The Department
  Administration of ESI scheme
  Organisational Structure
  Beneficiaries
  Our Mission and
Infra structure
  Monitoring Committees
  Frequently Asked Questions
Grievances Redressal 
Government Order 
Rules and Procedure 
  ESI Corporation Forms 
   Treatment under Regulation – 96A
  Citizens Charter  
  Right to Information Act 2005
 
 
 

 

ESI Corporation Forms on Website

For the convenience of employers/employees, ESI Corporation Forms can now be downloaded from ESI Corporation Website:

i)  www.esic.org.in            ii) www.esic.nic.in


SI No
Name of Dispensary
Pincode
Tel.No
SI No
Name of Dispensary
Pincode
Tel. No

72

Ernakulam 682018   82 Thoppumpady 682006 2231852

73

Fort Kochi 682001   83 Karimugal 682303  

74

Kalamassery 682024   84 Thrippunithura 682301  

75

Cochin Special Economic Zone, Kakkanad     85 Udyogamandal   2555542

THRISSUR


SI No
Name of Dispensary
Pincode
Tel.No
SI No
Name of Dispensary
Pincode
Tel. No

86

Alagappanagar

680302

2851345

94

Kuttanalloor

   

87

Alloor

680683

2880267

95

Mala

680735

 

88

Chalakkudy

680307

 

96

Mulamkunnathukavu

680581

 

89

Chavakkad

680512

 

97

Olarikkara

680012

2361239

90

Irinjalakkuda

680125

 

98

Ollur

680306

2352349

91

Karuvannur

680711

2342280

99

Poonkunnam

680002

2381742

92

Koratty

680308

2832029

100

Vadakkancherry

680589

 

93

Kunnamkulam

680517

         


Palakkad
Idukki
SI No
Name of Dispensary
Pincode
Tel.No
SI No
Name of Dispensary
Pincode
Tel. No

101

Chittur

678101

 

108

Thodupuzha

685584

 

102

Kanjkode

678621

   

Malappuram

103

Ottappalam

670101

 

109

Kuttippuram

679571

 

104

Palakkad

678012

 

110

Malappuram

676519

 

105

Parali

678612

 

111

Nilambur

679329

 

106

Shornur

679121

 

112

Vazhakkad

673640

 

107

Walayar

678624

 

113

Kottakkal

   

Kozhikode


SI No
Name of Dispensary
Pincode
Tel.No
SI No
Name of Dispensary
Pincode
Tel. No

114

Beypore

673015

 

120

Kainatty, Vadakara

673004

 

115

Chakkorathukulam

673006

 

121

Chemancherry

673321

 

116

Chalappuram

673002

 

122

Kunnathupalam

673011

2430835

117

Cheruvannur

673631

 

123

Mavoor

673661

2483123

118

Chungam

673631

 

124

Meenchanda

673018

2402241

119

Eranhipalam

673006

 

125

Puthiyara

673002

2302694


Kannur


SI No
Name of Dispensary
Pincode
Tel.No
SI No
Name of Dispensary
Pincode
Tel. No

126

Azhikode

670009

 

131

Mangattuparamba

670562

 

127

Chonadam

670641

 

132

Melechovva

670006

 

128

Dharmadom

670106

 

133

Pappinisserry

670561

2778103

129

Kannur

670004

 

134

Payyannur

670307

 

130

Kuthuparamba

670643

 

135

Thaliparamba

670241

 
       

136

Valapatanam

670010

2778091


Kasargod


SI No
Name of Dispensary
Pincode
Tel.No

137

Kasargod

671123

 




What is the procedure to be followed by the ESI beneficiaries to avail super speciality treatment?

The ESI beneficiary should first approach the Medical Officer of the ESI Dispensary to which he/she is attached with all his/her medical records including the concerned specialist’s advice that treatment at super speciality hospital is essential.

The Insurance Medical Officer will the give a letter to the beneficiary for getting eligibility certificate from the local office of the ESI Corporation. The IMO informs him/her on all the procedural formalities to be followed, gives him three photo affixed identity certificates and refers him/her to the Superintendent of the nearby ESI Hospital.

The Superintendent of the ESI Hospital will then examine the patient and verify all the records produced by him. If the case is found to be genuine, he will give a preference letter to the concerned department of the super speciality hospital. The reference letter will contain the details such as name of the patient, two identification marks, home address, name of Insured Person, relationship to the patient, Insurance Number, name of work place, eligibility, diagnosis, clinical history, investigations done, treatment given and the need for reference.

The patient will then attend the super speciality hospital where he is examined and an estimate of the required treatment is issued.

The following documents are then submitted in original and sufficient copies to the Director of Insurance Medical Services for scrutiny and sanction.

  • The Insured Persons’ request (+2 copies)
  • Forwarding letter from the ESI Hospital Superintendent (+1 copy)
  • Reference form filled by the Superintendent (+3 copies)
  • Identification Certificate (with photo and 2 identification marks) (+2 copies)
  • Entitlement Certificate (+3 copies)
  • Medical Records from the Dispensary
  • Medical Report and estimate from the Super Speciality Hospital (+3 copies)
  • Certificate of Non-availability of treatment from Medical College in the case of Private Hospitals (+3 copies)

If the application is in order, the Director of Insurance Medical Services will forward it to the Government for sanction of teh estimated amount. Once Govt. sanction is accorded, it will be sent back to Director of Insurance Medical Services to meet the expenses from Revolving Fund. The Director of Insurance Medical Services will forward the sanction order to the Regional Director, ESI Corporation, Thrissur for the issue of cheque. The RD will send the cheque favouring the head of the Medical Institution to the Director of Insurance Medical Services, who in turn will send it to the concerned hospital and also inform the Insured Person immediately.

Once the treatment is completed the bills for the utilized amount, demand draft in favour of RD, ESIC, Thrissur for the unutilized amount, utilization certificate and treatment certificate are to be sent to the Director of Insurance Medical Services by the Hospital authority.

3.  What is the procedure for availing treatment from Regional Cancer Centre? (Treatment on credit)

The reference letter is obtained from the Superintendent, ESI Hospital, as above and the patient can straightaway start treatment at the RCC. Copies of the reference letter and other documents are forwarded to the Director of Insurance Medical Services by the Superintendent.

Once treatment is completed RCC will submit the bills with copies reference letter, entitlement certificate, identification certificate and the treatment certificate to the Director of Insurance Medical Services. The bills are passed and sent to the Government for sanction. The sanction order is sent to the RD for payment. On receiving the cheque from RD, Thrissur, the Director of Insurance Medical Services will forward it to the Regional Cancer Centre.

4. Which are the Hospitals in the State where ESI beneficiaries can avail super speciality treatment>

i. All Medical College Hospitals (Government)

ii. Regional Cancer Centre

iii. Sree Chithira Thirunal Institute for Medical Sciences & Technology (SCTIMST), Thiruvananthapuram

iv. Amritha Institute of Medical Sciences & Research Centre, Kochi

v. Fathima Hospital, Kozhikode

5. What is the procedure for getting money re-imbursed for purchasing medicines which are not available in ESI Institutions from outside?

First the details of all drugs purchased should be entered in an essentiality form. The bill and the essentiality form should then be countersigned by the doctor who prescribed it affixing seal. The bill, essentiality form, doctor’s prescription and an application in white paper should then be submitted to the IMO of the Dispensary.

Treatment under Regulation – 96A

Regulation 96-A reads as follows:- claims of expenses incurred in respect of medical treatment of Insured Person and his family may be accepted in circumstances and subject to such conditions as the Corporation may be general or special order specify.

The following conditions have been laid down under this regulation:

  • Full authority is vested with the State Government concerned to re-imburse expenditure in respect of medical treatment of Insured person and his family.
  • It may be left to the discretion of the State Government to decide the Authority within their machinery who will approve the expenditure in question; and
  • Time limit for submission of the claims for re-imbursement is one year.

A list of Types of cases for which re-imbursement is permitted is given below: -

1.  Serious cases of accident or illness admitted directly into recognized hospital’s where owing to the clinical condition of the patient, being unconscious or otherwise, it was not possible to reveal his identity; as an ESI patient and the hospital authorities recovered hospital expenses directly from the patient or the employer.

2.  Serious cases of accident / illness where a beneficiary was admitted directly at a Private Hospital or in a non-recognized Hospital where admission in a hospital recognized under the scheme would have seriously jeopardized his health like sudden heart attacks, fracture of the spine, cerebral hemorrhage etc.

3.  Expenditure incurred on investigation for blood transfusion which is not available in the ESI Hospitals.

4.  In respect of specialized examination, laboratory test, X-ray, other imaging services etc, recommended by specialist and which is beyond the scope of the facilities available in the ESI/empanelled Hospitals.


State Public Information Officer and State Assistant Public Information Officer or the Insurance Medical Services Department as per Right to Information Act 2005 are the following: - 

District

State Public Information Officer

Asst. Public Information Officer

Thiruvananthapuram

Dr. V.A John, Joint Director,
O/o the Director of Insurance Medical Services, Trivandrum

Sri. N.Rajeev, Head Clerk|
O/o the Director of Insurance Medical Services, Trivandrum

Kollam

Smt. K.C.Prabhadevi,
Senior Supdt,
O/o the RDD, Kollam

Sri. R.Unnikrishnan, U.D Clerk
O/o the RDD, Kollam

Pathanamthitta

Dr. Bindu. K. Gopal, IMO
ESI Dispensary, Kadampanad

Smt. Monikkamma Joseph,
Head Clerk

Alappuzha

Dr. R.Ajitha Nair, Supdt
ESI Hospital, Beach Ward, Alappuzha

Smt. P.R.Prasannakumari,
Junior Supdt.
ESI Hospital, Alappuzha

Kottayam

Dr. M.C. Mathew, Supdt
ESI Hospital, Vadavathur

Sri.K.Sudarsanalal, Junior Supdt
ESI Hospital, Vadavathur

Idukki

Dr. Binny James Dantes, IMO
ESI Dispensary, Thodupuzha

Smt. Annamma Eapen, U.D Clerk
ESI Hospital, Thodupuzha

Ernakulam

Smt. K.Vanaja, Senior Supdt.
O/o the RDD, Ernakulam

Sri. P.K.Dileep, U.D Clerk
O/o the RDD, Ernakulam

Palakkad

Dr.K.S.Vijayasree, Supdt.
ESI Hospital, Palakkad

Smt. V. Valsala, Head Clerk
ESI Hospital, Palakkad

Kozhikode
Wayanad

Sri. P.P.Apputty, Senior Supdt.
O/o the RDD, Kozhikode

Sri.M.Vijayan, U.D Clerk
O/o the RDD, Kozhikode

Kannur

Dr. K. Sukumaran, Supdt.
ESI Hospital, Thottada

Sri.A.Sivaprasad, U.D.Clerk
ESI Hospital, Thottada

Kasargod

Dr. Subha, IMO
ESI Dispensary, Kasargod

Sri. Purushothaman, U.D Clerk
ESI Dispensary, Kasargod

 




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for Public Relations Department, Govt. of Kerala.