Facing ESI Claim Denial After Emergency Hospitalization: What Are My Options?

I am working with IND Swift Ltd. My joining date is 20th Feb 2008. I was admitted to GMCH 32 Chandigarh in the emergency ward for five days due to chest pain and heart problems on 14th Oct 2008. When I submitted my papers for a claim, the officials at the ESI Local office told me that I am not entitled to the claim because nine months had not been completed since my joining. Please provide me with detailed information on the ESI claim process for emergency cases.

Maninder Bansal
09872110798

An employee's entitlement to benefits will be due only in the corresponding benefit period. Just as there are two contribution periods, i.e., April to September and October to March, there are two corresponding benefit periods. The benefit period of the contribution period April-Sept is January to June of the following year, and the benefit period of the October-March contribution period is July to December of the following year.

Since your date of joining is February 08, your benefit period will be from January 2009 to June 09. You will not get the benefit period July to December 2008 because your contribution for the contribution period October 2007 to March 2008 was not even 78 days. Normally, for a newly joined member, the benefit period will start roughly about nine months after joining only. That is why your claim was dismissed.

Regards, Madhu.T.K