Having own hospital is not the sole parameter for granting exemption from coverage of ESI for the establishment. If that is so, the private hospitals will not come under the purview of ESI Act. In order to get exemption from coverage of ESI the employer has to establish that his employees are in receipt of facilities and benefits better than that offered (just offered by ESIC and not necessarily be given by ESIC is enough!!) by ESIC in terms of medical, sickness, maternity, old age benefits, dependants' benefits etc. In many cases leave on the ground of prolonged illness, extension of medical facilities after retirement, dependent benefits etc are a few areas where the private organisations including hospitals fail to meet whereas there are lot of public sector companies which provide for these benefits and have taken exemption from ESI.
Medi Claim policies do not guarantee any benefit but do work with a lot of hidden parameters for admitting claims. I think only ESI will give free medical assistance (cashless) to an employee, his family members and dependents from his date of joining without going back to the history of illness and the age of the member or dependents. Medi claim policies will not cover existing diseases and your parents of a certain age but for ESI there is no such bar. You can not imagine a cashless surgery under medi calim if you have not paid premia for a certain period unless it is a tailor made one costing a handsome amount by way of premium.
However, you should not expect the same care and hospitality from the ESI Corporation as are highlighted in their website or publicity posters, perhaps due to administrative flops.
Madhu.T.K