Can an employee enroll parents-in-law in ESIC?

Can an employee enroll in parents-in-law under the ESIC scheme? And is that applicable to all states?

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Hi @Rohin

Eligibility conditions of ESIC family members

Family means all the relatives of the insured persons mentioned below

● Spouse

● Minor legitimate child or adopted child dependant

● Child dependent on the earning of employee

● Receiving education till he/she or of twenty-one years

● Unmarried daughter

● A child with mental or physical abnormalities

● Dependant’s parents whose income does not exceed as prescribed by the central government

● In case of an unmarried employee with deceased parents, minor brother or sister dependent on the earnings of the employee are eligible

As of now for parents -in-law there seems to be not covered under Sec. 2(11) of the ESI Act.

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Hi,

In Laws are not allowed. Only employee parents can be enrolled.

Thanks you.

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Thank you for the detailed and quick reply.

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Thank You for your reply Arpana.

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Father in law and Mother in law are not comes under the definition of family under Sec. 2(11) of the ESI Act… Hence they will not get any benefit on the ESI Card of Married Insured Women/Person… Further if an Insured Person/Woman do n’t have the parents and their dependent minor brother & Sisters will get benefit for medical care.

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Please note, under eligibility criteria it is mentioned that -
● Dependant’s parents whose income does not exceed as prescribed by the central government

So if a wife is dependent, then aren’t her parents, i.e. parents-in-law covered under this?

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Thank You for your reply Shefalipatil.

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Hi @shefalipatil that was a nice one.

Unfortunately, we do not have that yet in the ESI Act :slight_smile: But if a female - working pertaining to the law of eligibility might still have parents covered.

But I believe a lot of other Group insurance schemes that are popular among companies do cover as an alternate for now.

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Hi,

Question : Can an employee claim for for IVF Fertility treatment through ESIC ?

If yes what are the procedure .

As it is understood that these treatment are not possible through ESIC Hospitals.

Regards,

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Hi,

Yes your are right that all the latest technologies are not available in ESIC hospitals.

To avail other than ESIC hospital services ESIC dispensary doctor should give you the certificate that so and so treatment is not possible in ESIC hospital so you can avail such treatment from other hospitals., and all the expenses will be borne by ESIC.

Same is with IVF fertility treatment. If ESIC dispensary doctor give certificate then employee can avail this facility.

Hope this information helped you.

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Hi @bbnayak adding to what @Arpana mentioned

Until I know, Yes! they are covered under ESIS (https://www.esic.nic.in/CIRCULARS/standardnote010111230911.pdf) but only I certain facility centres where there is such provision.

Can I take treatment outside, Yes!

But, this should fulfil ESIC Reference Protocol and definitely only to Hospitals which got Tie-up Agreement signed with ESIC in selected cases and conditions are allowed which also means these cannot be treated under ESIC Infrastructure so they allow cashless treatment at outside Private Hospitals.

And the procedure to claim (https://www.esic.nic.in/reimbursement) is mentioned here.

To know more: https://www.esichospitals.gov.in/Specials/clinic_intdetail/4 and if you’re in Karnataka you can use these details to know more: https://www.esic.nic.in/karnataka

Hope this help.

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Dear Sir /Madam,

Please help us about the below queries :

  1. Can we re appoint employees after their retirement ( 58 is our
    retirement age).

  2. In case of re appointment whether they will be covered under PF & ESI ?

  3. If covered whether they can opt to be out of PF & ESI since they
    have retired from the Services.

Thanks & Regards

B B Nayak

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Hi @bbnayak

Will answer somethings that I know. Yes! You can reappoint being a private firm it is absolutely under your rules and regulations but slightly differs for reappointment of senior candidates.

They will be covered if they have not withdrawn their PF and was still a continuing member - but employee PF contribution will be nulled and only employer PF contribution will be made.

Opting our purely depends on the previous ‘PF’ continuity.

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Dear Sir / Madam,

Please suggest on the following query :

One Employee has been absent from duty due to Legal matter ( Court Case)
: April 2006

His retirement date was : July 2017

Due to on going court case we could not show exit from PF .

Please suggest can we put exit date as April 2006.

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Hi @bbnayak

It’s better to consult a legal advisor in this case who knows the details in specific and can help in this particular scenario.

As far as I know - since he was on the role and was marked as absent from duty & not being with a proper termination / Settlement it should be only as per his retirement.

But again do consult a legal advisor in this case for more information.

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