Quick Summary
Medical Benefit
- The Insured Person and/or his family members in case of being infected with COVID-19 can avail free of cost medical care in any of the ESIC/ ESIS Hospital which has been declared as COVID-19 dedicated hospital. Presently 21 ESIC hospitals run directly by ESIC with 3676 COVID Isolation Beds, 229 ICU beds and 163 ventilator beds and 26 ESI Scheme Hospitals run by State Govts. having 2023 beds are functioning as COVID-19 dedicated hospitals.
- In addition to above, instructions have been issued to each of the ESIC hospital to function with a minimum of 20% of its bed capacity as dedicated Covid beds for ESI IPs, beneficiaries, staff & pensioners.
- Plasma therapy which has shown promising results to save the lives of serious COVID-19 patients, is also available in ESIC Medical College & Hospital, Faridabad (Haryana) and ESIC Medical College & Hospital, Sanath Nagar (Telangana).
- ESI Beneficiaries may also seek Emergency/non-Emergency medical treatment from tie-up hospital directly without referral letter, in accordance with his/her entitlement.
- In case the IP or family member being infected with COVID-19 takes treatment in any private institution, the reimbursement of expenditure may be claimed.
Cash Benefit
- In case the Insured Person abstains from his work being infected with COVID-19, he can claim Sickness benefit for his period of abstention as per his entitlement. Sickness benefit is paid @ 70% of average daily wages for 91 days.
- In case any Insured person becomes unemployed, he may avail relief under Atal Beemit Vyakti Kalyan Yojana(ABVKY) under @ 50% of average per day earning for a maximum 90 days. For availing this relief, the Insured Person can submit his claim online at www.esic.in.
- In case, any Insured Person becomes unemployed due to retrenchment or closure of factory/establishment as per ID Act, 1947, he may claim unemployment allowance for a period of 02 years subject to qualifying conditions under RGSKY.
- In the event of unfortunate demise of any Insured Person, funeral expenses of Rs.15000/- are paid to the eldest surviving member of his family.
FAQ :
Infected insured persons and their family members can receive free medical care at any ESIC/ESIS hospital designated as a COVID-19 dedicated facility. This includes access to isolation beds, ICU beds, and ventilators.
Yes, if an insured person or their family member infected with COVID-19 receives treatment in a private institution, a claim for reimbursement of expenditure can be submitted.
If you are infected with COVID-19 and abstain from work, you can claim Sickness Benefit, paid at 70% of your average daily wages for up to 91 days.
Yes, unemployed insured persons can claim relief under the Atal Beemit Vyakti Kalyan Yojana (ABVKY) at 50% of their average daily earnings for a maximum of 90 days. They can also claim unemployment allowance for up to two years under RGSKY if unemployed due to retrenchment or closure.
In the unfortunate event of an insured person's demise, funeral expenses of Rs. 15,000/- are paid to the eldest surviving member of their family.
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