioned that Additional contribution from company for PF and family health insurance. I met with an accident and hospitalized during my probation period. After my accident HR responded that we do not provide health insurance during probation period and you were intimated regarding the same at the time of joining. However as fas as i remember such thing was not communicated orally to me. Also company did not have any policy document or written evidence for the same. Now is their legal or any other way that company is liable to pay me the bills as HR refused to pay the bills on behalf of company. Any kind of suggestions are welcome.

From India, Hyderabad
Kalpnayadav
5

Hey Pareek,
1st of all go thru ur appointmnt lettr and find out what xactly is mentioned in ur terms and conditions of employment. from that u can find out whether u r eligible 4 dis benefit or not. Secondly if it doesn't help u, den go thru the employee handbook or HR manual if they have provided any and try to find out the related matter in that. Telling something verbally and getting something on papers are 2 separate matters. u cant expect much from company by just believing what they say .
If you will find anything which supports ur case, den u can take the paper wid u n can ask ur HR for the same. And if no result come then ask some senior people 2 look into.This all depend upon the policy of company.
Thanks

From India, Gurgaon
divs.155
Dear Prateek,
As mentioned by Kalpana, you need to check whether it is particularly mentioned in your HR Manual or the offer letter or the appointment letter or any other document provided by the HR that you will get the medical reimbursement, if any accident takes place. Then only they are liable to reimburse you the medical expenses.

From India, Mumbai
pareek.prashant
Hello Kalpana and divya,
Following are the clarification for the same:
1. First of all company did not provide me any hand book however they mentioned to provide handbook at the time of joining.
2. In appointment letter HR mentioned "Additional contribution from company for PF and family health insurance"
3. They were not having any written policy or any other evidence that they will not provide health insurance during probation period.
4. I was having accident during office time only as i went for lunch, met with accident and got fracture in thigh bone. After recovery i raise the issue to whom i was reporting and to HR. HR told me clearly that company will not reimburse and i don`t think senior management will give me favor as it will be major financial loss for company.
Kindly suggest me some alternative approch

From India, Hyderabad
deepakmendiratta
5

If the PF is getting deducted during probation, it can become an extension of logic to provide Health Insurance as well.
Though a major difference here is that while PF is a statutory right / obligation between both parties respectively, Health Insurance is a benefit.
In any case, if the name has not been endorsed with the insurance company, I do not think you will get the reimbursement from the insurer. Perhaps from the organisation is where you can get it from. But then do have a strong logic other than pointing towards what did or did not get verbally communicated to you at the time of joining.
Hope this helps.
Regards, Deepak

From India, New Delhi
Kalpnayadav
5

Hey Pareek,
No issue if they have not given u any hand book, normally some company dont feel the importance of it.
Regarding the health insurance, do they have provided u any health insurance card or number of any health insurance agency. if not then u are not covered under any insurance. Do ask other employees who are old employees of ur org, that what is the process for this kind of things in the org till date. does anyone is covered under any insurance agency or have taken any benefit lke this during their job duration.
and that accident is happened within the office premises or outside. Normally if it happens within the premises then its totally d liability of employer to get d treatment done.
Rest seniors plz guide how 2 tk it further
Thanks

From India, Gurgaon
kannanmv
256

Dear Pareek Prashant,
As pointed out by members if there is no clear statement made in your offer of appointment you will not be able to seek a claim. Yet another fact that arises from your statement that you have suffered an accident that has led to a fracture. But the fact is medical insurance does not cover fracture unless there was a hospitalisation for 24 hours. The terms and condition of the insurance policy taken by your employer will be the deciding factor.
M.V.KANNAN

From India, Madras
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