The Hindu : Tamil Nadu / Chennai News : Quality treatment now made possible for insured employees in State

Online edition of India's National Newspaper
Thursday, Dec 15, 2005

Tamil Nadu

Tamil Nadu - Chennai

Quality treatment now made possible for insured employees in State

Special Correspondent

Employees State Insurance Corporation ties up with super-speciality hospitals One major advantage of ESI is that the benefits are available to insured employees even after their superannuation on payment of a nominal subscription fee.

MAKING A POINT: Sailesh R.Mehta, president, ACC (left) and B.K.Venkatesh, Regional Director, Employees State Insurance Corporation, at a group meeting of the Andhra Chamber of Commerce in Chennai on Wednesday. — Photo:S. R. Raghunathan

CHENNAI: Thanks to the Employees State Insurance (ESI) Corporation's tie-up with super-speciality hospitals in the State, poor patients have been able to undergo treatment in these hospitals. The Corporation paid Rs. 3.5 crore last year towards medical expenses incurred by employees insured under the ESI.

Addressing the Andhra Chamber of Commerce here on Wednesday, B.K. Venkatesh, Regional Director of the Corporation, said the initiative for the tie-up was taken by the State Government. Earlier, the insured patients had to make their own arrangements to meet hospitalisation expenses and then claim the refund from the ESI. The procedure was now simplified; only a reference letter from ESI doctor was needed. The insured employee did not have to pay fees, as the Corporation would take care of it. In one case, the Corporation paid Rs. 8 lakh to a multi-speciality hospital for treatment of an employee.

Unique labour scheme

Describing ESI as a unique labour welfare scheme, he said the employers, like the Corporation, were equally responsible in ensuring proper medical facility to their employees. There might be some flaws and defects in the working of the corporation. But they could be rectified, as the organisation's prime motive was to help workers. The scheme covered employees whose daily wage was less than Rs. 50. They were exempted from payment of premium but were entitled to all medical benefits such as any other insured person. The employers' share of contribution was, however, payable.

Replying to a question, Mr. Venkatesh said the ESI Act had provisions for a factory owner to opt out of ESI, provided he was able to give medical benefit on a par with that of the Corporation. Many industrial units had opted out of the scheme only to rejoin because they could not provide benefits similar to the ESI.

One major advantage of ESI was the benefits available to insured employees even after their superannuation on payment of a nominal subscription fee.

For the unemployed

The corporation recently introduced a scheme for employees, who were unemployed for no fault of their own.

Under the "Rajiv Gandhi Shramik Kalyan Yogna," the insured person was entitled to unemployment allowance for six months.

Under the ESI Act, penal action could be taken against employers who defaulted payment of premium.

Though there were some 3,500 defaulters in the State, penal action was initiated against 25 only. The corporation was for convincing the defaulters rather than punishing them. However, any default by companies would not affect their employees from availing themselves the ESI benefits.

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