New to HR: How Do ESIC Claims Work for Major Accidents and Private Hospital Treatments?

Hello Seniors, I am new to this site and also to my HR-Admin post in my company. With some knowledge about the HR field, I was able to secure this job, but I need to learn more about HR activities. Please assist me in this regard.

ESIC Claims for Major Accidents

1) How much can we claim through ESIC for any major accidents?

Treatment at Private Hospitals

2) Can we seek treatment at any private hospital, and can we claim the expenses from ESIC?

Please let me know if anyone can provide guidance on these matters. Thank you.

Dear friend,
01. It depends on the nature of the accident only. The ESI hospital itself provides treatment, and the corporation will only provide leave wages. In some cases, we can submit all the original bills and payment receipts to claim the expenditure. However, the medical referee will investigate the case and ask us to appear in front of him along with a witness, and they will sanction the amount. But they will not give the full amount.

02. The ESI corporation itself publishes the approved hospitals list on its website. You can find out the names of the hospitals. Otherwise, in an emergency, you can admit to the nearest hospital and inform or register the case immediately with the dispensary and the local office for further claims.

Regards,
Alphonse
[Phone Number Removed For Privacy Reasons]

Dear Sir, Thank you for your kind response. Actually, we are contractors. A few of our employees who are under the ESIC policy are working at our Bangalore site without ESI cards due to not submitting family photos. So far, all our ESI activities have been managed through an outside auditor only. However, from now on, I will need to undertake all of this myself.

Obtaining ESI Cards in Bangalore

My question is, "Is there any other way to obtain ESI cards for them in Bangalore? Because I cannot bring them all to our office for family photos (even my auditor told me there is no way to process it in Bangalore). Please, I need your valid suggestion here.

Regards

What Mr. Alphones said is right. For your information, one of my workers met with a road accident after logging out from the shift due to an emergency. As an HR & IR professional, I went to the local hospital to understand his situation. There was no better equipment in the local hospital, so I decided to send him to Chennai GH. After that, I wrote a letter to ESIC about his situation for a medical claim. However, in the local dispensary, they clearly stated that they would take care of the medical claim if the person comes to them, and they refused to accept the letter.

Following that, we went to talk with the dispensary office and convinced them about the situation. Eventually, they accepted the letter. So, the moral is, if the accident results in heavy injuries and the person is admitted to any government local hospital, ESIC will take care of his medical claim. If the person goes to a private hospital, they won't.

Sir, this is Riyas from Chennai, and I have been working for a domestic BPO company. My query is about my salary. I am getting a salary of about 9000, but my company is deducting Rs. 400 for ESI. Can anyone please guide me on what I can do?