ESIC Benefits

Including medical (documentation) support to all employees

We are providing free consultation for employees to get benefit of below mentioned ESIC benefits.

BENEFITS UNDER THE ESI SCHEME :

The section 46 of the Act envisages following social security benefits:-

1. Medical Benefit

Medical benefit consists of "full medical care" including hospitalisation, free of cost, to the Insured Persons in case of sickness, employment injury and maternity.

2. Sickness benefit (SB)

Sickness Benefit represents periodical cash payments made to an IP during the period of certified sickness occurring in a benefit period when IP requires medical treatment and attendance with abstention from work on medical grounds. Prescribed certificates are Forms 8,9,10,11 & ESIC-Med.13. Sickness benefit is roughly 50% of the average daily wages and is payable for 91 days during 2 consecutive benefit periods.

i) Temporary Sickness Benefit:

Sickness Benefit represents periodical cash payments made to an IP during the period of certified sickness occurring in a benefit period when IP requires medical treatment and attendance with abstention from work on medical grounds.

ii) Extended sickness Benefit:

In addition to 91 days of sickness benefit, insured persons suffering from certain long-term diseases are entitled to extended sickness benefit for 34 diseases.

iii) Enhanced Sickness Benefit:

The ESI Corporation has also extended additional cash incentive to insured persons to promote acceptance of sterilization method by providing sickness cash benefit equal to full wage for a period of 7 days for vasectomy and 14 days for tubectomy. The period for which cash benefit is admissible is extended beyond the above limits in the event of any complications after Family Planning operations.

3. Maternity benefit

The benefit is payable in cash to an insured woman for confinement / miscarriage or sickness arising out of pregnancy / confinement or premature birth of child or miscarriage. For confinement, the duration of benefit is 12 weeks, for miscarriage 6 weeks and for sickness arising out of confinement etc. 30 days. The benefit is allowed at about full wages.

4. Disablement benefit

The Act provides for cash payment, besides free medical treatment, in the event of temporary or permanent disablement as a result of employment injury as well as occupational diseases. The rate of temporary disablement benefit is about 72% of the wages as long as the temporary disablement lasts. In case of total permanent disablement, the insured person will be given life pension at full rate i.e., about 72% of his wages, while in cases of partial permanent disablement a portion of it will be granted as life pension. Cases where daily pension is upto Rs.1.50, it is commutable.

5. Dependant’s benefit

In case of death, as a result of employment injury, the dependants of an insured person are eligible for periodical payments. Pension at the rate of 40% more than the Standard Benefit Rate will be paid periodically to widow (s) and children in accordance with the prescribed share. An eligible son or daughter is entitled to dependant’s benefit up to the age of 18 without any proof of education; the benefit is withdrawn if the daughter marries earlier.

6. Funeral Expenses

Funeral benefit is a cash payment payable on the death of an insured person towards the expenses on his funeral, the amount not exceeding Rs.2,500/-.

7. OTHERS

i) Rehabilitation allowance:

Disabled IPs who remain admitted in an Artificial Limb Centre for fixation or repair or replacement of the artificial limb are entitled to a rehabilitation allowance for each day on which they remain admitted at Artificial Limb Centre at double the Standard Benefit rate. This is not subject to any contributory condition.

ii) Vocational Rehabilitation:

This scheme has been designed to provide financial assistance to IPs who are referred to Vocational Rehabilitation Centre for training. Under the scheme, IPs aged not more than 45 years who are permanently disabled as a result of an employment injury (EI) with loss of earning capacity of not less than 40% and are not in gainful employment subsequent to EI are entitled to receive cash allowance equal to the expenditure charged by the Vocational Rehabilitation Centre or Rs.45/- per day whichever is more during his stay at the Vocational Rehabilitation Centre. Such IPs are also paid conveyance charges for the journey undertaken by them from their normal residence to the centre and back.

iii) Medical Benefit to Retired IP’s and Permanent Disabled IP’s

On payment of Rs.10/- P.M. or Rs. 100/- Per annum in lump sum for one year in advance, Medical Benefit can be provided to:

a) An Insured Person and his or her spouse who leaves insurable employment on attaining the age of superannuation after being insured for not less than five years, till the period for which contribution is paid.
b) An Insured Person and his/her spouse who ceases to be in insurable employment on account of permanent disablement due to employment injury shall be entitled to medical benefit.

 

 

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