Medical Bill Reimbursement Form Esic - PDF Download - CiteHR
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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

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


Attached Files
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File Type: pdf DENGUE FEVER REMEDY.pdf (91.0 KB, 8845 views)
File Type: pdf ESIC Form-Medical Expense Reimbursement (1).pdf (1.47 MB, 13915 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

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.

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


Attached Files
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File Type: doc ESIC-FORM-105.doc (46.0 KB, 8539 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


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

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

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

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

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