BENEFITS under Employees State Insurance Act 1948 –

If an employer is employing 10 or more persons in any factories, Shops, Hotel, Restaurants, Cinema including preview theatres, Road-motor transport undertakings, Newspaper establishments, Private Medical Institutions, Educational Institutions and to contract and casual employees of Municipal Corporation/Municipal Bodies, such employer is required to obtain coverage from ESI corporation which provides benefits for his / her employees who are drawing wages / salary upto Rs. 21,000/-

The employee’s contribution rate is 0.75% of the wages and that of employer’s is 3.25% of the wages paid/payable in respect of the employees in every wage period.

Employees State Insurance act, 1948 is very much beneficial to those employees and their family members covered under the act as it provides several benefits.

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The section 46 of Employees State Insurance Act envisages following 6 social security benefits:

(a) Medical Benefit : Employees State Insurance corporation provides full medical care to an Insured person and his family members from the day he or she joins any employment. There is no expenses ceiling on expenditure for the treatment of an Insured Person or his family member. Medical care is also provided to the persons who are retired or permanently disabled and their spouses on payment of a token annual premium amount of Rs.120/- .

 

(b) Sickness Benefit (SB) : ESIC also Sickness Benefit in the form of cash compensation at a rate of 70 per cent of salary or wages is payable to insured workers for the duration of certified sickness for a maximum of 91 days in a year. For an insured person to qualify for sickness benefit he or she is required to contribute for a minimum of 78 days in a contribution period of 6 months.

1. Extended Sickness Benefit (ESB): Sickness Benefit is extendable upto 2 years in case of 34 malignant and long-term diseases at an enhanced rate of 80 per cent of salary or wages.
2. Enhanced Sickness Benefit: ESIC provides enhanced Sickness Benefit equal to full wage is to insured persons undergoing sterilization for 7 days for male and14 days for female workers.

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(c) Maternity Benefit (MB) : Maternity Benefit for confinement/pregnancy is payable for 26 weeks, which is further extendable by 1 month on medical advice at the rate of full wage subject to a contribution for 70 days in the preceding 2 Contribution Periods.

 

(d) Disablement Benefit

1. Temporary disablement benefit (TDB) : From the day and employee/worker enters insurable employment & irrespective of having paid any contribution to ESIC, in case of employment injury he or she becomes eligible for this benefit. Temporary Disablement Benefit is paid at the rate of 90% of wage so long as disability continues.
2. Permanent disablement benefit (PDB) : The permanent disablement benefit is paid at the rate of 90% of wage in form of monthly payment depending upon the extent of loss of earning capacity which is certified by Medical Board.

 

(e) Dependants Benefit(DB) : Dependents benefit is paid at a rate of 90% of salary or wage in the form of monthly payment to dependants of a deceased Insured person if the death occurs due to employment injury or due to any occupational hazards.

 

(f) Other Benefits :

1. Funeral Expenses : In case of death of insured person, an amount of Rs.15,000/- is payable to dependents or to the person who performs last rites. This is applicable from day he or she enters insurable employment.
2. Confinement Expenses : In case of an Insured Women or an Insured person’s wife if confinement occurs at a place where necessary medical facilities under the ESI Scheme are not available, one can claim confinement expenses.

In addition to the above mentioned benefits, the scheme also provides some other benefits which are need based, to the insured workers.

1. Vocational Rehabilitation : to the worker/employees who are permanently disabled for undergoing VR Training at VRS.
2. Physical Rehabilitation : this is applicable if an insured person is disabled due to an employment injury.
3. Old Age Medical Care : Insured Person retiring on attaining the age of superannuation or under VRS/ERS or such person having to leave service due to permanent disability, such insured person & spouse on payment of Rs. 120/- per annum can avail medical care.

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Rajiv Gandhi Shramik Kalyan Yojana :

Rajiv Gandhi Shramik Kalyan Yojana of Unemployment allowance was introduced w.e.f. 01-04-2005. An Insured Person who becomes unemployed after being insured for 3 or more years, due to closure of factory or establishment, retrenchment or permanent invalidity are entitled to the:-

• Unemployment allowance which are equal to 50% of wage for a max. period of upto 2 Years.
• The Medical care for self & family from ESI Hospitals or Dispensaries during the period when Insured Person receives unemployment allowance.
• Vocational Training is provided for upgrading skills – Expenditure on fee or travel allowance is borne by ESIC.

 

Author:-

Shashikant Phadtare

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