Dear Sarfaraz-Ahmad,
Check hospital tie-up with ESI Corporation
Find out first whether the hospital in Kolkata where your mother is admitted has a tie-up with ESI Corporation. If the hospital is in a tie-up, you need to provide the hospital with your insurance number and ID proof of your mother. If Aadhar is linked to your insurance number, then submit Aadhar. You need not pay any charges to the hospital.
Procedure if hospital is not in a tie-up
If the hospital is not in a tie-up, then you need to immediately inform the ESI Corporation, justifying the circumstances for the hospitalization in a private hospital and not in an ESI hospital or tie-up hospital. You need to pay the bill of this private hospital and then submit an application for the reimbursement of the bill to ESI.
Reimbursement conditions
The reimbursement is given only in case of emergency hospitalization when there is no ESI hospital or tie-up hospital nearby, or circumstances forced you to admit to a private hospital. You need to inform this to the respective ESI office immediately. ESI will decide whether to reimburse the bill after considering various facts.
Procedure for reimbursement application
There is a procedure for applying for reimbursement of the bill paid to a private hospital that I request you to find out from the ESI office or from your employer. The procedure varies from place to place to my knowledge.