Can I Claim ESIC Reimbursement for My Father's Private Hospital Treatment in Pune?

I have a query regarding ESIC. I am a worker who took treatment for my father for hernia and prostate gland issues from a private hospital in Pune last week without referring to ESIC. This was due to my ignorance of ESI benefits. He is listed in ESIC, and his medical expenses exceed his paying capacity.

Now, I want to claim his medical expenses from the ESI department as we have been paying his contributions. Is it possible to claim his expenses from ESIC in this case? If yes, then what is the complete procedure for this?

Immediately visit your ESIC panel doctor and obtain a referral. Only on his referral will AMO be in a position to consider the reimbursement.

As you said, he is hospitalized and cannot pay bills. So, you have to visit the panel doctor with your TIC, your and his Aadhar card, hospitalization documents, and state that it was done in an emergency and you did not have the scope to get in touch with ESIC. By any means, get his referral on your hospitalization documents; he will sign it and send you to AMO. AMO will check the documents and hand over a form (not available online or to the public) by putting his signature on top for onward submission to the hospital where he is admitted. They will fill the form and return it in a sealed envelope (confidential), and you have to return the same to AMO. After receiving the same, AMO will decide whether he will settle the bills directly or the reimbursement procedure.

Everything is possible until the patient is discharged because nobody will make an entry in the backdate, neither the panel doctor, AMO, nor the hospital, so do it immediately.

If the hospital is registered in ESIC panel list, direct payment is possible, and the hospital will submit bills to ESIC, not the patient, provided the form reaches them within time.

I have a query regarding ESIC. I am the worker who took treatment for my mother's Throat tones from a private hospital in Jaipur without referring to ESIC two days ago. This was due to my ignorance towards ESI benefits, and he is listed in ESIC, and his medical expenses exceed his paying capacity.

Now, I want to claim his medical expenses from the ESI department as we are paying his contribution. Is it possible to claim his expenses from ESIC in this case? If yes, what is the complete procedure for this?