Dear All,
In our organisation we have a mediclaim policy. Later as no. of of employees started growing we came under ESIC. My question is can an employee take the benefit of ESIC and mediclaim both?
Is it necessary to have mediclaim and ESIC both or can we opt for only ESIC?
Please guide
From India, Pune
In our organisation we have a mediclaim policy. Later as no. of of employees started growing we came under ESIC. My question is can an employee take the benefit of ESIC and mediclaim both?
Is it necessary to have mediclaim and ESIC both or can we opt for only ESIC?
Please guide
From India, Pune
Hi Rohit, ESI benefit is to provide medical assistance to employees, hence we may give only one benefit out of two. As ESI has more benefits than any other medical insurance, preferable would be ESI.
From India, Hyderabad
21From India, Hyderabad
1. Sir, please refer to sections 53 and 61 of ESI Act, 1948 which bars claims under any other enactments in case a person is entitled for benefits under this Act.
2. However, since mediclaim policies are a private affair and hence ESIC has no role to play, but 2 aspects are essentials to be kept in view- firstly the compliance under ESI Act, 1948 and rules/regulations framed thereunder is compulsory irrespective of the fact that any type of mediclaim policies have been taken and secondly the employer cannot be legally bound to incur expenses for the said mediclaim policies of the employees already covered or coverable under said Act.
From India, Noida
2. However, since mediclaim policies are a private affair and hence ESIC has no role to play, but 2 aspects are essentials to be kept in view- firstly the compliance under ESI Act, 1948 and rules/regulations framed thereunder is compulsory irrespective of the fact that any type of mediclaim policies have been taken and secondly the employer cannot be legally bound to incur expenses for the said mediclaim policies of the employees already covered or coverable under said Act.
From India, Noida
It is always advisable to have ESIC as it offers more benefits compared to any mediclaim policy and also, this falls under statutory requirement. On other hand, you can keep both Mediclaim and ESIC depending on management decision. It's normally been seen in higher cadre employees that, they prefer to go to private clinic rather than ESIC. In this case Mediclaim policy will be beneficial.
Any employee is under the purview of ESI then It is mandatory to cover them under ESI. For such employees Mediclaim is just optional & if management is willing then yes, certainly can plan for both.
Any employee is above the ESIC limit then they are not eligible for ESI in this case you may consider for Mediclaim
From India, Bangalore
Any employee is above the ESIC limit then they are not eligible for ESI in this case you may consider for Mediclaim
From India, Bangalore
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Bombay Anand Bhavan Restaurant-vs- ESIC SC 2-09-2009.pdf
MEDICLAIM MADE EASY.doc