Binoj Varghese
Accounts executive
My mother admitted in a private hospital due to dengue fever. After one week she discharged yesterday.
Whether we can claim reimbursement through ESI dispensary.
Last February I started paying ESI. Somebody told 2 years to be completed to get reimbursement. For dengue fever reimbursement is available? .
Kindly advice whether I can claim through ESI?
Thanking you
Binoj Varghese

From India, undefined
Harsh Kumar Mehta

Consultant in Labour Laws/HR
1. Sir, so far as I understand ESIC has its own referral system for medical treatment. As a general rule treatment and reimbursement from private hospitals is not permissible until and unless such hospitals are on the panel of ESIC and the patient is referred by the authorised ESIC dispensary/Hospital and if there is scope for its reimbursement as per instructions/referral policy of ESIC. In the past, I had uploaded copies of such referral policy in this citeHR, which can be referred to.

2. Whether disease is dengue or of any other category is irrelevant. There are no such conditions of 2 years for reimbursement so far as I understand. Such condition can be in respect of long term diseases. In respect of general illness, only condition appears to be that the insured person or covered employee must be covered under said scheme and must possess Permanent Identity Card/TIC which may also contain the names of his family members for which treatment is to be obtained.

3. Therefore, it will be more better to contact the appropriate ESIS dispensary as well as ESIC Branch Office to which the insured person is attached.

From India, Noida
Aniket Pathak

Sr. Executive HR
No you cant claim even if you do they will reject the claim.
From India, Pune
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