An employee is covered under ESI scheme. Now, he is affected by some disease and admitted to a private hospital because the required equipment for his treatment is not available in the ESI hospital. The bill value amounts to about 6.5 lakhs. Can the employee claim at least partially through the ESI scheme? If yes, kindly provide me with the procedures. Thank you.
From India, Tirupur
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From India, Tirupur
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1. Sir, it is not mentioned by you whether the treatment being obtained from a private hospital is being done after the case has been referred by the ESI Hospital or not. If the case has not been referred by ESIC, I think it will not be possible to claim any refund from ESIC.
2. I think you may discuss the issue locally with the concerned ESI dispensary to which the said employee is attached, from where you can also obtain the prescribed form for such reimbursement if allowed.
From India, Noida
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9442. I think you may discuss the issue locally with the concerned ESI dispensary to which the said employee is attached, from where you can also obtain the prescribed form for such reimbursement if allowed.
From India, Noida
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