Professional Documents
Culture Documents
Benefits Under Employees' State Insurance Act, 1948) : L L - II
Benefits Under Employees' State Insurance Act, 1948) : L L - II
PROJECT REPORT ON TOPIC: Benifts Under Employees State Insurance Act, 1948
JAMIA MILLIA ISLAMIA FACULTY OF LAW SUBMITTED IN PARTIAL FULFILMENT OF B.A.LL.B. (HONS.) SIXTH SEMESTER
1|Page
In the first place, I thank our Lecturer of administrative laws I as he had time and again helped me, guided me throughout, and answered all the queries that encountered while my work relating to project was afoot.
Secondly, I thank the library staff who liaised with us in searching material relating to the project.
Thirdly and finally, I thank the almighty for the monumental tacit support, which boosted my morale and help me stay confident all through my work upon the project, placed forth by him.
2|Page
6|Page
Cases In Cricket Club of India v. ESI Corporation2 case, where by some club not only sporting facilities but a kitchen is also maintained, wherein a big number of members come, yet is not necessary that they are participating only in sports activities, they are also entertaining themselves and their guests by partaking beverages and tea served by the club. Activity in the kitchen has a direct connection with the activities carried on in the rest of the club premises. It is necessary that the
7|Page
case, the scheme of the Act does not provide that the
provisions should be made applicable to all the areas and all the establishments at one stroke or to none at all. It would defeat beneficial scheme prescribed by the Act. The power conferred on the State Government under s. 1(5) of the Act can be exercised only with the approval of the Central Government, and therefore, it cannot be said that the limit of extension only to certain areas out of the areas covered under s. 1(3) of the Act would amount to encroachment of the powers of the Central Government. Sec. 1(5) does not indicate that the approval must be sought from the Central Government only after the expiry of the period mentioned in the notice of intention but there are circumstances to indicate that such approval must be secured beforehand. Requirement of s.1(5) is that State Government can extend the scheme provided Central Government gives approval and after consultation with the corporation Where in an establishment activities like that of clearing and forwarding is going on, it would fall within the expression "shop" even though clearing of documents is done in customs house meant for export and import of goods. Person involved in such business is catering to the needs of exporters and importers and others wanting to carry the goods further.-- AIR1993 SC 252 In Cochin Shipping Company v. Employees' State Insurance Corporation 4 case, Sec. 1(4) in the first instance is made applicable to all the factories. The Act envisages the extension of benefit to the employees in other establishments or class of establishments, industrial, commercial or otherwise. The extension of benefit is to be done by means of a notification by the appropriate government. Thus the benefits conferred by the Act cover a large area of employees than what the Factories Act and the akin legislation intended. In Cochin Shipping Co. v. ESI Corporation5 case, it is not actually necessary that the delivery of the goods to the purchaser should take place atthe premises in which the business of buying or
3 4
1989 (1) LLJ 356. 1992 (65) FCR 676. 5 1992 (65) FLR 676.
8|Page
Act does not apply to: Seasonal factories engaged exclusively in any of the activities like: cotton ginning, cotton or jute pressing, decoration of ground nuts, manufacturing coffee, indigo, lac, rubber, sugar, or tea or any manufacturing process incidental to or connected with any of the afore said activities, and including factories engaged for a period not exceeding seven months in a year in blending, packing or repackaging tea or coffee, or in such other processes as may be specified by the central govt. The factories exempted as seasonal from the provisions of the act. Mines Railway running sheds Govt. factories or establishments and Indian naval, military,or air force Other Govt. notified exempted establishments
9|Page
Employer/ Employees Contribution It is the principle employers responsibility to deposit his own as well as employees contribution in respect of all employees including the contract labour, into the E.S.I. Account. Non-availability of funds cannot be a ground for non-payment of contributions under the act. There is no provision to waive the contribution, damages and interest
10 | P a g e
Benefits available to insured employee The purpose of the Employee State Insurance Act is to provide benefits as detailed in the Act particularly in section 46, to the insured persons or their dependants. The following benefits are provided under section 46. 1. Sickness benefit 2. Maternity benefit 3. Disablement benefit 4. Dependents benefit 5. Medical benefit 6. Funeral expenses
1. SICKNESS BENEFIT Acc. To Sec 46(1)(a) of the ESI Act, 1948, Sickness benefit is a periodical payment to an insured person. Sickness has been defined under sec.2(20) of the ESI Act as follows: Sickness means a condition which requires medical treatment and attendance and necessitates abstention from work on medical grounds.
11 | P a g e
Conditions to be observed by recipient of sickness benefit 1.To remain under medical treatment at a dispensary, hospital, clinic or other institution provided under the Act. 2. To carry out instructions given by medical officer or medical attendant in charge of clinic. 3. Not to do anything which retard or prejudice the chances of recovery from the sickness. 4.Not to leave the area in which the medical treatment provided by the Act is given. The recipient can leave such area with the permission of the medical officer as may be specified by the regulation. 5.Receipient allows himself to be examined by any duly appointed medical officer. Examination may be done by other person authorized by the corporation in this behalf.
Disentitlement to sickness benefit (Sec 63) 1.On the day on which he works or remains on leave on a holiday in respect of which he receives wages. 2. On any day on which he remains on strike.
Cases M.L. Kuntarao v. Azam Johi Mills Ltd. Warangal7 In this case the court held that, where provision is made for sick leave by standing order, the employer cannot require the employee to seek sickness benefit provided under this sub-section.
12 | P a g e
13 | P a g e
10
on 4 August, 1994
11
14 | P a g e
3. DISABLEMENT BENEFIT Acc. to Sec(46)(1)(c) and Sec(51), an insured person is entitled to disablement benefit if he: a) Suffers employment injury b) Such employment injury causes; i. temporary disablement for not less than three days ii. Permanent disablement whether total or partial iii. Fulfils the other eligibility condition specified in the regulations of the ESI Act. A. EMPLOYEMENT INJURY Sec 2(8) of the ESI Act.1948 define employment injury as follows: employment injury means a personal injury to an employee caused by accident or an occupational disease arising out of and in the course of his employment, being an insurable employment, whether the accident occurs or the occupational disease is contracted within or outside the territorial limits of India. Acc to Sec2(8), employment injury means personal injury caused to the employee: I. By an accident arising out of & in the course of employment II. By an occupational disease arising out of & in the course of employment III. Such employment is an insurable employment B.DISABLEMENT To claim disablement benefit under the ESI Act, the employment injury suffered by the insured employee must cause ; I. Temporary disablement for not less than three days(excluding the day of accident) II. Permanent disablement whether total or partial. TEMPORARY DISABLEMENT ( Sec 2(21)) Temporary disablement means a condition resulting from an employment injury which requires medical treatment and rendersan employee, as a result of such injury, temporarily incapable of doing the work which he was doing prior to or at the time of injury.
15 | P a g e
Accidents happening while meeting emergency ( Section-51D ) An accident happening to an insured person in or about any premises at which he is for the time being employed for the purpose of his employer's trade or business shall be deemed to arise out of and in the course of his employment, if it happens while he is taking steps, on an actual or supposed emergency at those premises, to rescue, succour or protect persons who are, or are thought to be or possibly to be, injured or imperilled, or to avert or minimise serious damage to property.
Conditions to be specified or observed by the recipient of temporary disablement benefit (Sec 64) i. To remain under medical treatment at a dispensary, hospital, clinic or other institution provided under the Act. To carry out the instruction given by the medical attendant in charge of that dispensary, hospital, clinic or other institution ,as the case may be. ii. While under treatment not to do anything which might retard or prejudice his chances of recovery. iii. To allow himself to be examined by any duly appointed medical officer or other person authorized by the corporation in this behalf. iv. Not to leave the area in which medical treatment provided by the Act is being given, without the permission of the medical officer, medical attendant or such other authority as may be specified in this behalf by the regulations. In Krishnan Kutty Nair v. P.B.V. Regional Director, E.S.I. Corporation and Another12 The appellant who was a covered employee under the E.S.I scheme ,met with an accident in the course of his employment on June 15, 1990. The claimant suffered injury after he had ceased to be an employee. Dismissing the appeal it was held that section-46(c) of E.S.I. Act, 1948
12
17 | P a g e
4. MEDICAL BENEFIT Acc. To Sec 46(1)(e) of the ESI Act, the medical benefit refers to medical treatment for and attendance on insured treatment person. The medical benefit may be extended to the family of the insured person by the corporation at the request of the appropriate Govt.
Acc. To Sec 46(2), the extension of medical benefit to the family of the insured person is subject to such conditions as may be laid down in the regulation under the ESI Act,1948. Acc. To Sec 56(1), an insured person or where such medical benefit is extended to his family, a member of his family whose condition requires medical treatment& attendance shall be entitled to receive medical benefit Acc. to Sec 56(2), medical benefit to the insured person or to his family may be given in the form of ; i. Out-patient treatment & attendance in a hospital or dispensary, clinic or other institution. ii. Treatment as in-patient in a hospital or other institution. iii.Visits to the home of the insured persons. Sec-2(11) of the ESI Act,1948 defines family as follows : family means all or any of the following relatives of an insured person, namely: i. a spouse ii. a minor legitimate or adopted child dependent upon the injured person iii. a child who is wholly dependent on the earning of the injured person and who is: a) Receiving education, till he or she attains the age of 21years b) an unmarried daughter iv. a child who is infirm by reason of any physical or mental abnormality or injury and is wholly dependent on the earnings of the insured person so long as infirmity continues. v. dependent parents
18 | P a g e
13
19 | P a g e
Persons not entitled to receive benefit in certain cases [Sec (63)]An insured person is not entitled to SICKNESS BENEFIT AND DISABLEMENT BENEFIT for temporary disablement:
On the day on which he works, or remains on leave or is on holiday in respect of which he receive wages or, On the day on which he remains on strike Payment of benefit to the nominated person [Sec (71)]
Adjudication of dispute & claims Employees Insurance Court Institutions of proceedings, etc. Powers of employees Insurance Court Reference to High Court
21 | P a g e
Offences and penalties Punishment for false statement :- In this case any false statement or false representation, shall be punishable with imprisonment up to Rs.2000 or with both Punishment for failure to pay contributions :- if any person fails to pay any contribution which under to this act he is liable to pay, he shall be punishable with imprisonment up to three years. Punishment for other contravention :- in contraventions like dismisses, discharges, reduces or otherwise punishes an employee, shall be punishable with imprisonment up to one year or with fine up to Rs.4000 or with both
Power to recover damages :- If employer fails to pay the amount of contribution then corporation may recover from the employer byway of penality. Power of court to make orders :- If court makes order for employer-if employer is not able to make this order within period then employer shall be punishable with imprisonment in respect thereof U/S.85 and shall also be liable to pay fine up to Rs.1000 for everyday.
Miscellaneous Provisions Exemption of a factory or establishment (sec.87 ) Exemption may be granted to any factory or establishment for maximum period of one year. Any exemption granted shall be notified by the notification in the Official Gazette. The appropriate Govt. while granting exemption can improve any terms and conditions upon the factory/establishment. If required any exemption can be renewed for max. one year Before granting any exemption Corp. must be given opportunity to make representation which has to be considered by the Govt.
22 | P a g e
Exemption of a factory or establishment belonging to Govt./any local authority App.Govt. must consult the Corporation Any exemption granted shall be notified by the notification in the Official Gazette. Exemptions shall always be subj. to the conditions imposed by the Govt. Exemptions shall always be in order only if the employees in any such factory/establishment are already in receipt of benefits substantially similar or superior to the benefits provided under this act.
Exemption from one or more provisions of the act (sec.91) Exemption may be granted to any factory or establishment or Any person or class of person by App.Govt. Any exemption granted shall be notified by the notification in the Official Gazette. Any exemption granted under the sec.87,88,90 or 91 in respect of any person or class of person may be enforced either prospectively or retrospectively the date of its enforcement has to be specified(sec.91A)
Obligation of the Employers 1). Get your Factory / establishment registered with in 15 days after the Act becomes applicable. Submit Form 01 to the Regional office for this purpose. Obtain Employers code No. for use in all ESIC Forms / documents and correspondence with the offices of the ESI Corporation. 2). Fill up Declaration Forms in respect of all coverable employees and submit the same to the Regional Office/ Local Office of the corporation well before the Appointed Day and obtain
23 | P a g e
Bar against receiving or recovery of compensation or damages under any other law (Section-53) An insured person or his dependants shall not be entitled to receive or recover, whether from the employer of the insured person or from any other person, any compensation or damages under the Workmen's Compensation Act, 1923 or any other law for the time being in force or otherwise, in respect of an employment injury sustained by the insured person as an employee under this Act. Bhajan Ram v. E.S.I. Corporation14 It was held that the right of the dependent to claim benefit under Section 53 is independent and the mere fact that some amount of compensation has been paid to him under the Workmens Compensation Act, 1923 would not disentitle him from realizing the dependents benefit under the act.
14
71 Punj LR 641.
24 | P a g e
15 16 17
(1983)I L.L.J. 340 (Karn). V.Thangappan v. Tamil Nadu Industrial Insurance Corpn., (1993) II L.L.J. 483 (Mad). (1987) II L.L.J. 183 (Kerala).
25 | P a g e
26 | P a g e
Sickne s benefit
27 | P a g e
Condition for sickness benefit :The recipient of sickness and disablement benefit must observethe
30 | P a g e
following condition.
Sickness benefit Sickness bebenefit
31 | P a g e
32 | P a g e
33 | P a g e