In my company, one worker took treatment for multiple sclerosis from a private hospital in August 2017 without referring to ESIC due to his ignorance towards ESI benefits. He is listed in ESIC. Now, how should the employer write a request letter to ESIC?
From India, Bangalore
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1From India, Bangalore
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In my company, one worker took treatment for multiple sclerosis from a private hospital in August 2017 without referring to ESIC due to his ignorance towards ESI benefits. He is listed in ESIC and now needs to write a request letter to ESIC by the employer for late submission.
Please let me know if you need further assistance with the letter.
From India, Bangalore
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Please let me know if you need further assistance with the letter.
From India, Bangalore
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Employer has no role in such case; he has to visit the AMO of his regional ESIC zone and clear the situation to him regarding the circumstances under which he had to get treatment without informing ESIC. He will provide a proforma to be submitted along with a few forms to be signed by the hospitals and doctors where he availed treatment. Thereafter, he would be able to submit the bills for processing. It is uncertain whether the expenses would be admissible or not, as per ESIC rules which require being informed within 72 hours of such incidents.
Significantly, I hope this post is made by an employer representative. When the employee does not attend for more than 3 days, it is deemed that the employer was aware of the employee's medical status. HR should advise the employee or their family members to get in touch with ESIC dispensary with details. From there, they would be referred to any nominated private clinic or nursing home at zero cost. This process is crucial, and negligence on the part of HR could be evident in not following these steps.
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Significantly, I hope this post is made by an employer representative. When the employee does not attend for more than 3 days, it is deemed that the employer was aware of the employee's medical status. HR should advise the employee or their family members to get in touch with ESIC dispensary with details. From there, they would be referred to any nominated private clinic or nursing home at zero cost. This process is crucial, and negligence on the part of HR could be evident in not following these steps.
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As per the query posted above, it appears that hospitalization, treatment, and even being absent from work were not known to the employer. However, the employee is required to submit an ESIC medical leave certificate if the leave extends beyond 3 days. Moreover, the employer cannot re-employ the person without a fitness certificate from the designated ESIC panel doctor or RMO ESIC, as the establishment is covered under the ESIC act.
So, how can the employer assist the employee in such a situation?
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So, how can the employer assist the employee in such a situation?
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Hi,
As per the ESIC Act, an employee has to utilize medical benefits solely from ESIC dispensaries or hospitals. In cases of emergencies, if it is proven, or in situations where ESIC facilities are not available in a specific region, employees may seek medication or treatment from private hospitals with prior approval from ESIC. In the event of an emergency or accident, employees can receive benefits from the nearest private hospital and subsequently claim reimbursement from ESIC, subject to ESIC approval.
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As per the ESIC Act, an employee has to utilize medical benefits solely from ESIC dispensaries or hospitals. In cases of emergencies, if it is proven, or in situations where ESIC facilities are not available in a specific region, employees may seek medication or treatment from private hospitals with prior approval from ESIC. In the event of an emergency or accident, employees can receive benefits from the nearest private hospital and subsequently claim reimbursement from ESIC, subject to ESIC approval.
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