22nd December 2015 From India, Salem
Mediclaim policy may be of different types . It may cover employee only or may cover dependents also.
Rightly said by Umakant Sir that the benefit would be as per policy you opted and I believe your employer opted for coverage of employees only. To cover dependents also employer would have to pay more premium.
But on the same day of accident you could have at least informed the nearest ESI dispensary about the accidents and got some hospitals recommended by them in your area as no ESI hospitals were there or you could have asked your employer to inform ESI dispensary.
Remember 6.5% of your gross goes to ESIC so that you could get the benefit. On meeting accidents everybody should visit nearest ESI dispensary to inform them and to get the treatment. In case the ESI dispensary or ESI authorised hospitals fails to cure permanently, they may refer your case to the other hospitals and in that case they reimburse the expenses at the maximum extent as per ESI act.
In your case also, as no ESIC hospitals were there, showing the urgency/criticality of the accidents to the ESI dispensary personnel, you could have got outside hospitals recommend by them in your place and could have raised bill for reimbursement.
23rd December 2015 From India, Delhi