ESI patient denied cashless treatment, forced to pay Rs 5.5 lakh at Mohali hospital
ESIC Hospital
Mohali: In a shocking incident, an ESI beneficiary was reportedly required to pay over Rs 5.5 lakh upfront for treatment at an ESIC-empanelled hospital in Mohali, despite being entitled to cashless treatment.
According to the news reports, the patient, an employee of Kosmo Automobiles, Mohali, suffered a work-related injury and was admitted to Eden Critical Care Hospital from November 5 to November 15, 2025. As an ESI beneficiary, he was fully entitled to cashless treatment under the ESIC rules.
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However, the hospital allegedly asked him to pay Rs 5,50,396 upfront, demanding a written undertaking that the amount would be reimbursed later by ESIC. Despite repeated assurances from the patient’s father that his son was eligible for cashless treatment, the hospital kept its demand. This move violates the Memorandum of Understanding signed between ESIC.
A complaint was submitted on November 14, 2025, to the Regional Director and Senior Medical Officer (SMO) of ESIC. Following this, the SMO reportedly instructed the hospital to refund the amount. Yet, the patient was discharged without receiving the full reimbursement.
Speaking to the Indian Express, Advocate Jasbir Singh stated that the matter was later taken up again with the Regional Director and SMO, ESIC, who assured that the entire medical bill would be reimbursed. Accordingly, all bills were submitted to the SMO, ESIC office on December 5, 2025. Shockingly, on December 20, 2025, the insured person received only Rs 1,86,545 against the total bill of Rs 5,50,396, leaving a balance of Rs 3,63,851 unpaid.
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The family has now appealed to the Regional Director of ESIC, Pankaj Vorha, urging urgent intervention to ensure Eden Critical Care Hospital pays the remaining amount. They have also demanded that if the hospital fails to comply, the balance be recovered from its ESIC security deposit and paid to the patient without further delay.
