ESIC’s New Guidelines for Timely and Effective Resolution of Public Grievances

The Employees’ State Insurance Corporation (ESIC) on November 21st 2024 , has issued an important Office Memorandum regarding the qualitative, effective, and timely resolution of public grievances. This notice comes after concerns were raised about delays and poor-quality resolutions in addressing grievances received from Insured Persons (IPs) and other ESI beneficiaries, particularly through the CPGRAMS portal and other channels.

The delay in resolving grievances beyond 21 days was noted as a source of dissatisfaction among petitioners. To address these concerns, updated instructions have been provided to ensure a more efficient and transparent grievance redressal process.

Key Points from the ESIC Notification

  1. Priority Handling of Grievances
    All Head of the Offices (HoOs) and Grievance Redressal Officers (GROs) are now required to treat public grievances as a priority and resolve them qualitatively within 21 days of receipt. These grievances could be submitted through various means, including the CPGRAMS portal, emails, hard copies, walk-ins, or even complaint boxes. Coordination between different offices or branches is essential to ensure a prompt resolution.
  2. Daily Monitoring of CPGRAMS
    To ensure that grievances are addressed on time, the GROs are instructed to monitor the CPGRAMS portal twice a day — preferably in the morning and evening. This ensures no grievance is left unattended for long periods.
  3. Timely and Qualitative Responses
    Grievances must be resolved within 15 days from the date of receipt, with a clear explanation provided to the petitioner. The quality of the response is crucial, and a reasoned reply must be sent to the complainant, either by letter or email, before marking the grievance as resolved. Additionally, a telephone confirmation of the complainant’s satisfaction must be recorded in the CPGRAMS portal to ensure effective closure.
  4. Prioritization of Key Grievances
    Certain types of grievances will be prioritized, including those related to medical reimbursement, medical facilities, cash benefits, corruption, and issues related to the coverage or under-reporting of employees under the ESI Act. These will be addressed with the utmost urgency, but all grievances must still be resolved within 21 days.
  5. Medical Reimbursement Grievances
    When dealing with medical reimbursement issues, ESIC offices must ensure that complete details are provided to the petitioner, including the amount claimed, entitlement, applicable rates, and any deductions made according to the CGHS rates. This transparency will help prevent recurring complaints.
  6. Timely Responses to PG Appeals
    Appeals against grievances must be responded to with a reasoned reply and referencing the relevant rules, regulations, and instructions. Efforts should be made to resolve public grievance appeals within 20 days of receipt, and no appeal should remain pending for more than 30 days.
  7. Increasing GROs for Efficiency
    To improve grievance resolution efficiency, the number of GROs may be increased if needed. However, the quality of grievance resolution must never be compromised in favor of quantity.
  8. Updating GRO Information
    In case of a change in the Grievance Redressal Officer (GRO) due to transfer, new nomination, or revised work allocation, the details of the new GRO should be immediately updated on the CPGRAMS portal using the existing GRO’s user ID. Additionally, this update should be communicated to the PG Branch at Headquarters, New Delhi via email at pg-hqrs@esic.nic.in.
  9. Language Requirements for Grievances in Hindi
    Grievances submitted in Hindi must be replied to in Hindi to maintain language consistency and better communication with the petitioners.
  10. Standard Operating Procedures (SOPs) for Grievance Redressal
    ESIC’s SOPs and instructions related to grievance redressal, particularly those issued by Headquarters on 8th December 2020, must be followed meticulously when resolving grievances. The SUVIDHA SAMAGAM events, aimed at providing on-the-spot resolutions and gathering feedback from Insured Persons and ESI beneficiaries, will continue at field offices and branch offices as per previous guidelines.

Conclusion

The ESIC’s updated directives are a significant step towards enhancing the grievance redressal process and ensuring that the concerns of Insured Persons and ESI beneficiaries are addressed promptly and qualitatively. With a focus on efficiency, transparency, and a quicker turnaround time, these guidelines will help reduce dissatisfaction and improve the overall experience of the insured persons.

All ESIC officials must adhere to these updated instructions and prioritize public grievances to ensure a smooth and effective grievance resolution process.

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