Harsh Kumar Mehta
Consultant In Labour Laws/hr
Hr Manager

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Hi dears,
Before six month, in our company there were occurred an accident in our company and employee is covered under the ESIC Act.
In accident, his right hand was completely break and fractured and we have to admit him the private hospital which is locate to near of our company. that employee has expense of 50000 rs. but when we put his claim with the complete documents in ESIC(Surat) for Said that , in Only Heart attack case, the ESIC would provide the Remuneration.
That employees is belong from very poor family and so how can we remunerate this amount to that employee?

From India, Surat
1. Sir, I think, in order to claim benefits from ESIC. you should have submitted Accident Report to the approriate Branch Office of ESIC to which the said Insured Person was attached and followed and pursed the case with appropriate authorities.
2. Even if due to emergency the said insured person was admitted in a hospital, whether immediately after admission, the matter was informed to the appropriate ESI dispensary or Hospital to which the said insured person was attached ?
3. I think, ESIC has its own referral or reimbursement policy. Kindly examine the same and if you consider appropriate, concerned employee can make appeal or representation to the higher authorities. ESIC is justified in rejection of the case if the compliance of its policies are not made by the insured persons or their dependents.

From India, Noida
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