Harsh Kumar Mehta
Consultant In Labour Laws/hr
Korgaonkar K A
Wish you too happy new year in advance and also wish your father healthy life.
Under ESI Scheme, hospitalization with ESI hospitals or ESI wards attached to Govt. or public hospitals or with tie up hospitals, you need not to spent any amount from your pocket. Treatment is free of cost (cash less) with no limit. Hospitalization with private hospitals under extreme emergency / life threatening situation, reimbursement of medical expenses are made by ESIC at actuals with no limit. This reimbursement / expense is not at all linked with your contribution.
19th December 2013 From India, Mumbai
Happy New Year,
The question is whether the treatment in respect of dependant was obtained from ESIC Hospital or dispensary? If yes, then there is no question of any reimbursement since the expenses were to be incurred by the ESIC institutions.
But if the treatment is obtained from any private/even government hospital without recommendations and reference through ESIC dispensary/hospital, then in such situation, the reimbursement of any amount is doubtful.
However, for reimbursement etc. the Insured Person can visit concerned ESI Dispensary and submit the claim on prescribed form and completion of formalities as per procedure laid down.
19th December 2013 From India, Noida
4th April 2019 From India, New Delhi