ESIC’s restrictions end up ‘penalising’ insured persons

ESIC’s restrictions end up ‘penalising’ insured persons

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Rakshitha, who was studying in second PUC, dropped out of the college after being diagnosed with fourth stage ‘Sarcoma Cancer’.

Seventeen-year-old Rakshitha, who survived the cancer with the help of experts at KSHEMA (K S Hegde Medical Academy), is now undergoing chemotherapy cycle and had completed 7 out of the total 12 cycles of chemotherapy. But the road to recovery for Rakshitha looks uncertain after being denied chemotherapy and other medical facilities under the Employees State Insurance (ESI) scheme by the tie-up hospital.

Officials at the ESI dispensary informed that both the mother (Insured Person) and her daughter Rakshitha (dependent) were not entitled to super special treatment as their employer had failed to submit the contribution on time (for the period from July to September 2018).

Rakshitha’s cousin Anil said the employer on learning about the denial of treatment to Rakshitha, was willing to file the contribution with penalty.

‘’The recent restrictions incorporated in ESIC (Employees State Insurance Corporation) employers portal like not being able to file the contribution after the expiry of 42 days from the end of contribution period, prevented the employer from filing the details of her attendance and wages online. Despite paying contribution, neither Rakshitha nor her mother can avail any treatment until December 2020,” Anil told DH.

Strict enforcement

The ESIC asserts that strict enforcement of such regulations will discipline employers and benefit the Insured Persons in the long run.

ESIC member V Radhakrishnan said, ‘’On the one hand ESIC insists on sticking to the regulations, but on the other ESIC is not implementing Delhi High Court’s order declaring regulation 96(c) (an employee should have worked for more than 78 days in order to be eligible for benefits) as illegal and void.”

Radhakrishna, during his visit to Mangaluru, recollected meeting an Insured Person whose cancer-ridden father was prevented from availing treatment. The daughter had availed six-month paid maternity leave under the ESI scheme. The ESIC insisting that the IP had not worked for more than 78 days (an illegal rule), had deprived the IP and her family members of super specialty treatment in hospitals.

He asserted that the artificial barriers created by the ESIC for employers was not only unconstitutional but was depriving benefits to the Insured Person and their dependents.

Radhakrishnan told DH that he had written a letter to Union Minister and Secretary to Ministry of Labour and Employment Heeralal Samariya on how it was not fair to deprive benefits guaranteed by ESI Act by creating artificial barriers.

The Insured Persons are attempting to clear mounting medical bills by raising loans.

Kanara Chamber of Commerce and Industry president Isaac Vas said a meeting would be convened with ESIC to find a solution.

ESIC Director-in-charge S Sivaramakrishnan told DH that they had written to director general, ESI, recommending restoration of benefits as under section 2(14) as contributions was deducted from their salary.

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