Headlines: New Regulation 96C inserted to the Employees’ State Insurance General Regulations, 1950 empowering ESIC or the State Government to refer Insured person or their Family member for Super Speciality medical Treatment at Tie-Up Hospitals, and the expenditure for the same will be borne by ESIC, if prescribed conditions are complied.
Detailed Read:
The Employees’ State Insurance Corporation vide its circular dated June 12, 2019, inserted a new Regulation 96C to the Employees’ State Insurance General Regulations, 1950. The final notification for the insertion of the said Regulation was published on May 27, 2019, in the Gazette of India.
The new Regulation 96C prescribes for the “Referral for Super Speciality Treatment to Tie-Up Hospitals and Expenditure to be incurred by Employees’ State Insurance Corporation Directly.” The Regulation renders the Corporation or State Government to refer any insured person or beneficiary to any tie-up hospital for any medical treatment or facility and all the expenditure of the medical treatment will be borne by the Corporation. The regulation is a step towards ensuring enhanced medical treatment to the insured person and his family members.
An insured person in order to receive the benefit of the Regulation 96C should have completed a minimum period of six months in the insurable employment from the date of registration and must have completed a service a of not less than 78 days in the contribution period. And, when the benefit has to be extended to the family members of the insured person, the insured person should have completed a minimum period of one year from registration and must have completed a service of not less than 78 days in each of the two contribution period. Moreover, an insured person with employment injury and an insured woman with complications arising out of the maternity or in case of any extended sickness provided under the Employees’ State Insurance Act, 1948, and their family members will be eligible to receive the benefit of the said regulation.
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