The Employees State Insurance Act 1948

objects

The Act Provides certain cash benefits to employees in case of sickness, maternity and employment injury and to make provisions for certain other related matters. Its is applicable to employees in a wide range of establishments drawing monthly wages up to Rs. 1600 (as per 1985 amending Act.) The dependants also are now covered for medical benefits and they receive pension if a worker dies of an employment injury.

Main Provisions
The important benefits provided under the Act are: 1) Sickness benefit 2) Maternity benefit 3) Disablement benefit 4) Dependents benefit 5) Medical Benefit

Main Provisions

All employees covered under the Act and drawing wages of less than Rs. 6 per day are now entitled to receive free medical care. In respect of other, contributions have to be made by both employee and employer. The employees share in the contribution is to be deducted from his wages by the principal employer. The rates of contribution are laid down in Schedule I of the Act and the Government can revise them, if necessary.

Sickness Benefit

Sickness signifies a state of health necessitating Medical treatment and attendance and abstention from work on Medical grounds. Financial support extended by the corporation is such a contingency is called sickness Benefit Sickness Benefit represents periodical payments made to an Insured Person for the period of certified sickness after completing 9 Months in insurable employment.

Sickness Benefit

The Maximum duration for availing sickness Benefit is 91 days in two consecutive benefit periods Standard benefit rate this rate corresponds to the average daily wage of an Insured person during the corresponding contribution period and is roughly half of the daily wage rate.

Extended Sickness Benefit

Extended Sickness Benefit is a Cash Benefit paid for prolonged illness (Tuberculosis / Leprosy, Mental and Malignant diseases) due to any of the 34 Specified diseases The IP should have been in continuous employment for a period of 2 years and should have contributed for atleast 156 days in 4 preceding contribution periods

Maternity Benefit

Maternity Benefit is cash payable to an Insured women for the specified period of abstention from work for confinement or mis-carriage or for sickness arising out of pregnancy, confinement premature birth of child or miscarriage confinement connotes labour after 26 weeks of pregnancy whether the result issue is alive or dead

The daily benefit rate is double the sickness Benefit rate and is thus roughly equivalent to the full wages. Benefits is paid for Sundays also.

Disablement Benefit

Temporary disablement benefit : In case of temporary disability arising out of an employment injury or occupational disease., Disablement benefit is admissible to insured person for the entire period so certified by an Insurance Medical officer / Practitioner for which IP does not work for wages. The benefit is not subject to any contributory condition and is payable at a rate which is not less than 70% of daily average wages. However, not payable if the incapacity lasts for less than 3 days excluding the date of accident.

Disablement Benefit
2. Permanent disablement benefit In case an employment injury or occupational disease results in permanent, partial or total loss of earning capacity, Periodical payments are made to the IP for life at a rate depending on the actual loss of earning capacity as may be determined and certified by a duly-constituted Medical Board. The rates of Disablement Benefits are determined in accordance with the provisions of Rule 57 of ESI (Central) Rules, 1991.

Dependants Benefit

Dependents Benefit is a monthly pension payable to the eligible dependents of an insured person who dies as a result of an Employment Injury or occupational disease Beneficiaries and Duration of benefit a). Widow / widows during life or until remarriage b). Legitimate or adopted son until age 18 or if legitimate son is infirm, till infirmity lasts. c). Legitimate or adopted unmarried daughter until age 18 or until marriage, whichever is earlier, or if infirm, till infirmity lasts and she continues to be unmarried. In the absence of any widow or legitimate child, the benefit is payable to a parent or grandparent for life, to any other male dependent until age 18 or to an unmarried or widowed female dependent until age 18.

Main Provisions

The standard benefit rates prescribed under various schemes also can be revised. Medical care is provided through hospitals set up under the Act as also through reservation of beds in existing hospitals. The Act also provided for setting up special courts by the State Governments to decide disputes and to adjudicate claims.

Administration

The Employees State Insurance Corporation is created under the Act to administer the various provisions.

Assessment

At the end of march 1983, 88950 employers and 62.72 lakh employees were covered under the Act.