Dear HRs, Please suggest a solution for this issue. One of our employees joined our organization in March 2013. He was allotted an ESI Number on behalf of the organization, and ESI contributions were paid for him for the months of March and April. For the month of May, his contributions remained nil. The employee left the organization at the end of May and joined a new organization, where he was given another ESI number, and contributions were made from June to October 2013.
Issue with ESI Contributions and Specialized Treatment
The issue now is that his daughter needs specialized treatment at an ESI Hospital. However, the hospital refused to provide the treatment because the employee had less contributory service in the last ESI contribution period. To be eligible for specialized treatment, the Insured Person (IP) should have contributed for at least six months in the last contribution period for dependents.
1) The employee has more than six months of contributory service by combining details from both employers. How can we merge the two IP numbers to obtain eligibility? Is it possible?
2) If merging is possible, who should be approached, and what is the procedure?
3) In case of an emergency for the mentioned dependent, can special permission be obtained from higher ESI authorities for super specialty treatment at an ESI Hospital?
4) If special permission is an option, who should be approached, and what is the procedure?
5) What measures can be taken to prevent such cases from arising in the future?
Thank you.
From India, Pune
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Issue with ESI Contributions and Specialized Treatment
The issue now is that his daughter needs specialized treatment at an ESI Hospital. However, the hospital refused to provide the treatment because the employee had less contributory service in the last ESI contribution period. To be eligible for specialized treatment, the Insured Person (IP) should have contributed for at least six months in the last contribution period for dependents.
1) The employee has more than six months of contributory service by combining details from both employers. How can we merge the two IP numbers to obtain eligibility? Is it possible?
2) If merging is possible, who should be approached, and what is the procedure?
3) In case of an emergency for the mentioned dependent, can special permission be obtained from higher ESI authorities for super specialty treatment at an ESI Hospital?
4) If special permission is an option, who should be approached, and what is the procedure?
5) What measures can be taken to prevent such cases from arising in the future?
Thank you.
From India, Pune
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In my opinion, the employee may visit the appropriate Branch Office of ESIC (present Branch Office) along with the old Identity Card, a copy of the Declaration form submitted to obtain the old insurance number, and also a copy of the Return of Contributions submitted for the previous contribution period. He may discuss the matter with the Branch Office Manager and request to make his dependents eligible for super-specialty treatment.
Preventive Measures for Future Situations
To avoid such situations in the future, it is essential for employees to disclose their old Insurance Number and Identity Card, if any, issued by ESIC at the time of joining new jobs/establishment.
Regards;
From India, Noida
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944Preventive Measures for Future Situations
To avoid such situations in the future, it is essential for employees to disclose their old Insurance Number and Identity Card, if any, issued by ESIC at the time of joining new jobs/establishment.
Regards;
From India, Noida
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