Employee State Insurance (esi) - Pdf Download

Kind Attn: Members

Kindly post your valuable comments and expert advice regarding Employee State Insurance (ESI) FAQs, problems faced, and solutions found concerning various matters. For example:

"During hotel or factory construction, 20 plus employees were involved in construction-related activities. However, due to ignorance of the ESI Act, employees were not covered, and ESI levied a penalty."

Many hotels and factories may have faced penalties similar to the above scenario. Please share your experiences and views, which would be highly appreciated.

Hemant
Yahoo ID: hemantwiz

Hi Hemant,

Enjoy with folowing FAQ:

FAQ On Employees' State Insurance Scheme, Gujarat

1) How do I get medical treatment once my contribution has started deducted ?

2) How do I get hospital treatment ( OPD/Indoor) ?

3) How do I get Ayurvedic Treatment ?

4) What should I do in emergency ?

5) How do I get Advance Payment or Reimbursement.?

6) How do I get Cash Benefit ? The procedural Aspect

7) How do I get medical treatment once my contribution has started deducted ?

Each person after joining insurable employment , after completing certain formality , is issued an identity card which has all essential particulars i.e. name , insurance no. of the IP , dispensary and local office to which he is attached and names of his/her family members. This card is a very important document and has to be produced while obtaining medical benefits.

A beneficiaries can claim treatment at the dispensary/clinic of the IMP to which he/she is allotted on the production of the card.

How do I get hospital treatment ( OPD/Indoor) ?

To claim specialists consultation and/or indoor treatment at an ESIS institution or a hospital where arrangement has been made for the ESIS beneficiaries.The concerned doctor of the allotted dispensary refer him/her to that hospital with necessary prescribed forms.

How do I get Ayurvedic Treatment ?

For aurvedic treatment a separate case of ayurved has to be obtain from the case counter. Aurvedic Medical Officer will prescribed the ayurvedic treatment after examining the patient. If required Auy. Medical Officer will refer the patient to any of the following hospital of Ahmedabad for specialist consultation.

· Panchkarma & Kharsutra unit , Bapunagar General Hospital, Ahmedbad.

· Akhand Anand Ayurved Hospital , Ahmedabad.

· Maniben Ayurvedic Hospital , Ahmedabad.

· Vivekanand Ayurvedic Hospital , Ahmedabad.

The patient the dispensary where there is no post of the Ayurvedic Medical Officer first obtain the case of the his/her dispensary and then go to nearby dispensary. There he/she should again get a new case paper of that dispensary and get the treatment of the Ayruved there,

What should I do in emergency ?

Usualy in case of emergency , a beneficiary should report to the those State Insurance dispensaries/ hospitals where arrangement to provide emergency treatment have been made.

How do I get Advance Payment or Reimbursement.?

For obtaining Superspeciality treatment first of all Insurred person or his/her family member should go to his/her registered dispensary or penal doctor ( IMP) for primary examination.

Doctor of the dispensary after examining the patient fill up the form no. 4 (or form no 22 in emergency ) to refer to the concern super specialily facutly.

For establishing eligibility of the treatment Insured Person should obtain the Form No. 37 from the his/her occupational place, endorsed by the his/her local office and then submitted to the his/her dispensary.

Treatment prescribed by the specialist on Form no 4 or Form No. 22 of the referred patient will be provided.

Any extra amount to be required to be spend after the treatment of the then patient should contact Liaison Officer at Room No. 70 of Civil Hospital , Ahmedabad ,

If Insured Person want to bear the extra expenditure by his/her own then he/she should take the permission of the Assistant Director Medical Servicers (ADMS) of his/her region.

If Insured person wants payment in advance for this extra expenditure he/she should Apply in written to the Incharge Medical Officer of his/her dispensary furnishing following documents.

· Application regarding obtaining the advance payment.

· Copy of ESIC 37

· Form no. 4 of Form No. 22 showing detail of the treatment prescribed by the specialist.

· In case of family member certificate of dependency on Insured Person.

· Other required documents and Document as per instruction of the Incharge Medical Officer.

If Insured Person has bear the expenditure of his own he/she should apply in written for reimbursement with in one year to the Incharge Medical Officer of his/her dispensary furnishing following documents.

· Application regarding reimbursement.

· Copy of ESIC 37

· Form no. 4 of Form No. 22 showing detail of the treatment prescribed by the specialist.

· In case of family member certificate of dependency on Insured Person.

· Receipt of the institute that Insured Person had paid.

· All the prescription of the drugs and instrument as well as bill.

· Copy of the Discharge Card.

· Other required documents and Document as per instruction of the Incharge Medical Officer.

Once advance payment or reimbursement is passed the Insured Person will be informed and he/she will get the cheque though the Incharge Medical Officer. In case of Advance Payment the Concern Treatment giving organization will get the cheque and Insured Person or his/her family member can take the super speciality treatment for the organization without paying any extra.

How do I get Cash Benefit ? The procedural Aspect.

Cash benefits are distributed by the corporation xxxxx local office to an eligible IP on production of medical certificates given by the Medical officer of the dispensaries as per section 52 of the ESI Act.s

Regards

Sidheshwar

Hi,

Could someone please explain the benefits of E.S.I.C that employees can avail of? Additionally, what are the benefits for the employer as well?

Regards,
Moushmi

Kind Attn:-
Thank you very much for posting informative article – “ FAQ ESI , Gujarat.”
I would like to request and other members to post more views / experience about ESI problems enconcountered like Inspection, Penalties….& Solution found to problems like “Deleting records with words labour so as to avoid being penalized by ESI Officer for non compliance” & such other examples, so that in future budding managers of www.citihr.com would not have to face any kind of problems.
Looking forward to read many post on Employee State Insurance (ESI) – Problems & Solutions.
Best regards
Hemant
Yahoo id:- hemantwiz

Hi Mousami,

Enjoy the rainy season! This means to enjoy the enclosed file.

Your response:

1) See the benefits block in the enclosed file.
2) See the penalties block in the enclosed file. All penalties are benefits for the employer. If employees are receiving benefits under ESI, it means their morale, loyalty, productivity, etc., will be high, which is a benefit for the employer.

I believe your question has been fully answered. If you have any further queries, please feel free to write to me.

Note: Please save the file in the "pdf" format. Right-click and select "save target as" on your PC, then open it.

Regards,
Sidheshwar

Hello Hemant,

I am working as an HR Assistant at Rajkot. The problem we are facing is that our company provides an ESI scheme for our employees located in Gandhidham. I would like to know the location of the dispensary where our employees can visit.

Please reply.

Neha

Hi, I would like to make a letter for a salary cash advance. I know it's a simple letter, but I would like to ask for a favor from all of you.

Hi All,

If an employee covered under ESIC passed away after working for 8 months and did not submit his Declaration Form, his card was not obtained, but deductions were made from his salary, and the same was deposited. Please let us know if he is eligible to claim under ESIC.

Ravi

Hi, I am Hema and I am pursuing my PGDHRM. Below mentioned are assignments given from college. Can anyone help me out with this assignment? I require corporate examples of the following companies:

(a) Organization development Intervention & Implementation of the Company

(b) Innovative rewards & Recognition Programs

(c) Organization Change Models

(d) Compensation Structure & Incentive Program of the company

Please email me at hema19184@gmail.com.

HRM Assignment Organization Culture Change & Development:
- Presentation on Comparative Study of Organization Change Models & Implementation with corporate examples/cases
OR
- Comparative study of Organization Development interventions & Implementation with corporate examples/cases

HRM Assignment Compensation & Benefits:
- Presentation on compensation structure & Incentive programs of Companies
OR
- Presentation on innovative rewards & recognition programs of companies

Kindly do the needful ASAP.

Thanks & Regards,
Hema