How Should We Handle ESIC's Outstanding Bills Affecting Employee Healthcare in Bihar?

Dear All, HR Professionals!

Our organization is a private company in Bihar, India. There are 20 employees enrolled in ESIC from our organization over the past 2 years. One of these beneficiaries is suffering from acute liver disease and is facing a shortage of funds. Consequently, he opted to avail of the ESIC facility at the local dispensary. After diagnosis, the dispensary referred him to its main branch. Upon arrival, the patient discovered that the branch lacked the best medical facilities. Therefore, upon his request, the main branch referred him to IGIMS (Indira Gandhi Institute of Medical Sciences) Hospital.

IGIMS refused to provide medical facilities on the grounds that ESIC has 50 lakh outstanding bills. Following this complaint, all the beneficiaries created a great uproar.

CASE: Next Steps

What should be my next step? Should I take up the matter with a governing body or withdraw the beneficiary names? I am awaiting your suggestions.

Regards,
Ankita
Executive HR

First and foremost is the mismatch between the heading of the post and the subject contents. When I read the heading, I felt that ESIC is not allowing Bihar to grow. However, when I read the post, I found this is an individual case. Therefore, I recommend you post the messages with the right heading.

Other states have grown notwithstanding the pathetic services of ESIC. Bihar can also do that.

The case that you have explained is common. It can happen anywhere in India. ESI's deficiency in service is a known fact to everybody. But the problem with our country is that we do not revamp our laws periodically. Once some law is made, it remains in the statute books for decades notwithstanding the changes in ground reality.

As a solution, I recommend that let this Insured Employee (IE) approach the consumer court. Let a lawyer decide whether to make ESIC the respondent or IGIMS the respondent to his writ petition. In my opinion, IGIMS should be the respondent. If IGIMS has an outstanding amount of Rs 50 lakhs, then they should have proceeded with legal action for recovery. Not providing medical services to a patient is not only a deficiency in service but a crime too.

By now, that IE must have taken treatment from some hospital. Let him submit all the medical bills for scrutiny to the court. Let the consumer court decide on the reimbursement of medical expenses from ESIC or IGIMS. In addition to this, IE can ask for the recovery of legal expenses as well.

Ok...

Dinesh V Divekar

I appreciate your reply, but the problem is that asking the employees to approach the consumer court is not an easy task. This is only one case that I have referred to, and there are many more cases. You know that not all people are as well-educated as we are. So, should I ask each of them to go to the consumer court?

Thanks & Regards,
Ankita