Good Morning
I have noticed an issue in a company where i have placed for Internship training. There was a women who got injured in the Restroom of the company premises. Then she was taken to the ESI hospital and got treatment. Then she went to home for rest, after sometime again she got pain in the injury, so her husband taken her to another private hospital without informing to the Company's Safety Officer.
Statement 1: Her husband has spent rupees 5000 in the Private Hospital
Statement 2: Her husband wants to claim the amount from the Company.
Problem: The HR manager refuses to pay the amount because the victim and the victim's husband didn't give any prior information before going to the private hospital.
Question: Should the company pay the amount or not?
From India, Chennai
I have noticed an issue in a company where i have placed for Internship training. There was a women who got injured in the Restroom of the company premises. Then she was taken to the ESI hospital and got treatment. Then she went to home for rest, after sometime again she got pain in the injury, so her husband taken her to another private hospital without informing to the Company's Safety Officer.
Statement 1: Her husband has spent rupees 5000 in the Private Hospital
Statement 2: Her husband wants to claim the amount from the Company.
Problem: The HR manager refuses to pay the amount because the victim and the victim's husband didn't give any prior information before going to the private hospital.
Question: Should the company pay the amount or not?
From India, Chennai
Did the officer concerned file/ submit accident report in form 12 (online)?
If Yes, then she will get accident benefits from the ESI Corporation and not from the employer. If, during leave period, she had developed any pain which is related to the accident/ injury, she should have consulted the Medical Officer of the ESIC first and get her referred to private hospital by the Medical Officer. She is not supposed to go to the hospital of her own choice directly. Therefore, the HR manager is right in rejecting the claim of reimbursement of amount spent by her in the private hospital. Even if the injured or her spouse had informed the officer of the company that she is being taken to private hospital for treatment the reimbursement should not be admitted. This is because of one reason that the employer has been paying a contribution (at the rate of 3.25% of salary paid) and that absolved his liability towards all possible risks including death.
From India, Kannur
4262If Yes, then she will get accident benefits from the ESI Corporation and not from the employer. If, during leave period, she had developed any pain which is related to the accident/ injury, she should have consulted the Medical Officer of the ESIC first and get her referred to private hospital by the Medical Officer. She is not supposed to go to the hospital of her own choice directly. Therefore, the HR manager is right in rejecting the claim of reimbursement of amount spent by her in the private hospital. Even if the injured or her spouse had informed the officer of the company that she is being taken to private hospital for treatment the reimbursement should not be admitted. This is because of one reason that the employer has been paying a contribution (at the rate of 3.25% of salary paid) and that absolved his liability towards all possible risks including death.
From India, Kannur
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ESI contribution rates lowering.pdf
Death while in service letter for pf death claim.docx