Navigating ESIC: How Do I Settle an Emergency Hospital Claim for an Employee?

ganesh_cool
Please guide me on how I can settle the claim of an employee who was admitted to a private hospital in an emergency and is covered under ESIC.

Thanks & Regards,
Ganesh.
Alphonse
First of all, please check whether he registered his card in the ESI dispensary. (Many ESI-covered employees have not registered their card in the local dispensary and are facing a lot of problems.) Inform the incident or accident to the ESI Dispensary Medical doctor through a letter stating the need for admission to private hospitals. After discharge from the private hospital, the IP has to report to the dispensary. At that time, submit the admission and discharge summary collected from the hospital to the ESI authority and have them converted into ESI Records.

Collect all the documents (Admission and Discharge certificate, medical records, Expenditure medical bills statements, Scanning records, etc.) from the private hospital and submit them to the ESI Local office. If required, the medical referee will come and investigate the case, and they will determine the further course of action from their side.

Regards,
Alphonse
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