Lost ESIC Benefits After Salary Increase: How Can I Claim Medical Allowance Now?

I am working for a private limited company. Earlier, I was receiving ESIC benefits for medical expenses. However, now that my salary exceeds 15,000, the benefits have been stopped. Could you please guide me on how to claim the medical allowance or ESIC benefits?

Thank you.

After quitting from ESIC, your employer should cover you under Mediclaim Insurance benefits as per company policy.

Regarding ESIC Benefits

The benefits from ESIC stop after one month if your contributions are not deposited to ESIC for any reason. You should ask the HR Department to cover you under the Mediclaim Insurance Scheme of your organization.

Thanks

I am working for a private limited company. Earlier, I was receiving ESIC benefits for medical expenses. Now, my salary is above 15,000, and the benefits have been stopped. Could you guide me on how to claim the medical allowance/ESI benefits?

I also agree with Mr. Surendra. ESIC coverage can cease either from the 1st of April or 1st of October. During this time, your ESIC deductions will continue, and you remain eligible for all ESIC benefits. Following this, you will be covered under the medical insurance provided by the company, based on the company policy. You can then utilize the insurance coverage and benefits, rather than those provided by ESIC.

I hope this clarifies your query.

I think you have not contacted the HR Department. Please contact your HR Head; he will explain to you that as you have crossed the salary limit of ₹15,000 per month, you are not eligible for ESIC benefits. The company must have covered the Mediclaim policy, so that you can avail the insurance benefits. We hope that you have received a proper answer to your query.

Best Regards,
JAYANT NISAL
Corporate Manager - H.R./I.R. (Consultant)

Dear Shushant, I think you have not contacted the HR Department. Please contact your HR Head; he will explain to you that as you have crossed the salary limit of ₹15,000 per month, you are not eligible for ESIC benefits. The company must have covered the Mediclaim policy so that you can avail the insurance benefit. We hope you have received a proper answer to your query.

Even after cessation of the contribution to ESIC, he is eligible for his following beneficial period. Hence, he can avail the sickness benefits up to the end of the beneficial period. Medical insurance is the company's optional but not mandatory or statutory.

Regards,
JAYANT NISAL
Corporate Manager - H.R./I.R. (as consultant)

Take mediclaim or ask your company to extend mediclaim for those who are not covered under ESI to have uniform benefits.

If the salary is less than 15,000, then only the ESI Act is applicable; otherwise, it is not. If your salary increases, the ESI contribution will also be stopped. Hence, without ESI contribution, how will you be entitled to benefits?

Dear sir,

My mother was sick, and I have treated her in a non-ESI hospital. Can I claim this amount in the ESI office?

I think ESIC has its own procedure for the reimbursement of medical expenses, and perhaps only those expenses incurred through their tied-up hospitals are reimbursed. I believe it would be better if you visited the ESI dispensary to which you are attached and discussed the matter.