Harsh Kumar Mehta
Consultant In Labour Laws/hr
Kalpnath1433
Accounts

An employee appointed on 01.12.2014 and registered on 18.01.2015 on ESIC Portal . He was suddenly gone heavy headache and went private hospital since not having TIC from where he has been reffered to AIIMS .
Is he eligible to take ESI benefit for treatment expense which will incurred in AIIMS by way advance for medical expenses directly in the name of AIIMS / reimbusement . Kindly suggest since he is a poor employee and can not afford such treatment.
8th February 2015 From India, Delhi
1. Sir, ESIC has their own referral policy and for this purpose, the insured person should have appeared before Insurance Medical Officer(Doctor) of concerned ESI Dispensary to which he was attached. As mentioned in above remarks, the employee was not having ESI Identity Card/TIC. Therefore, it is doubtful whether ESI will make any reimbursement.
2. Further in cases requiring super speciality treatment, ESIC has laid down some eligibility conditions. In my opinion, the said employee or his employer may contact ESI Dispensary and discuss the issue.
8th February 2015 From India, Noida
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