Relief Measures Under Employees State Insurance Act 1948 (ESIC) For Covid-19 Pandemic
Employees State Insurance Corporation (ESIC) has given the following reliefs to the employees covered under the ESI Act for the Covid-19 Pandemic.
ESIC has not specifically come up with notification stating whether treatment for Covid-19 is covered under ESIC or not.
However, various queries were raised with the ESI authorities regarding the same, and some officials which are reliable sources have informed that, definition of sickness under ESIC does not specifically exclude Covid-19 and hence it is implied that treatment of covid-19 will be covered under ESI Act.
Further, ESIC has dedicated few of its hospitals and have also set up laboratories for Covid-19 treatment.
Stakeholders are requested to confirm this point from ESIC authorities or take second opinion as there is no official notification from ESI Corporation as on date of this article.
ESIC beneficiaries may now avail non-covid medical services including emergency and non-emergency through tie-up hospitals during the period for which concerned ESIC hospital functions as dedicated Covid-19 hospital.
ESI beneficiaries can be referred to tie-up hospitals for providing prescribed secondary/SST consultation/ admission / investigation during the period for which concerned ESIC hospital functions as dedicated Covid-19 hospital.
This service can be availed directly without referral letter.
All treatment / procedure will be given in ESIC tie-up hospitals even if there is no ESI tie-up for any specific treatment / procedure.
Medical services from ESIC Hospitals which are designated to provide Covid treatment and where medical services were earlier curtailed in view of corona pandemic resume t work w.e.f 5th May 2020. The social distancing norms and safety precautions will be observed as per instructions of Government of India.
In order to ease out the hardship of ESI beneficiaries in this tough time, ESIC has allowed the purchase of medicines by beneficiaries from private chemists during the lockdown period and its subsequent reimbursement by ESIC.
Medical benefit is provided under Rule 60-61 to the insured persons who cease to be in insurable employment on account of permanent disablement and to the retired insured persons, on payment of advance lump-sum contribution for a year at the rate of Rs.10/- per month.
Under the prevailing circumstances of lock down, there may be cases where the validity of Medical Benefit Cards issued to these beneficiaries expire as these beneficiaries are unable to deposit the advance annual lump-sum contribution due to the lockdown.
Such beneficiaries have been allowed to avail medical benefit under Rule 60 and Rue 61 of ESI ( Central Rules) till 30th June 2020.
The card holder shall deposit the lump-sum contribution for one year as soon as the lockdown ends and the situation normalises. The contribution thus deposited will count from date on which it was due, for one year.