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Hi Friends,
I am working as HR- Execuitve. One outsource employee, who is working in my organization, met with an accident, and he is taking treatment from a private hospital, Though He comes under ESI. Since that date he is on leave.
So in this case i just want to know that ---
1. can we process his salary as he is on leave for more than a month ?
2. can he claim the whole expense of his treatment from ESI.
He is visiting ESI hospital, regularly.
waiting for some good help from all of you -------
Regards,
Vivek.

From India, Meerut
get sickness registered with the esi officer , then only the employee can sickness certificate & claim for cover , no need to give him salary as double payment i.e. from company and esi is not possible ,if u will give the salary esi will cancel the claim (according to form 28) ,,,,,make sure the employee doesnt bluff you.
amit
Pll

From India, Gurgaon
Dear Vivek,
Please let me know Are you submit his accident form ( Form 16) to ESI Office. It is important. When employee meet with an accident you have to submit his Form 16 to ESI office within 24 hours after Accident. After submitting the form ES officer will come for check the record. After that he will file the case to Regional office and then he will get the accident benefit. The benefit depend up on the accident like Pension, Salary, Disablement
As you told that he take treatment from private hospital. He never get reimbursement of this expenses from ESI. because employee must take a treatment from ESI hospital which are free of cost.
He can take this reimbursement on one point, If he intimate due to emergency he take a treatment from private. but it is time consuming & lengthy process.
I think you are clear about this accident
Thanks,
Amit Pawar

From India, Delhi
hi
guys
i would like to inform u that eventhough the employees covered under ESI, in our company we are covering all the employees under Group personal accident policy for getting claim for leave days and 25% of medical expenses. For accident death we can get 60 times of gross salary as claim.
Now the company will meet all the hospital expenses and latter deduct from the claim amount.
And also taken Group insurance policy for any kind of death.
We can not get good treatment from ESI and also the compensation for leave period is very low. but we can get good amount from Insurance.
why can't others can follow this systems.
regards

09442637009

From India, Madras
dear friend, r u submit the accident report form 16. in your esi local office ? when the happened? where the accident happened ? inner the factory premise or outside. Regards, MG 9842511533.........
From India, Madras
Dear,

On occurance the accident and compliance under E.S.I.

1. Accident Report Form 16 with in 24 Hours to E.S.I. Local office.

2. Sickness benefit can only be claim if treatment in E.S.I. hospital or reffered by E.S.I. in other Hospital, and treatment minimum for 3 days.

E.S.I. authority pay the sickness cash benefit only more than three days sickness. Maximum 91 days in two consecutive benefit period. other wise medical refery of E.S.I. suggest for more period for payment.

3. E.S.I. Local Office seek abstention verification through Form - 28. Due to the reason that the employer should not pay his salary. and show his /her as on sick leave. during the period of verification.

4. No need to pay salary for the period of sickness. Since E.S.I. will pay sick ness cash benefit for the period at the rate of Statndard Benefit Rate. (S.B. R. is almost 50% of average wages).

5. Not to engage a sick employee on duty.

6. No contribution is payable for the period of sick ness is the E.S.I. is paying sickness benefit for that period.

7. Muster Roll and in Form - 7 of E.s.I. show him as on sick leave.

Hope it will clarify all the doubts on the subject.

for more information can write to me at

Mohd. Arif Khan


Hi Friend,
My name is lakshmanan i'm working at HCL Tech corporate Hr,
you can claim all the expence in ESI procedure because, the
employee's who taking the first month salary the ESI( Medical Claim)
Should be coverd So, if you claim know, the will pay our govt ESI Dept...
If you need any quaries, please don't feel you call my mobile # during
at any time..
The #is 9941056476....
Regards,
Lakshmanan.m

From India, Madras
Dear Sir(s),
I undertsand that ESI is mandatory for employee drawing Rs10,000 or less.
All the employees are regulary taking benefits from mediclaim / group accident scheme.Not a single employee from the date of ESI coverage either has gone to ESI dispensary or, take any ESI benefit.
The company is regularly / timely depositing the ESI dues/returns etc.
1.I want to know that, whether it is mandatory for an organisation to cover ESI if the organisation has a suitable & best mediclaim insurance policy /group accident policy GPA for it's employees.
2. I think we can extend GPA for all employee including those who are coverd by ESI.
3. Is GPA is mandatory under any act?
4.Is thr any nexus between ESI or GPA?
5. Is it ok,,,if employee have any of the two coverage ESI or GPA?
Thanks in anticipation,regards
Amit

From India, Delhi
Mohd. Arif Khan’s comments r very useful but Amit’s query doesn’t get answered in that.
From India, Mumbai
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