Dear All,
I have an issue regarding Maternity Benefit under ESI to one of my employee.
Let me tell you in brief.
One of my employee was under ESI and she has been enjoying all ESI Benefits under ESI for more than 3 years. When her salary increased above Rs.10,000/-, (Salary limit for ESI at that time) she had came out of ESI. Later when ESI Limit was enhanced to Rs.15,000/-. she was reinstated under ESI in may-2010 since her salary was Rs.12,000/-.
Now she is under leave for maternity starting Dec-10 (12 weeks - 3 months) and was under treatment with ESI till the date of Leave. After delivery, when she approached the ESI for reimbursement of maternity expenses, they refused saying that nine months have to be completed for claim. Since she was reinstated under ESI in May-10, she is not eligible for any maternity benefit. I also would like to mention that on reinstatement under ESI, she was given the same ESI Card number which was given before reinstatement.
Can somebody give me clarity on this, whether is there any such rule under ESI Act? If so, is there any otherway she get's her expenses claimable?
Now this employee was not paid any salary since Dec-10 thinking that she was under ESI. Now wht to do? I am also facing similar problem with one of my male employee where his father was denied treatment for the same reason. he was also re-entered ESI on enhancement of ESI limit to Rs.15,000/- since his salary is Rs.12,000/-.
KIndly advise.
Regards,
Krishna T B R
From India, Hyderabad
3I have an issue regarding Maternity Benefit under ESI to one of my employee.
Let me tell you in brief.
One of my employee was under ESI and she has been enjoying all ESI Benefits under ESI for more than 3 years. When her salary increased above Rs.10,000/-, (Salary limit for ESI at that time) she had came out of ESI. Later when ESI Limit was enhanced to Rs.15,000/-. she was reinstated under ESI in may-2010 since her salary was Rs.12,000/-.
Now she is under leave for maternity starting Dec-10 (12 weeks - 3 months) and was under treatment with ESI till the date of Leave. After delivery, when she approached the ESI for reimbursement of maternity expenses, they refused saying that nine months have to be completed for claim. Since she was reinstated under ESI in May-10, she is not eligible for any maternity benefit. I also would like to mention that on reinstatement under ESI, she was given the same ESI Card number which was given before reinstatement.
Can somebody give me clarity on this, whether is there any such rule under ESI Act? If so, is there any otherway she get's her expenses claimable?
Now this employee was not paid any salary since Dec-10 thinking that she was under ESI. Now wht to do? I am also facing similar problem with one of my male employee where his father was denied treatment for the same reason. he was also re-entered ESI on enhancement of ESI limit to Rs.15,000/- since his salary is Rs.12,000/-.
KIndly advise.
Regards,
Krishna T B R
From India, Hyderabad
Dear Mr.Krishna,
There is some administrative error on the part of ESIC. It is not the mistake of employer or the employee. She has been in continuous service with you and it was the ESIC that changed rules everytime and subsequently put hardship to employer and employee.
If a new Insurance card No. was given to her, then the rule is right. The case is that already she has the number which was in force and then deactivated when ceiling changed, then activated during reinstating. So as per law, ESIC is bound to reimburse the expenses.
Request you to take legal guidance/Labour Court on the above subject. It is surprising why nobody has given a reply for this tricky query. Justice has to be done to this employee.
Regards
Chandru
From India, Madras
There is some administrative error on the part of ESIC. It is not the mistake of employer or the employee. She has been in continuous service with you and it was the ESIC that changed rules everytime and subsequently put hardship to employer and employee.
If a new Insurance card No. was given to her, then the rule is right. The case is that already she has the number which was in force and then deactivated when ceiling changed, then activated during reinstating. So as per law, ESIC is bound to reimburse the expenses.
Request you to take legal guidance/Labour Court on the above subject. It is surprising why nobody has given a reply for this tricky query. Justice has to be done to this employee.
Regards
Chandru
From India, Madras
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Introduction Of Self-Declaratio n Form For Insured Woman Relating To Maternity Benefit Under ESI .pdf