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Employee State Insurance Corporation (ESIC)

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Information for Employees

a) Medical Benefit

This ECIS Scheme provides comprehensive range of medical/healthcare facilities to an insured individual and his/her dependants including their family members, through a network of ESI Dispensaries & Panel Clinics, ESI Hospitals and Diagnostic Centres. Super-speciality medical facilities are provided to the beneficiaries of this scheme through recognized advanced medical institutions that are empanelled on ECIS list for the purpose on referral basis. The Corporation has set up a Revolving Fund in most of the States across India so as to ensure smooth flow of funds for super-speciality treatments of ESIC beneficiaries.

All insured individuals and their family members are entitled to free and comprehensive medical facilities under this Scheme. The package covers all aspects of healthcare ranging from primary to super-speciality facilities.

b) Identity cards

Temporary identity card (TIC) indicating the Insurance Number and family particulars along with photograph affixed thereon are issued to the employees immediately on submission of declaration form to Branch office to which the employer is attached. This TIC is valid for three months.

After three months, Permanent Identity Card (PIC) is issued to the particular employee. In case, due to any reason, if the PIC is not issued after the period of 3 months, TIC is revalidated for another 3 months by the concerned Branch Manager. This TIC will entitle the insured person and his/her family to avail medical cover for three months or till the extended period.

c) Contribution & Benefit periods

There are two contribution periods of six months duration each in a year, in respect of an insured worker or employee, with corresponding benefit period of six months given below:
Contribution period Corresponding benefit period
1st April to 30 September 1st January to 30th June of the year following
1st October to 31st March of the year following 1st July to 31st December of the calendar year
In case an individual becomes an employee within the ambit of the ESIC Act for the first time, the first contribution period will commence from the date he/she enters into insurable employment for the first time in the contribution period current on that day and his/her corresponding benefit period will commence on the expiry of nine months from such employment date.

d) Revolving Fund

Revolving Fund is a corpus fund raised for the benefit of insured individuals who undergo speciality / super-speciality treatment by the insured individuals including their family members/dependants under this scheme.

As and when administrative sanctions for reimbursement of medical/healthcare expenses on speciality or super-speciality treatment are accorded in individual cases based on their merits as per the decisions made by the Director of Medical Services up to Rs.75,000/- or the State Government above Rs 75000/- as the case may be, the payment will be made by the Regional Director from the Revolving fund at his/her disposal.

Revolving funds are utilized for making payments in respect of the following claims:

Bullet Pre-authorization or advance given for availing speciality/super-speciality treatments and reimbursement thereof, if the insured person had borne the expenditure incurred on medical expenses from his/her own sources.

Bullet Reimbursement of medical expenses with respect to expensive diagnostic services exceeding Rs 1000/- each.

Bullet Reimbursement of medical expenses case where the patients are admitted in a recognized hospital without any referral from ESI Hospital especially in cases of a medical emergency.

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Dear Sir,

Kindly inform me the details of ESI schemes for dental treatments and also the available dental hospitals in Kerala.

NiyasPandallur Thursday, July 14, 2016
How do we report use of ESIC insurance by people who are enrolled in organisations for the sake of use of ESI previlages hand in glove.
akm8591 Tuesday, June 23, 2015
My father was working in ESI as Lab assistance he Expired on may 1, 2012 during job period . so kind u send policy from which i can get that Job in place of my father or is there in rule from which we can get job please suggest and reply coz my family background is very bad situation and i need this job very urgently ......please suggest . thanx
taxmann Friday, April 10, 2015
Dear Sir, I joined ESI scheme on 1st Aug'14, I have paid one month contribution only. Now my father needs to undergo eye surgery. Is it possible to have such facility from ESI scheme. Please give me details in this regard.
aprchristumas Thursday, August 14, 2014
Hi, I joined company on 2nd May 2014, Please can you advise when can i and dependent can get full medical treatment or reimbursement from ESIC.
reachankitbansal Tuesday, July 1, 2014
sir i joined a company 3_3-2014`n fill esi form when i got alll the esi facility??????
pankaj1239 Saturday, April 5, 2014
Dear sir Please guide me how to avail the facilty.This is anusuya from bangalore. Thanks and Regards Anusuya ESI Insurance No - 534269872 pls conform me. my esi num its working r not.......regards

anusuya Tuesday, March 4, 2014
Dear Sir I want to take esi facility but there is no idea of the procedure. Last day I went to renuka orthopaedic hospital in patna, doctor checked and demaded for the fee. But as I know in esi there is nothing to pay from pocket. Please guide me how to avail the facilty Thanks and Regards Manish Kumar ESI Insurance No - 4215223985 Mob- 7781007602
Manish4215223985 Tuesday, January 14, 2014
sir i am naveen kumar ,i go esi hospital for my wife's treatment of eyes, but doctor speak ruffly and said here is no treatment in hospital, we said then reffer any hospital but he said we can not reffer, then i go to another hospital , iwant to treatment another hospital how can i collect my bills to esi
naveensood Friday, November 22, 2013
one of fr she worked with me.nw she relived from our company.her father was in critical stage,whether she can apply for esi with her no.Kindly reply as soon as possible
aparna30 Wednesday, November 13, 2013
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