The Employees’ State Insurance scheme is an integrated measure of Social Insurance embodied in the Employees’ State Insurance Act and it is designed to accomplish the task of protecting ‘employees‘ as defined in the Employees’ State Insurance Act, 1948 against the impact of incidences of sickness, maternity, disablement and death due to employment injury and to provide medical care to insured persons and their families. The scheme is managed by ESIC. ESIC (EMPLOYEES STATE INSURANCE CORPORATION) an autonomous body under the Ministry of Labour Welfare & Employment, Government of India .ESIC manages a fund managed according to the rules and regulations stipulated in the ESI Act, 1948The ESI Scheme applies to factories and other establishment’s viz. Road Transport, Hotels, Restaurants, Cinemas, Newspaper, Shops, and Educational/Medical Institutions wherein 10 or more persons are employed. However, in some States threshold limit for coverage of establishments is still 20. Employees of the aforesaid categories of factories and establishments, drawing wages up to Rs.21000/-(Gross salary) a month, are entitled to social security cover under the ESI Act.

 

The ESI Scheme is financed by contributions from employers and employees currently the employees ‘contribution rate is 0.75% of the wage and that of the employer is 3.25% of the wages is paid/payable in respect of the employees in every wage period.

ESI – Employee and family

Family means all or any of the following relatives of the insured person under ESI:

1. Spouse
2. Minor child
3. Adopted child
4. A child who is receiving education till he attains the age of 21 years
5. An unmarried daughter
6. A child who is infirm by reason of any physical/mental disability
7. Dependent parents
8. Where the Employee is unmarried and his or her parents are not alive, a minor brother or sister wholly dependent upon the earnings of the Employee would also be considered as a family member.

ESI – Medical benefits:

Full medical and surgical care are provided to persons registered under ESI and his dependents without any limit in ESI dispensaries and hospitals including a supply of medicine, ambulance services, and super specialty consultation.

ESI – Sickness Benefit:

Sickness benefit in the form of cash compensation at the rate of 70% 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. Workers suffering from malignant and long-term diseases can claim extended sickness benefit for up to two years at an enhanced rate of 80% of wages.

ESI – Disablement benefit:

From the day of entering insurable employment and irrespective of having paid any contribution, 90% of wage is payable so long as the temporary disability continues. Permanent disablement benefit is payable at the rate of 90% of wage in the form of a monthly payment, in case of permanent disablement based on the extent of loss of earning capacity as certified by a Medical Board.

ESI –Death and Dependent benefit:

A dependent benefit is paid at the rate of 90% of wage in the form of monthly payment to the dependents of a deceased insured person, in cases death occurs due to employment injury or occupational hazards. Benefits are available for dependent parents and spouse till their death and for dependent children until they attain 21 years of age.