Is My Company Liable for Hospital Bills During Probation? Seeking Legal Advice and Suggestions

Hello All, I need some advice regarding payment during my hospitalization. In my offer letter, HR mentioned that there would be an additional contribution from the company for PF and family health insurance. I met with an accident and was hospitalized during my probation period. After my accident, HR responded that we do not provide health insurance during the probation period and that I was informed about this at the time of joining. However, as far as I remember, such a thing was not communicated orally to me. Additionally, the company did not have any policy document or written evidence to support this.

Now, is there a legal or any other way that the company is liable to pay my bills as HR refused to pay the bills on behalf of the company? Any suggestions are welcome.

First of all, go through your appointment letter and find out what exactly is mentioned in your terms and conditions of employment. From that, you can determine whether you are eligible for this benefit or not. Secondly, if it doesn't help you, then go through the employee handbook or HR manual if they have provided any and try to find out the related matter in that. Verbal communication and written documentation are two separate matters. You cannot expect much from the company just by believing what they say.

If you find anything that supports your case, then you can take the paper with you and ask your HR for the same. If no results come, then ask some senior people to look into it. All of this depends on the company's policy.

Thanks

As mentioned by Kalpana, you need to check whether it is specifically mentioned in your HR Manual, offer letter, appointment letter, or any other document provided by HR that you will receive medical reimbursement if any accidents occur. Only then are they liable to reimburse you for medical expenses.

Hello Kalpana and Divya, Following are the clarifications for the same:

1. First of all, the company did not provide me with any handbook; however, they mentioned providing the handbook at the time of joining.

2. In the appointment letter, HR mentioned "Additional contribution from the company for PF and family health insurance."

3. They did not have any written policy or any other evidence that they would not provide health insurance during the probation period.

4. I had an accident during office hours when I went for lunch, met with an accident, and fractured my thigh bone. After recovery, I raised the issue with the person I was reporting to and with HR. HR clearly told me that the company would not reimburse me, and I don't think the senior management will be in favor as it would incur a major financial loss for the company.

Kindly suggest an alternative approach.

Regards

Health Insurance and PF During Probation

If the PF is getting deducted during probation, it can become an extension of logic to provide Health Insurance as well. Though a major difference here is that while PF is a statutory right/obligation between both parties respectively, Health Insurance is a benefit.

In any case, if the name has not been endorsed with the insurance company, I do not think you will get the reimbursement from the insurer. Perhaps from the organization is where you can get it from. But then do have a strong logic other than pointing towards what did or did not get verbally communicated to you at the time of joining.

Hope this helps.

Regards,
Deepak

Hey Pareek, no issue if they have not given you any handbook; normally, some companies don't feel the importance of it. Regarding health insurance, have they provided you with any health insurance card or the number of any health insurance agency? If not, then you are not covered under any insurance. Please ask other employees who are old employees of your organization what the process is for these kinds of things in the organization to date. Does anyone have coverage under any insurance agency or have taken any benefits like this during their job duration?

If the accident happened within the office premises or outside, normally, if it happens within the premises, then it's totally the liability of the employer to get the treatment done.

Seniors, please guide on how to take it further.

Thanks

Dear Pareek Prashant, as pointed out by members, if there is no clear statement made in your offer of appointment, you will not be able to seek a claim. Another fact that arises from your statement is that you have suffered an accident that has led to a fracture. However, medical insurance does not cover fractures unless there was a hospitalization for 24 hours. The terms and conditions of the insurance policy taken by your employer will be the deciding factor.

Regards,
M.V. Kannan