Dear All,
In our organization, we have a mediclaim policy. Later, as the number of employees started growing, we came under ESIC. My question is, can an employee take the benefit of ESIC and mediclaim both? Is it necessary to have both mediclaim and ESIC, or can we opt for only ESIC? Please guide.
From India, Pune
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In our organization, we have a mediclaim policy. Later, as the number of employees started growing, we came under ESIC. My question is, can an employee take the benefit of ESIC and mediclaim both? Is it necessary to have both mediclaim and ESIC, or can we opt for only ESIC? Please guide.
From India, Pune
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Hi Rohit, ESI benefit is to provide medical assistance to employees, hence we may give only one benefit out of two. As ESI has more benefits than any other medical insurance, preferable would be ESI.
From India, Hyderabad
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22From India, Hyderabad
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1. Sir, please refer to sections 53 and 61 of the ESI Act, 1948, which bars claims under any other enactments in case a person is entitled to benefits under this Act.
2. However, since mediclaim policies are a private affair and hence ESIC has no role to play, but two aspects are essential to be kept in view. Firstly, the compliance under the ESI Act, 1948, and rules/regulations framed thereunder is compulsory irrespective of whether any type of mediclaim policies have been taken. Secondly, the employer cannot be legally bound to incur expenses for the said mediclaim policies of the employees already covered or coverable under the said Act.
From India, Noida
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2. However, since mediclaim policies are a private affair and hence ESIC has no role to play, but two aspects are essential to be kept in view. Firstly, the compliance under the ESI Act, 1948, and rules/regulations framed thereunder is compulsory irrespective of whether any type of mediclaim policies have been taken. Secondly, the employer cannot be legally bound to incur expenses for the said mediclaim policies of the employees already covered or coverable under the said Act.
From India, Noida
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It is always advisable to have ESIC as it offers more benefits compared to any mediclaim policy and also, this falls under statutory requirement. On the other hand, you can keep both Mediclaim and ESIC depending on management decision. It's normally been seen in higher cadre employees that they prefer to go to a private clinic rather than ESIC. In this case, a Mediclaim policy will be beneficial.
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Any employee who falls under the purview of ESI must be covered under ESI. For such employees, Mediclaim is optional, and if management is willing, they can plan for both.
If an employee exceeds the ESIC limit, they are not eligible for ESI. In this case, you may consider Mediclaim.
From India, Bangalore
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If an employee exceeds the ESIC limit, they are not eligible for ESI. In this case, you may consider Mediclaim.
From India, Bangalore
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