Esi Claim Amount Calculation

ankithagupta
Greetings
Hi senior iam working in a private company for above two year. my ESI dedution amount is 100 or99 or 95 routine .6 month before my father was admitted in hospital for heart problem .i was claim the hospital expense amount in ESI Rs.29,755 .what is the calculation they make .what is claim amount they give for me.
Thanks in advance
\"\"\"Wish u all advance Happy New year\"
korgaonkar k a
Dear Ankithagupta,
Wish you too happy new year in advance and also wish your father healthy life.
Under ESI Scheme, hospitalization with ESI hospitals or ESI wards attached to Govt. or public hospitals or with tie up hospitals, you need not to spent any amount from your pocket. Treatment is free of cost (cash less) with no limit. Hospitalization with private hospitals under extreme emergency / life threatening situation, reimbursement of medical expenses are made by ESIC at actuals with no limit. This reimbursement / expense is not at all linked with your contribution.
Harsh Kumar Mehta
Dear Member(s),
Happy New Year,
The question is whether the treatment in respect of dependant was obtained from ESIC Hospital or dispensary? If yes, then there is no question of any reimbursement since the expenses were to be incurred by the ESIC institutions.
But if the treatment is obtained from any private/even government hospital without recommendations and reference through ESIC dispensary/hospital, then in such situation, the reimbursement of any amount is doubtful.
However, for reimbursement etc. the Insured Person can visit concerned ESI Dispensary and submit the claim on prescribed form and completion of formalities as per procedure laid down.
goutam-sarkar
Sir my father was seafaring diabetes .. and also take insulin for that . Sir Please ensure that is its possible to treatment for that our whole family are covered by ESIC . also told me if its necessary to take insulin weekly wise than how to get the insulin injection from ESIC .
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