Difference Between Group Mediclaim And WC - CiteHR
Mohanasundaram_Subramani
Sr Officer Human Services
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Dear Senior, Can any one describe the benefit employee will get under mediclaim and WC policy...? Like In WC can employee will get the benefit for injury..? Regards, Sunil Prajapati
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Dear Sunil,

The Workmen's Compensation Act, 1923 (Now known as Employee's Compensation Act) provides Insurance for legal liability coverage for compensation to the employees for bodily injury or death caused due to accidents / occupational diseases arising out of and in course of employment where the employees are not eligible to be covered under ESI Act.

Mediclaim Insurance is a hospitalisation benefit policy offered by both Public & Private sector general insurance companies. The policy takes care of medical expenses incurred for Hospitalisation/Domiciliary treatment of the insured in case of sudden illness. The Mediclaim Policy  stipulates that a claim is admissible when the insured is admitted in a Hospital/Nursing Home for a minimum period of 24 hours for the treatment.

The coverage of accidental injuries can be covered by extra premium or separate workmen compensation policy can be obtained for accidental injuries caused in and out of employment.

BS Kalsi,

Member since August, 2011
Thank You Sir,
for your reply. In WC policy if an employee is in the course of employment like if he travel from staff bus or if he is on out duty from company premises for company work so he will get the benefit of medical reimbursement..? Second one is can employee claim his minor injury claim in like fingure cutting while doing work..etc..WC..? or we have to take medical policy for the same.Can we take ESIC with WC policy if employer suggest..?
please suggest..
Regards,
Sunil Prajapati
Dear Sunil,
I have already mentioned to you that Employee's Compensation Act,1923 is applicable where the employees are not eligible to be covered under ESI Act. Coverage of employees under the ESI Act is the BEST OPTION, if the establishment is meeting the criteria and it falls in the implemented area.The ESI Act provides the following benefits:-
1.Medical Benefit
2.Sickness Benefit (SB)
i) Temporary Sickness Benefit
ii) Extended sickness Benefit (ESB)
iii) Enhanced sickness Benefit
3.Maternity Benefit
4.Disablement Benefit
i. Temporary disablement benefit (TDB)
ii. Permanent disablement benefit (PDB)
5. Dependants’ Benefit (DB)
6.Funeral Expenses
Others:
(a) Rehabilitation allowance
(b) Vocational Rehabilitation
(c) Medical Benefit to Retired persons
BS Kalsi,
Member since August, 2011
Dear seniors,can any one clear that one of my friend is willing to operate security manpower supply contract with less than 10 employees at present and he needs to know the process and procedure to take those contract.
Please give suggest in this regards.
Thanks.
sm mohan
Dear sir,
one of our employee working in steel plant since 12 years, due to sound pollution, he has lost nero sensor of both ears ( hear loss) up TO 50 db, can he eligible to get benefit from Mediclaim policy, he covered under Mediclaim policy, as per the ear loss, he is not going to admit in nursing home for 24 hours, he will take treatment on OPD basis only, Now, he require ear aids, the amount of ear aids can be reimbursed by insurance company under mediclaim policy ?
Jahangir Hospet
Please meet commissioner for employee compensation having jurisdiction over the factory or ESI regional office with all reports & data. The factory inspector / ESI insprector may ask for his earlier medical records from the factory.
On the face of it looks like a valid case for entitlement of compensation.
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