Claims for Treatment at Private Hospital by ESI-covered Employee

Harsh@2309
In My Company One Worker In My Company One Worker Took Treatment Of multiple sclerosis From A Private Hospital Without Referring ESIC In August 2017 Because Of His Ignorance Towards ESI Benefits and He Is Listed In ESIC And now how to write request letter to esic by employer
Harsh@2309
In My Company One Worker In My Company One Worker Took Treatment Of multiple sclerosis From A Private Hospital Without Referring ESIC In August 2017 Because Of His Ignorance Towards ESI Benefits and He Is Listed In ESIC And now how to write request letter to esic by employer for late submission letter.
Glidor
employer has no role in such case, he has to visit the AMO of his regional ESIC zone and clear the situation to him that in what circumstances he had to get treatment without informing ESIC, he will provide a proforma to be submitted along with few forms to be signed by the hospitals and doctors where he availed treatment , thereafter he would be able to submit the bills for dispensing off ....... hard to say now that it would be admissible or not, as ESIC rules needs to get informed within 72 hours of such incident
Significantly, i hope this post is done by employer representative, so when the employee did not attended for more than 3 days ........... its deemed that employer was aware of his medical status, and HR had to avice him or his family members to get in touch with ESIC dispensary with details, from where they had to refer the patienent to any nominated private clinic or nursing home at zero cost payable ........ so it is part of HR negligence
Glidor
as per the query posted above, it appears that hospitalization, treatment and even absent from work was also not in knowledge of the employer, where as the employee has to submit ESIC medical leave certificate if leave is more than 3 days, and employer can not re-employ the person without a fitness certificate from his designated ESIC panel doctor or RMO ESIC, as the establishment is covered under ESIC act.
so how the employer would be in position to help the employee in such case?
manojkamble
Hi,
As per the ESIC act employee has to take the medical benefits only from the ESIC dispensaries or hospitals. In case of emergency if it is proven or in case of non availability of ESIC facility in specific region employee may take the medication / treatment from the private hospital with prior approval from ESIC.(in case of emergency / accident employee can take the benefit from the nearest private hospital and can claim later on from ESIC which subject to ESIC approval).
manish-bairagi1
Dear sir my name is manish my wife delivery is emergency so going to private hospital without esi refer so how claim bill
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