1)
All factories excluding seasonal factories
employing 10 or more persons and working
with electric power.
2)
All factories excluding seasonal factories
employing 20 or more persons and working
without electric power.
3)
Any establishment which the Government may
specifically notify as being covered.
4) Shop employing 20 or more persons.
Note:
As soon as the above conditions are fulfilled
the employer should furnish the details
in Form-01 to ESI office for registration
under the ESI Act, 1948 & Obtaining
of the employer’s Code No.
Eligibility
1)
Any person employed for wages (up to Rs.
6,500) in or in connection with the work
of a factory or establishment end.
2) Any person who is directly employed
by the employer in a factory or through
his agent on work which is ordinarily
part of the work of the factory or incidental
to purpose of the factory.
Benefits
1)
Free medical treatment is offered to covered
employees at hospital and dispensaries run
by the ESI Corporation.
2) About 7/12th of employees normal
wage will be payable to him by ESI during
sickness.
3) Maternity benefit for 12 weeks
of which not more than 6 weeks should be
preceding confinement.
4) Injury during/in course of employment
resulting in temporary/permanent disablement
entitles the covered employee to a
regular payment to substitute his lost wages.
5) Death during course of employment
entitles specified dependents to a regular
payment.
6) One time payment of Rs. 1,500
to help meet funeral expenses.
Penal
Provisions
1)
For employees’ contribution : Imprisonment
for minimum 2 yrs. to maximum 5 yrs. and/or
fine of Rs. 25,000/- .
2) For employer’s contribution
: Imprisonment for minimum 6 months to maximum
3 yrs. and/or fine of Rs. 10,000/- .
BENEFITS
AT A GLANCE
Benefits
Contributory
Conditions
Duration
Rate
To
Whom Payable
1} a)
Sickness Benefit.
I.P.
Should work for wages for 78 days
in the corresponding C.P.(wef 19-9-98).
91
days in any two consecutive B.P.
As
per S.B.R.
Only
to the insured person
b)
Extended sickness benefit for long
term diseases like TB, leprosy, etc.
Continuous
employment for the period of two years.
124
days which may be extended upto 309
days in specified chronic cases during
a period of three yrs.
25%
Above S.B.R.
Only
to the insured person
c)
Enhanced sickness benefit (for under-going
sterilization operation for family
planning)
Same
as for Benefit (a)above
7
days for vasectomy & 14 days for
tubectomy extended in cases of post-coperative
complications etc.
Twice
the S.B.R
Only
to the insured person
2}
Disablement Benefits (employment
injury)
No
Conditons
In
case of temporary disablement: as
long as incapacity lasts & in
case of permenant dis-ablement: for
life time.
a)
For temp. Only to disablement the
injured 40% above person S.B.R
EXPLANATION:
Where more injuries than one are caused
by the same accident, the rate of
benefit payable under clauses (c)
& (d) shall be aggregated but
not so in any case as to exceed the
FULL RATE and in cases of disablement
not covered by clauses (a), (b), (c)
& (d) at such rate, not exceeding
the FULL RATE, as may be provided
in the regulations.
3}Dependent’s
Benefit (employment injury)
No
condition
To
the WIDOW/S during life time until remarriage.
To the legitimate or adopted SON/S until
he attains the age of 18yrs.
3/5
of the FULL RATE, if there are 2 or
more widows, the amt. payable to the
widows shall be divided equally between
the widows.
2/5 of the FULL RATE, if there are 2
or more sons, the amt. payable to the
sons shall be divided equally between
the sons. Subject to a min of Rs. 14/-
Benefits
Contributory
Conditions
DurationRate
To
Whom Payable
To
the legitimate or adopted unmarried
Daughter/s until she attains the age
of 18 yrs. or until marriage, whichever
is earlier,
-----do-----
In
case the deceased person does not
leave a widow or legitimate or adopted
child. D.B. shall be payable to...
a)
Parent or grand parent, for life
3/10th
of the
FULL RATE
b)
Any other male dependent, until
he attains the age of 18 yrs.
2/10th
of the
FULL RATE
c)
Any other female dependent, until
she attains the age of 18 yrs. Or
until marriage whichever is earlier.
-----do-----
N.B.
An insured person whose PERMANENT DISABLEMENT
has been assessed as final and who has been
awarded permanent disablement benefit at
a rate not exceeding Rs. 1.50 per day may
apply for a lumpsum payment and such amount
shall be determined by multiplying the daily
rate of permanent disablement benefit by
the figure indicated in Co. 2 of the Schedule
III of the Regulations.
Benefits
Contributory
Conditions
Duration
Rate
To
Whom Payable
4}Maternity
Benefits
Payment
of contribution for 70 days in one or
two consecutive
periods.
12
weeks of which not more than 6 weeks
can precede the expected date of confinement.
Twice
S.B.R.
Subject t o min
of Rs.20/- p.d.
Only
to the insured
person.
6
weeks for miscarriage or for medical
termination of pregnancy
Additional payment for one month for
Complications (pre or post) arising
out of Pregnancy
Medical
bonus
of Rs.250/-
where ESI
facility is not
available.
5}Medical
Insured
Benefit
No
Condition
From
the date of entry of an employee into
an insurable employment so long as he
remains
in insurable employment and three after
for certain additional period
Full
Medical
care including
hospitalisation
Person
as
well as his/
her Family
Members as defined u/s 2(11) of the
Act.
6}Funeral
Expenses
No
condition (i.e.merely by virtue of being
an insured person)
One
time lump sum payment
Not
more than
Rs. 1,500/-
To the eldest
surviving
member of the
family of the
deceased I.P.
Or to the
person who
actually incurs
the
expenditure
on the funeral
of an I.P.
7}Rehabilitation
Allowance
No
condition
For
each day of which I.P. remains admitted
in Artificial Limb Center for fixation,
repair or replacement of artificial
limb.
Same
as at
1(a) Up to Rs. 15 L
for
Rehabilitation.
Only
to the
I.P.
8}Medical
Benefit to insured
persons who
ceases insurable
employment on
account of permanent disablement.
No
condition but an. I.P. has to pay Rs.
10/- pm in lump sum for one year in
advance every year.
Till
the date on which an I.P. would have
attained the age of
superannuation
Medical
Benefit
IP
and spouse.
9}Medical
Benefit to retired
Insured Period
1) Insurable employment
for a period of 5 years
and
2) Payment of Office of the
Contribution @ Rs. 15/-
PM in lump sum
for one year in
advance, each year.
Till the time
yearly contribution is
paid to the Concerned
Office of the
Corporation.
-----
Insured
person and
his spouse
OTHER
BENEFITS
Supply
of special aids : Insured persons and members
of their families are provided artificial
limbs, hearing aids, artificial dentures,
spectacles (for insured person only) &
artificial appliances like spinal supports,
cervical collars, walking callopers, crutches,
wheel chairs and cardiac pace makers, dialysis/dialysis
with kidney transplant etc. as part of medical
care under the ESI Scheme.
