ESIC beneficiary charged Rs 5 lakh by private hospital: Industrial bodies allege ‘deep-rooted nexus’, demand high-level probe

Vig demanded a comprehensive, top-level inquiry. “This is only one case that came to light. If investigated properly, large-scale corruption may be exposed. Workers are being deprived of their rightful benefits through illegal partnerships between private hospitals and officials,” he added.

‘Illegal actions, false story fabricated’

Advocate Jasbir Singh, chairman of the Labour Law Committee of Mohali Industries Association, criticised the actions of ESIC officials.

He alleged that SMO Dr Rajiv Chhabra had a “nexus with Eden Hospital” and attempted to divert attention by creating a false narrative related to another (Fulkumari’s husband) unrelated case involving a worker’s finger injury.

“Dr Chhabra wrote to Regional Director Pankaj Vohra citing verification emails and claiming that the insured person was not eligible for super specialty treatment. To support this false story, he formed a committee of four doctors to verify the accident from the factory, which is completely illegal,” Singh said.

He clarified that “since the implementation of the ESIC Act, no doctor has ever been authorised to verify an accident from a factory. Only a social security officer or branch manager can conduct such verification. This clearly shows an attempt to protect the hospital and himself”.

Singh added that despite clear orders from ESIC, the hospital still attempted to impose charges. “Strict action is necessary so that other workers are not harassed in the same manner,” he said.

The case backround

On November 5, Jashanpreet Khan, a worker at Cosmo Automobiles, suffered a rupture and severe infection while on duty. He was initially taken to GMCH-32 and later shifted to Eden Critical Care Hospital, Chandigarh.

Despite Jashanpreet being a registered ESIC beneficiary, the hospital allegedly collected Rs30,000 on the day of admission, received Rs 4,00,000 on November 13 and demanded an additional Rs 90,396 at the time of discharge.
His father stated that he informed the hospital on the first day that his son was entitled to cashless treatment, but the staff allegedly refused, claiming that “ESI treatment will take time”. The family alleged that they were forced to sign a written statement during the admission process.

Following this, Jashanpreet’s father filed a formal complaint with Dr Rajiv Chhabra, Regional Director and State Medical Officer (Punjab), accusing Eden Hospital of illegally taking money from an ESIC-insured patient.
Dr Chhabra issued strict directions to the hospital the same day, stating “a complaint has been received (that) Rs 4,30,000 has been collected from an ESIC beneficiary, which is a violation of the MoU. Refund the amount to the IP for early resolution. Ensure strict compliance with SOP. Treat this as most urgent.” Yet, the hospital allegedly still discharged the patient with a fresh bill showing Rs 90,396 due.

Hospital’s response

Eden Hospital’s manager Karamchand claimed that the family initially did not disclose that the patient was an ESIC card holder.

“When we were informed the next day, we took consent and told the family that we would get the bill reimbursed ourselves. The confusion led to the issue,” he said.

Industry demands transparency, accountability

The Mohali Industries Association has demanded an immediate and thorough inquiry into the conduct of Eden Hospital and the ESIC officials involved. “This case exposes the urgent need for transparency and accountability in ESIC’s functioning, particularly in the empanelled hospital system and medical reimbursement process,” the association said.