Under the Employee State Insurance Act, 1948, enrolled individuals can avail of benefits in the form of financial coverage during any untimely health-related eventuality. Under this scheme, eligible members can enjoy disability benefits, medical benefits, maternity benefits, unemployment allowance, etc.
This scheme is a godsend for employees who can enjoy financial coverage during medical emergencies.
Prime Minister Pandit Jawahar Lal Nehru rolled out the ESIC scheme on February 24, 1952. The primary purpose of the Employees’ State Insurance Act is to offer social security to workers with regard to sickness, permanent or temporary disablement or death during employment. Employees State Insurance Act, 1948 provides provisions for a worker’s immediate dependents.
Under Section 2(12), this Act applies to all non-seasonal factories with 10 or more employees. This scheme extends to –
Under State Government:
Under Central Government:
Employees’ State Insurance Act, 1948, aims to offer financial benefits to enrolled workers during sickness, pregnancy, and any disablement (permanent or temporary) due to employment injury.
Under the Employees’ State Insurance Act, the insured person and his/her dependents will receive cash benefits, medical relief, maternity cover, and compensation for fatal diseases or injuries. In addition, dependents of deceased workers will receive a pension.
Also Read – https://navi.com/blog/employee-state-insurance-corporation-scheme/
Let’s delve into some of the key features of this Government-sponsored social security scheme.
Insured members can avail of compensation of up to 70% of their wages during periods of certified sickness. This facility is valid for 91 days during two consecutive benefit periods. In case of long-term ailments, you can enjoy up to 80% compensation rates for 2 years.
Under medical benefits, you can get cover for surgical care, doctor’s consultation, ambulance charges, and medication. There is no limit on such expenses.
Beneficiaries can avail about 90% of their salaries as compensation in case of temporary disability. These benefits are available from the 1st day of employment.
Under such circumstances, individuals will get paid for the loss incurred in their earnings during that period. But a disability should last for more than 3 days from the accident date.
Women employees can receive cash benefits due to health issues resulting from premature birth, miscarriage, pregnancy, confinement, and medical termination of pregnancy.
The maximum compensation period ranges between 6 to 12 months, based on the medical requirement. This period can get extended by 1 more month.
You will have to contribute for at least 70 days in 2 successive contribution periods before your period of cash benefit.
In case of any death due to an accident during employment, a deceased member’s dependents can receive 90% of their salary. Parents and spouses can enjoy these benefits till their death. But children can avail of the benefits till the age of 25 years.
In case of death, dependents can claim up to Rs. 10,000 to complete all final rituals of an expired employee.
After coverage for at least 5 years, you and your spouse can utilise various medical benefits even post-retirement.
You must pay Rs. 120 as a fee every year to avail of this benefit.
After being insured for at least 3 years, if you lose your job due to retrenchment, closure of workplace, or permanent disability, you can receive certain benefits under Rajiv Gandhi Shramik Kalyan Yojana.
These benefits will include medical assistance and an unemployment allowance of up to 50% of salary for at least 1 year.
Step 1: The employer must fill in employee details after downloading the ESI application form from the official portal.
Step 2: As an employee, you must submit the photos of the dependents, and the employer has to attest to the photograph.
Step 3: After filling out a Pehchaan application form, take this form to the nearest ESIC office, where the fingerprints and photos will be documented.
Step 4: Within 30 days, you will receive 2 sets of cards through a courier or by visiting the nearest ESI branch.
The Employee State Insurance Act thus provides a range of benefits to workers. It also offers a financial safeguard to the families of an injured or deceased employee while at work. Social security schemes and insurance plans are thus of utmost importance in our daily lives.
Individuals failing to comply with the eligibility of this scheme can alternatively opt for a health insurance policy from institutions such as Navi. Navi provides a wide range of benefits from 10,000 plus network hospitals, daycare treatments, pre and post hospitalization charges and health cover up to 1 crore. Monthly Premium starts just from INR 241. Download the Navi App today!
Ans: Pehchan Card is the other name for an ESIC card.
Ans: In case of the demise of employees while at work, the benefits will get transferred to their dependents.
Ans: The records needed are:
Employee Wage Master
Books of Accounts
Accident Register in Form 11
Inspection Book
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