Employee State Insurance Act, 1948

Employee State Insurance Act,
1948
Contribution
• (w.e.f. 1.1.97)
Employee's contribution rate is 1.75%
Employer's is 4.75%
Employees in receipt of a daily average wage up to Rs.100/-

are exempted from payment of contribution. Employers will
however contribute their own share in respect of these
employees.
Collection of Contribution
• An employer is liable to pay his contribution in
respect of every employee and deduct employees
contribution from wages bill and shall pay these
contributions at the above specified rates to the
Corporation within 21 days of the last day of the
Calendar month in which the contributions fall due.
• The Corporation has authorized designated
branches of the State Bank of India and some other
banks to receive the payments on its behalf.
(a) Medical Benefit :
Full medical care is provided to an Insured person and his

family members from the day he enters insurable employment.
There is no ceiling on expenditure on the treatment of an
Insured Person or his family member. Medical care is also
provided to retired and permanently disabled insured persons
and their spouses on payment of a token annual premium of
Rs.120/- .
Sickness Benefit(SB) :
Sickness Benefit in the form of cash
compensation at the rate of 70 per cent of
wages is payable to insured workers during
the periods of certified sickness for a
maximum of 91 days in a year.
In order to qualify for sickness benefit the
insured worker is required to contribute for
78 days in a contribution period of 6 months.
Sickness Benefit…
• Extended Sickness Benefit(ESB) : SB extendable
upto two years in the case of 34 malignant and
long-term diseases at an enhanced rate of 80
per cent of wages.
• Enhanced Sickness Benefit : Enhanced Sickness

Benefit equal to full wage is payable to insured
persons undergoing sterilization for 7 days/14
days for male and female workers respectively.
(c) Maternity Benefit (MB) :
• Maternity Benefit for confinement/pregnancy
is payable for three months, which is
extendable by further one month on medical
advice at the rate of full wage subject to
contribution for 70 days in the preceding year.
(d) Disablement Benefit
Temporary disablement benefit (TDB) : From
day one of entering insurable employment &
irrespective of having paid any contribution in
case of employment injury. Temporary
Disablement Benefit at the rate of 90% of wage
is payable so long as disability continues.
Permanent disablement benefit (PDB) : The
benefit is paid at the rate of 90% of wage in the
form of monthly payment depending upon the
extent of loss of earning capacity as certified by
a Medical Board
(e) Dependants' Benefit(DB) :
DB paid at the rate of 90% of wage in the form of

monthly payment to the dependants of a
deceased Insured person in cases where death
occurs due to employment injury or occupational
hazards.
(f) Other Benefits :
Funeral Expenses : An amount of Rs.10,000/- is

payable to the dependents or to the person
who performs last rites from day one of
entering insurable employment.
Confinement Expenses : An Insured Women or

an I.P.in respect of his wife in case confinement
occurs at a place where necessary medical
facilities under ESI Scheme are not available.
Presently, Rs. 5000
Vocational Rehabilitation :To permanently disabled Insured Person for
undergoing VR Training at VRS.
Physical Rehabilitation : In case of physical disablement due to employment
injury.
Old Age Medical Care :For Insured Person retiring on attaining the age of
superannuation or under VRS/ERS and person having to leave service due to
permanent disability insured person & spouse on payment of Rs. 120/- per
annum.
Rajiv Gandhi Shramik Kalyan Yojana : This scheme of Unemployment
allowance was introduced w.e.f. 01-04-2005. An Insured Person who become
unemployed after being insured three or more years, due to closure of
factory/establishment, retrenchment or permanent invalidity are entitled to :-
Unemployment Allowance equal to 50% of wage for a maximum period of upto
one year.
Medical care for self and family from ESI Hospitals/Dispensaries during the
period IP receives unemployment allowance.
Vocational Training provided for upgrading skills - Expenditure on fee/travelling
allowance borne by ESIC.
Administration
• Employees' State Insurance Corporation(Apex
Corporate Body).
• Standing Committee (Executive Body)
• Medical Benefit Council (Statutory Body)
Administration
• The comprehensive and multi-pronged social security programme is
administered by an apex corporate body called the Employees' State
Insurance Corporation.
• It comprises members representing vital interest groups, including,
employees, employers, the Central and State Government, representatives
of Parliament and medical profession.
• The Corporation is headed by the Union Minister of Labour, as its
Chairman, whereas the Director General, appointed by the Central
Government functions as its Chief Executive Officer.
• The broad based corporate body is, primarily, responsible for coordinated
policy planning and decision making for growth, development and efficacy
of the scheme.
Administration
• A Standing Committee, constituted from
among the members of the Corporation, acts
as an Executive Body.
• The Medical Benefit Council, constituted by
the Central Government, is yet another
Statutory Body that advises the Corporation on
matters related to effective delivery of medical
services to the Beneficiary Population.
Administration
• The Corporation, with its Central Headquarters at New
Delhi, operates through a network of 52 Regional, Sub-
Regional and Divisional Offices located in various States.
• The administration of Medical Benefit is taken care of by
the respective State Government except in case of Delhi
and Noida/Greater Noida area in Uttar Pradesh where
the Corporation administers medical facilities directly.
• The Corporation has taken over the administration of 23
ESI Hospitals in various States for developing them as
ESIC Model Hospitals.
Claims and Disputes
• The E.S.I. Act provides for the establishment of Employees’
State Insurance Courts (E.I. Courts). Such Courts have been
established by the respective State Governments under
Section 74 of the Act all over the Country in areas where
the benefit provisions of the Act are in force.
• The State Governments are empowered to appoint the
presiding officers of civil or criminal courts or industrial
tribunals to function as Employees’ Insurance Courts in
addition to their normal duties.
• Under sub-section (3) of Section 75, the jurisdiction of the
Civil Court has been barred to decide the above disputes.

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Employee State Insurance Act, 1948

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Employee State Insurance Act,

Employee's contribution rate is 1.75%

Employees in receipt of a daily average wage up to Rs.100/-

Full medical care is provided to an Insured person and his

• Enhanced Sickness Benefit : Enhanced Sickness

DB paid at the rate of 90% of wage in the form of

Funeral Expenses : An amount of Rs.10,000/- is

Confinement Expenses : An Insured Women or

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