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ESI SCHEME V/S MEDICAL INSURANCE

How superior is the ESI Scheme as compared to the Mediclaim policy / Group mediclaim policy issued by the general insurance companies.

The benefits under the ESI Scheme are far superior as compared with the risks covered under the mediclaim policies. Medical care is only one of the many benefits available to the beneficiaries under the Scheme. Even this one benefit comes out far superior when compared with the mediclaim policies, as detailed below:

Commercial medical insurance ESI Scheme - medical benefit
Commercial motive Welfare motive
Premium based on age, sum insured & claims experience Uniform rate of contribution for all age groups
Medical check up reqd. for certain persons No medical checkup required for anyone
Ceiling on overall benefit (sum insured) as well as compartmental limits No limit on medical benefit
Exclusions prescribed No exclusions
Extra premium for covering family of insured person (IP) Family members of IP covered at no extra cost
Only medical benefit Provides many benefits in addition to medical benefit
Choice of class of treatment(general ward, pvt./ semi pvt. ward, etc.) No choice of class of treatment-only general ward