ESIC to set up societies in states to fix reimbursement issue

The Employees' State Insurance Corporation is working on a plan to set up societies across states for timely delivery of services to intended beneficiaries towards reimbursement of their medical bills.
Of late, ESIC has been receiving complaints of delays by state agencies to process medical reimbursements and sometimes even efforts to bury them, said Raj Kumar, Director General, Employees' State Insurance Corporation (ESIC), at an industry seminar here.
The corporation, he said, is firming up a plan to create societies under the Society Act in all state capitals that will have a mandate to resolve ESIC reimbursement issues of the beneficiaries.

"For this purpose, the ESIC would be writing to all state governments, including the Centre, to make a provisioning to this effect so that reimbursement issues relating to medical ailments of all its members are not subject to states' budgetary exercises and other such bureaucratic routes," Kumar said at the Employees' State Insurance seminar organised by PHD Chamber.
"With the proposed society in place, it will be their responsibilities to transfer the reimbursement amounts to beneficiaries with due diligence and the state agencies play virtually no role in the reimbursement cycle," he said.
The official said the ESIC is a tripartite kind of structure where employers and employees act as key components.

"Creation of societies in the states will smoothen the functioning of the ESIC," Kumar added.
Besides, the ESIC will take approval from its board of directors to hire private medical practitioners and doctors at ESIC hospitals, given a staff crunch.
There are many under-served and unserved areas and primary health care facilities will be extended to ESIC members in these areas too, he added.