Medical Facilities under ESIS, Assam
ESI Scheme Assam provides cashless and hasslefree medical facilities through 26 nos. of Dispensarieswith one Annexe Hospital at Tinsukia and one ESIC Model Hospital in Beltola at Guwahati. The Hospitals provides its services round the clock in all specialties, emergency services, OPD and indoor treatment facilities in all major disciplines. Dispensaries provide only OPD Services with free supply of drugs and dressings and adopts referral procedures for Secondary & Super Specialty treatments.
The Secondary Care Treatments are also provided to ESI beneficiaries through Tie-up Nursing Homes and the Super Specialty Treatment are provided through Tie-up private Hospitals.
Benefit after Retirement:
With a nominal annual contribution of Rs. 120/-, a superannuated or voluntary retired or a pre-mature retired employee having minimum 5 years of insured service can avail medical benefits for the insured person(IP’s) and their dependents on production of necessary proof for 1(one) year.
The medical benefit is also admissible to an insured person who ceases to be in employment on account of permanent disablement caused due to employment injury for the insured person(IP’s) and their dependents on payment of similar contribution till the date on which he would have vacated the employment on attaining the age of superannuation, had he/she not sustained such permanent disablement.
To redress the grievances on the spot of the ESI stakeholders, “SUVIDHA SAMAGAM” is being organized regularly in various filed offices i.e. at Regional Office / Sub-Regional Office / ESIC Hospitals on 2nd Wednesday of every month and at ESIC Branch Offices on 2nd Friday of every month. On the Spot decisions are taken, wherever possible, on the oral, written complaints / suggestions and grievances of ESIC stakeholders, thereby saving time and avoiding unnecessary frequent visits to various ESIC establishments.
Redressal of Public Grievances:
To ensure expeditious disposal and speedy redressal of public grievances, ESIC has set up Public Grievance Redressal system at its Head Quarter Office, Regional / Sub-Regional / Divisional / Branch Offices, ESI Dispensaries / Hospitals which also included a Toll Free Helpline No. 1800-11-2526 at Head Quarters Office. Grievances can be reported in writing, over telephone through Toll Free Helpline, by post, e-mail or in person to the concerned official of ESIC establishments.
WHAT TO DO WHEN:
To ensure smooth flow of ESI Benefits to Insured Employees
- Online registration of Employees may be done correctly and promptly on appointment, with all relevant information.
- Print out of temporary Identification Certificate may be given to employees so that they can avail of ESI benefit.
- Ensure that employees complete the formalities for enrollment and issue of Pehchan Card, at the earliest.
- On receipt of Pehchan Cards from the BO, the same should be passed on to the insured employees without delay.
- In order to facilitate a newly Insured Person to avail medical benefit under the Scheme in absence of an identity certificate / identity card, a “Certificate of Employment” may be issued to the Insured Person in Form – 86. This certificate, issued by the employer, remains valid 3 months but can be revalidated for a further period not exceeding 2 months.
- Whenever events, such as, marriage, birth or death entails any additions or deletions in the family particulars of an Insure Person, the requisite information may be uploaded in the ESIC web portal.
- One re-entry of a person into insurable employment or, where an Insured Person had been disentitled to medical benefit due to non-generation of Return of Contribution, the employer may issue a “Certificate of re-employment or “Containing employment” to such person in Form ESIC-37. This certificate will enable the Insured Person to avail of medical benefit from the date of its issuance.
- If an insured employee needs a change of dispensary due to any valid reason, the employer may change the dispensary from the drop down list in the ESIC web Portal.
- Whenever an Insured person goes out of station on duty or leave, he may be issued a certificate in Form ESIC 105. This will enable him and his family to avail of medical treatment in ESI Dispensaries / Hospitals elsewhere, if available at such outstation locations.
- If any insured person is in need of a duplicate Pehchan Card, an application may be made to the Branch Office manager in Form, ESIC-72.
- Employers may assist or guide individual employees, for claiming any lawful benefit under the ESI Scheme, and also educate them properly about their rights and responsibilities under the Scheme.
- The usefulness of the ESI Scheme in the face of an untoward event resulting in loss of wages or earning capacity could be explained to the employees.
- For clarification of any doubt vis-à-vis your rights and responsibilities under the ESI Act, it is advisable to get in touch with a ESIC/ESIS official rather than depend on advice from self-proclaimed consultants or any other unauthorized persons.