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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:

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.

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

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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sir i joined a company 3_3-2014`n fill esi form when i got alll the esi facility??????
pankaj1239 Saturday, April 05, 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
anu..



anusuya Tuesday, March 04, 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
Hi, I worked with an organization when I registered for ESIC . Now I moved to another company and its been 2years now. I want to contribute towards my ESIC IP NO. Please let me know how can I initiate contributing towards ESIC with my new company with the changed address. Thanks in Advance, Anil V.
Anee Tuesday, November 12, 2013
I have been working in an organization for the last one year, and astonishingly i found that this company employing around 200 employees is still not registered with ESIC and none of the employees are covered under ESI or even PF. I am wondering as to how a organization can survive like this cheating the employees and minting money like this. Could someone tell me as to how these people can be straightened out using the law.
goodsamaritan Thursday, November 07, 2013
hi my name is raghu my brother worked for 6 years in one organization, 6 months back he resigned due to close of that organization. will he get any benefits of medical and any pay from esi, if so how to get benefits. because he is still searching for job from 6 months. please give some advice
Raghu.M Thursday, November 07, 2013
Hi,i am swapna having esic card since from three years and i joined the new organisation 6 months back. There they are giving new esic cards to the employees. now im pregnant what should i do to get materinity benifit form esic. please, do needful.
swapna2308 Saturday, August 31, 2013
I'am Monalisa I want to know ESI coverage person details, i'am a married women .Can esi will cover to my parents plz give me reply?
bunns Saturday, August 24, 2013
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