Hospitals usually send bills directly to nib, but sometimes you may receive a bill after you leave hospital. As mandated by the ESI Act, treatment has to be taken only from the ESIC hospitals or dispensaries. This deduction can be claimed by an individual for medical expenses incurred for himself/herself or for a dependant. Can the ESI beneficiary claim an amount in ESI if they have taken treatment in a private hospital? 2)what is the process to claim for esic after taking treatment in private hospital? So most hospitals refuse ESI patients Payment is directly done by ESI to the hospital. Why did I get a hospital bill? Yes, it is possible to claim ESI in a private hospital. The section 46 of the Act envisages following six social security benefits :-(a) Medical Benefit: Full medical care is provided to an Insured person and his family members from the day he enters insurable employment.There is no ceiling on expenditure on the treatment of an … Inform the incident or accident to the ESI Dispensary Medical doctor through letter stating the need of admission in the private hospitals. 4th September 2017 From India, Pune The ESI applicability is also to non-seasonal factories employing 10 or more persons and since 2011 it has been extended to shops, hotels, restaurants, private … Hospital as per normal should receive in a month. But ESI is a poor paymaster. (Many ESI covered employees are not registered their card in the local dispensary and facing lot of problems.) 1)can she take treatment in private hospital? YOGESH JI 15/05/2018 ko 10000 ka claim kiya tha jo 19/05/2018 ko account mein credit ho chuka hai lekin 18/05/2018 ko jo 4000 ka submit kiya tha uska satus dikha raha ‘status not available’ aur uan portal pe under process hai. Also they deduct amounts and keep asking for clarification. The hospital. However, in case of emergency, if the treatment is taken from a private hospital, you can raise a claim with the ESIC subject to ESIC approval. Hi, You cont claim Medical Reimbursement from ESIC only u can avail Medical benefits ( Medical Treatment, Medicines,etc) what ever the cost maybe Free of cost, if your salary is lessthan 7500 pm & you have contributed to ESI for 6 months ie 1 contribution period april- september. This could be because: The specialist or anaesthetist. The pathology or radiology labs associated with the hospital. After discharge from the private hospital the IP has to report to the dispensary. the ESIS hospital concerned to bear the expenditure of such referred cases in case these patients are to be referred to tie-up hospital by ESIC hospital. Deduction under section 80DDB can be claimed by a resident individual or by a resident Hindu Undivided Family (HUF) for a member only. Therefore, non-resident individuals (NRIs) and non-resident HUFs cannot claim this deduction. Employee state insurance scheme (ESI) is one of the most useful schemes for the employees in India whose monthly gross salary is less than 21000 Rs.Under the ESI scheme, both employee and family members of employees will get treatment in ESIC hospitals, not only treatment this scheme provides so many other benefits to the members and their family members. nib does not bill you for any part of your hospital stay. 3)how much contribution of company in total bill payment? 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