Kin of workers’ families denied insurance benefits, Mohali industry claims

Says genuine medical claims being rejected, widows waiting months for dependent benefits; seeks upgrade of Mohali ESI Hospital to 400 beds

The Mohali Industries Association has leveled serious allegations against the Employees’ State Insurance Corporation (ESIC), regional office, Chandigarh, accusing it of systematically denying legitimate medical claims and delaying financial benefits to insured workers and their families despite regular contributions under the Employees’ State Insurance (ESI) Scheme.

Addressing a press conference, the association members alleged that the situation worsened since the appointment of regional director Deepak Malik in April this year, claiming that insured workers and employers were facing unnecessary hurdles in securing benefits guaranteed under the Employees’ State Insurance Act, 1948. (HT File)

Addressing a press conference, the association members alleged that the situation worsened since the appointment of regional director Deepak Malik in April this year, claiming that insured workers and employers were facing unnecessary hurdles in securing benefits guaranteed under the Employees’ State Insurance Act, 1948.

The ESI Act is a social security legislation that provides workers with medical, maternity and employment injury benefits. The scheme is mandatory for factories employing 10 or more workers, with employees earning up to ₹21,000 per month covered under the scheme. Employers and employees together contribute 4 per cent towards the ESI fund.

Claims being rejected on ‘technical grounds’

Advocate Jasbir Singh, chairman of the ESI, PF and Labour Laws Committee of MIA, alleged that legitimate medical reimbursement claims were routinely being rejected on technical grounds.

He claimed that families of deceased insured workers were facing prolonged delays in receiving dependent benefits, while excessive documentation was being demanded, creating unnecessary red tape. He further alleged that workers and employer representatives were often met with an uncooperative attitude by ESIC officials.

According to the association, more than 10 dependent benefit cases relating to workers who died due to employment injuries have remained pending for the past eight to nine months because of repeated demands for additional documents allegedly made on the instructions of the regional director.

The association cited three pending cases involving late Ramnath Paswan (IP No 1214222305), late Darshan Singh (IP No 1216233996) and late Murari Yadav (IP No 1215304840), alleging that their families were still awaiting monthly pension benefits.

Meeting with regional director yielded no result

The association’s general secretary Rakesh Vig said a delegation met regional director Deepak Malik on July 8, at MIA Bhawan to highlight the pending benefit cases and other grievances.

According to the association, the regional director maintained that the cases forwarded to his office were incomplete and asked that they be resubmitted as per his directions. MIA alleged that no positive assurance was given during the meeting and described his response as indifferent to the concerns raised.

Malik said, “The claims made by the MIA are factually incorrect. Since I assumed charge as regional director in April 2026, the backlog has been brought down substantially, from nearly 800 pending cases to around 50 within three months. At present, most cases are being processed and approved within 15 days, and we are working to further reduce the turnaround time to just seven days.”

Demand to upgrade Mohali ESI Hospital

Highlighting infrastructure deficiencies, the association said nearly 3.8 lakh insured persons are covered under the ESI scheme in Mohali, yet the city has only a 30-bed ESI Hospital, which it described as grossly inadequate.

The association pointed out that according to ESIC headquarters’ guidelines issued on July 11, 2022, areas with at least 3.5 lakh insured persons should have a 400-bed hospital. It alleged that despite meeting this criterion, Mohali’s hospital has not been upgraded.

The association also criticised the condition of the nine ESI dispensaries in Mohali, alleging that they function from inadequate buildings, suffer from acute shortages of doctors and paramedical staff, and in several cases are operated only by pharmacists.

The association further alleged that neither the ESI Hospital nor any of the nine dispensaries has ambulance facilities.

It claimed that in cases of serious workplace injuries requiring secondary care, patients are routinely referred to Civil Hospital, Phase 6, GMSH-16, GMCH-32 and PGIMER, Chandigarh, despite ESIC having no treatment tie-up with these institutions. As a result, insured workers are forced to bear treatment expenses themselves before seeking reimbursement at Central Government Health Scheme (CGHS) rates.

Task force constituted, 15-day ultimatum

Association president Ashok Gupta said the association constituted an MIA action taskforce to pursue issues affecting industries in Mohali, engage with government departments, monitor follow-up action and provide a structured platform for grievance redressal.

The association has demanded that, ESIC should release dependent benefits in the form of monthly pensions to the widows of the three deceased workers within 15 days. It warned that failing this, the MIA action taskforce would initiate ‘strict action as deemed fit’ against the regional director of ESIC, Chandigarh.