Pbskumar2006
Sr.manager-hr
Ramesan.pt
Group Compliance Manager
Glidor
Hr Consultant
Pulipaka_ramarao
Manager - Hr & Ir
DHANESWAR SAHOO
Marketing Executive
@kundar1985
Assistant Manager Hr
Sudhirmhambare
Hr Excutive
Sathyasaravan
Hr Manager
Subroto Bera
Service Engineer
Rajashekar.006
Service Engineer
Vijaydesale01
Computer Instructor
Hazar189
Guwahati
Deepu22deepakt
Software Engineer
+6 Others

Thread Started by #deepak_2006

Dear Seniors,
Greetings for the day,
I have a query regarding ESIC, In my company one worker took treatment of dengu fever from a private hospital without referring ESIC in October, because of his ignorance towards ESI benefits, and he is listed in ESIC. and his medical expenses are more than his paying capacity.
Now we want claim his medical expenses form ESI department as we are paying his contribution. is it possible to claim his expenses from ESIC in this case if yes than what is the complete procedure for this?
Thank you
Warm Regards
Deepak Agarwal
5th November 2013 From India
Dear Deepak ji,
Please see the attachment format of Medical Reimbursement from ESI where out patient treatment.
Also please read the collected article on "Dengu Fever" simple medical treatment.
Regards,
PBS KUMAR
5th November 2013 From India, Kakinada

Attached Files
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File Type: pdf DENGUE FEVER REMEDY.pdf (91.0 KB, 8728 views)
File Type: pdf ESIC Form-Medical Expense Reimbursement (1).pdf (1.47 MB, 13081 views)

Dear Friends,
We are in fast food services. We are having restaurants all over India.One of my employee located at Ranchi resturants had meet with an robbery while going back to home after night shift duty and he got seriously injured by knife by the dacoits on his head and neck. He was hospitalized at Raj Hospital and research centre to ICU as his condition was serious.
During the course of his treatment company has incurred cost of Rs.12000/- amount.
After the incident we have submitted accident report and sent an employee to ESI Branch office as well as letter of intimation to Administrative Medical officers, ESIC, Rranchi main office.
Then after we did not get any support from ESIC.
Can you pls guide me how to reimburse the same from ESIC. I am having Reimbursement Form of ESI.
Thanking You
Sunetra Mukherjee
8th November 2013 From India, Delhi
#Anonymous
On continuation previous case of Ranchi incident......
The private hospital was under ESIC medical superspeciality hospital of Ranchi. We had approached them and tried to convince but all efforts were in vain.
8th November 2013 From India, Delhi
Dear Friends,
While sending the ESI covered employee on official works to out of station. Along with PEHACHAN CARD it is advisable to carry ESI FORM - 105 for utilising the ESI benefits if he suffered any illness or accidents etc. The copy of the Form - 105 is attached.
Regards,
PBS KUMAR
8th November 2013 From India, Kakinada

Attached Files
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File Type: doc ESIC-FORM-105.doc (46.0 KB, 8115 views)

Refer to your query, pl note the following to proceed further for Medical Reimbursement from ESIC.

1. To obtain Discharge Summary or Discharge card where the IP take treatment from Private Hospital.

2. To obtain All Bills including Cost of operation, Doctor\'s Charges, Anastetian charges, Nursing Charges, Room service Charges, ICU Charges, Cost of Medicines, Tests examination charges with supporting bills etc., from the hospital.

3. Obtain Emergency Certificate from the treatment hospital.

4. Essentiality Certificate from the treatment hospital

5. No stock certificate from ESIC to purchase from out side for treatment.

6. Eligibility certificate from ESIC

7. Advanced Stamped Receipt for payment.

8. Bank A/c Details

9. Documents to be submitted as per Check list issued by ESIC for Reimbursement.

10. ESIC Pehchan Card/Permanent ID Card copy

11. Scrutiny Certificate.

12. All Bills to be certified by Treatment doctor and Medical Officer of ESI Hospital where the IP attached along with paid by me by the IP.

13. Letter from IP for submission of Bills for MR.

14. Letter forward from the Employer by the IP

15. Post Card for intimation from ESIC.

To submit the same along with above documents to DIMS office for MR by the IP.

Thanks & Regards,

V R RAO PULIPAKA


8th November 2013 From India, Chennai
yes this is possible to claim the all medical bill from ESIC
please make sure that you have to fulfill all the formalities like
1. OPD slip from ESIC medical Hosiptal
2.ESIC Card of Employee
3. Reimbursement from and duly sign by medical officer of ESIC with stamp
4. All the bill must sign by who treated the paitent
NOBAL KISHOR
8th November 2013 From India, Shimla
Dear All,
Thank you for your suggestions,
It will help me a lot.
When I visited ESI dispensary they say reimbursement is not possible because IP is not referred by the ESI medical officer from his attached dispensary to the private doctor. is there any clause like this in bill reimbursements. Should IP first take reference from medical Officer?
Thank You
Warm Regards
Deepak Agarwal
8th November 2013 From India
Hi,
I cannot exactly quote the clause, but I understand it from the ESI Officials that prior intimation is required. This is to avoid misuse of super specialty treatment especially when treatment facilities are available in ESI hospitals. The concept is if advanced treatment is not available with ESI hospitals, we can take treatment in private hospitals on their reference.
But this is not strictly required in the case of accidents and critical illnesses.
Regards
9th November 2013 From India, Coimbatore
Hi, our one of employee working Bangalore location mother is staying Assam state under esi act how she can go for treatment its outstation treatment , Kindly help me out procedure & if any formats send it to me
27th July 2015 From India, undefined
#Anonymous
Dear Seniors,
Greetings For The Day,
In My Company One Worker In My Company One Worker Took Treatment Of multiple sclerosis From A Private Hospital Without Referring ESIC In February 2016, Because Of His Ignorance Towards ESI Benefits and He Is Listed In ESIC. And His Medical Expenses Are More Than His Paying Capacity.
Now We Want Claim His Medical Expenses Form ESI Department As We Are Paying His Contribution. Is It Possible To Claim His Expenses From ESIC In This Case If Yes Than What Is The Complete Procedure For This?
Thank You
Warm Regards,
Basavaraju
19th March 2016 From India, Bengaluru
Dear sir, Hope u r fne. Every employee is eligible for reimbursment throught ESI. I will tel you the procedures hope u wil like
Insured person has to registered his ESI card in his ESI branch office
In ESI speciality treatment the ESI has been tie up with the private hopitals. if your insured person has got treatment under the ESI tie up hospital the medical expenses can be reimbursed .
Incase if he is already got treatment in private hopital he has to submit all his medical expenses with the enclosed of Discharge slip to the ESI. After submitting to ESI office they will examine and enquire the details from the hospital. Approximately 90% of the bills will be reimbursed. Hope it will be useful
Thank you
19th March 2016 From Kazakhstan, Aktau
dear friends

please help me to write a request letter to the esic manager for correction of change in the name of witness name, we entered witness one of the witness name wrongly who were left from our company one month before the accident
21st June 2016 From India, Thrissur
Hello Sir/madam,
This is to bring to your kind notice i subroto bera would like to reapply for a new card as the previous card was linked to my ex-Spouse.
what is the producer to link my new card to my current spouse.
please let me know how to move
21st September 2016 From India, Kolkata
Pls send the esi 7b form pls arjent Pls send the this mail id Rajasheka.006@gmail.com
6th April 2017 From India, Chityal
form 7B is available at employer portal duly filled by ESIC,
after login in portal, the employer has to select print TIC/E-Pahchan, and at top of it, there is link "medical acceptance card (7b), which should be downloaded and used
7th April 2017
Pls share Esic New circular for make Challan & payment on or before 15th of every month. Thanks, Vinod.
21st April 2017 From India, Kalyan
ESIC is very frustating. I am referring the case of DEHRADUN. For whatever illness or complications you go there, the doctor will always give you painkillers or such medicines, even if you are suffering from cancer. If you are lucky and he refers to you to a specialist, there are so many formalities that you will wish you had never came here.
So most of the ESI card holders never go to ESI dispensary. For one, if you are working some far away places, there is only one or two dispensaries, you will have to take leave from your work, which the employer grudingly allows. Secondly there are various formalities to fulfill.
Why don't the Govt introduce some bills that if a person doesn't go to an ESI dispensary, his accumulated money be returned to him so that at least he could go to a private hospital of his choice. Or a member may go to a private doctor and produce his bills to claim money - since it is his money that he is asking for.
27th April 2017 From India, Lucknow
You are right Mr. Debendra, ESIC always takes care of it's revenue not takes care of the patients/IPs. if any employee goes there, he has to face many formalities and after all if any IP's Family staying outstation also not able to get this benefit due to various documentation and ESI official's lengthy advice for fulfilling their formalities. always standing in Que , if medicine not available in ESI, how far the distance would be but the patient has to search for medicine then has to come to Dispensary to report for same. IP suffering from serious disease if want to reach good medical treatment will not be referred by ESI. how far the distance may be but they would send the patient to their linked medical if possible and that is also after so long days suffered.

However all Branch officials are not helpful. branch office under central government and dispensary under state government. IP's contribution paid to central government not to state government. For treatment when IP goes to dispensary, there is some different rules regulation shown by dispensary and branch office.

I think government should introduce something like if any employee, who is unsatisfied from ESI facility regarding treatment/medicine will not pay any contribution to ESIC.

Thanks
20th May 2017 From United States, Cambridge
dear team,
one employee has 5 lakh medical expenses in medical or doctor fees . how many % amount reimbursement this case in ESIC.
25th July 2017 From India, Pune
Most of the time when insured person or employer fails to intimate the respective ESI dispensary about joining of insured person in private hospital then the claim will get rejected.
9th August 2017 From India, Hyderabad
HI
Above topic , i have one clarification one of our employee also going same issues. but same procedure followed. claims bills rejected due to employee dosen't hold the icic bank a/c.
please let me know is it complusory they have issued reimbursement amount to only icic account?
Regards
Sheena
24th August 2017 From India, Bengaluru
hiii everyone..
i have an questions regarding maternity benefit for wife of IP.
1)can she take treatment in private hospital?
2)what is the process to claim for esic after taking treatment in private hospital?
3)how much contribution of company in total bill payment?
4th September 2017 From India, Pune
Dear Seniors
i have a query regarding ESIC medical reimbursement. I have an employee who was covered under esic. he admitted his mother to an esic tie-up hospital in emergency situation. He informed the ESI dispensary after 3 days. The esic dispensary gave him the referral letter to the tie-up hospital where his mother was admitted. But the irony was that the tie-up hospital refuse to accept the referral letter. he was told by hospital authority that they had stopped taking esic patients as esic is delaying/not paying their payments for months. he had no other choice but to pay the bills himself. Now is there any way to claim reimbursement from esi.If yes whats the complete procedure to claim it.
20th September 2017 From India, Guwahati
Any 1 please attach essentially certificate for reimbursement for esi
27th September 2017 From India, Ernakulam
Dear Sir/madam
Greetings for the day,
I have a query regarding ESIC, I am the worker took treatment for my father of PSORIASIS and MTX TOXICITY febrile neutropenia from a PGI hospital in Chandigarh without referring ESIC in Febuarary, because of my ignorance towards ESI benefits, and he is listed in ESIC. and his medical expenses are more than his paying capacity.
Now I want claim his medical expenses form ESI department as we are paying his contribution. is it possible to claim his expenses from ESIC in this case if yes than what is the complete procedure for this?
Thank you
Warm Regards
ROHTASH
7th March 2018 From India
Hi Friends,
I am working as HR at an Apparel mall, One of my employee has undergone a minor surgery & wishes to claim the amount under ESIC. What is the process for the same. Which form is to be proceeded for the same.
Regards
Preeti
16th January 2019 From India, Bengaluru
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