The Employee State Insurance Act provides social security benefits like sickness benefits, maternity benefits, dependents' benefits, and medical care to Indian employees and dependents. Benefits are financed by contributions from employers and employees. The scheme is administered by the Employees' State Insurance Corporation through a network of offices across India. Disputes are handled by specialized Employees' Insurance Courts established by state governments.
The Employee State Insurance Act provides social security benefits like sickness benefits, maternity benefits, dependents' benefits, and medical care to Indian employees and dependents. Benefits are financed by contributions from employers and employees. The scheme is administered by the Employees' State Insurance Corporation through a network of offices across India. Disputes are handled by specialized Employees' Insurance Courts established by state governments.
The Employee State Insurance Act provides social security benefits like sickness benefits, maternity benefits, dependents' benefits, and medical care to Indian employees and dependents. Benefits are financed by contributions from employers and employees. The scheme is administered by the Employees' State Insurance Corporation through a network of offices across India. Disputes are handled by specialized Employees' Insurance Courts established by state governments.
The Employee State Insurance Act provides social security benefits like sickness benefits, maternity benefits, dependents' benefits, and medical care to Indian employees and dependents. Benefits are financed by contributions from employers and employees. The scheme is administered by the Employees' State Insurance Corporation through a network of offices across India. Disputes are handled by specialized Employees' Insurance Courts established by state governments.
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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.