1. Sir, I may submit that so far as payment of cash benefit namely-Maternity Benefit(MB) for the entitled period of such leaves is concerned, ESIC generally allows payment of such cash benefit (MB) as an ALTERNATIVE EVIDENCE (AE) case depending upon the facts of each case and also depending on entitlement of insured woman during the relevant benefit period. Such powers, so far as I know, are vested with the Manager/ Branch Officer and concerned senior officer at Divisional/Regional Office of ESIC. Therefore, even if delivery is taken place in a private hospital, the period of maternity leave is generally sanctioned as an alternative case and paid subject to confirmation by the employer regarding absentation from work for the period of such claims. Therefore, in my opinion, the Insured Woman/claimant can contact the concerned office as mentioned above alongwith original certification of delivery, birth of child / fitness certificate etc. issued by such private hospital. If medical leave is still continuing she can visit her ESIS dispensary and get relevant certificate, if allowed by Doctor Incharge.
2. However, so far as reimbursement of medical expenses incurred in private hospital is concerned, such expenses if referral policy not followed are not re-imbursed. However, there is provision of reimbursement of Rs. 5000/- in confinement cases incurred at such places where there is no ESIS facilities ( viz. non-implemented areas) ( please see Rule 56-A of ESI (Central) Rules, 1950).