Form 22 ESIC (Funeral Expense Claim) PDF

PDF Name	Form 22 ESIC (Funeral Expense Claim)
No. of Pages	1
PDF Size	0.02 MB
Language	English
PDF Category	Government
Source / Credits	Multiple Sources
Uploaded By	Krishan

Form 22 ESIC (Funeral Expense Claim) - Summary

Download the Form 22 ESIC in PDF format using the link below. This application form is essential for claiming funeral expenses and is issued by the Employee’s State Insurance Corporation (ESIC), which operates under the Ministry of Labour and Employment, Government of India. You can easily download it from the official ESIC website at servagya.com or directly from the link provided at the end of this page.

Understanding Form 22 ESIC

Form 22 ESIC is an important document that acts as a medical acceptance card issued by the Employees’ State Insurance Corporation in India. This card serves as an identity proof for insured individuals and their family members, allowing them to access medical benefits under the ESIC scheme.

A nominee, or in their absence, the eldest surviving family member of the deceased insured person, must submit a claim using the provided format to cover the funeral expenses incurred for the insured person.

If the deceased is a minor, the guardian is required to sign the claim form on behalf of the minor. The guardian should also add the following details below their signature.