7/27/2019 Article - Unique ESI Scheme.pdf

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U N I Q U E S O C I A L S E C U R I T Y S C H E M E B Y I

(B.K.SAHU)Insurance Commissioner

Employees' State Insurance Corporation, INDIA

(VIEWSEXRESSEDARE PERSONAL)

Employees' State Insurance Scheme of Govemment

of India is a unique scheme for the workers in the organized

sector in that it provides medical care and cash benefits in

the contingencies of sickness, maternity, disablement and

death due to Employment Injury to workers covered under

this Act. It otherwise known to be a scheme for the workersfrom Cradle to Grave ..

Presently, the Scheme is extended to non-seasonal

factories employing 10 or more persons and to specified

establishments like shops, transport, medical and

educational institutions employing more than20/10 persons.

Recently, Central Government has issued notification for

extending ESI Scheme to contract/casual workers of Public

Sector Undertakings. The wage ceiling limit for coverage is

RS.15,OOO per month and contribution of1.75% employees

contribution ard 475% employers' contribution is paid by

eac, vorkers co ered under this,Scheme.

The benefits under ESI Scheme are deliveredthrough it's own network of 800 offices for cash benefit and

medical care through 1400 dispensaries, 150 hospitals ar.d

800+ corporate hospitals providing primary, secondary and

tertiary services. The various benefits provided under the

ESI are as follows:-

(1)

( 2 )(3)

(4)

( 5 )

(6)

( 7 )

(8)

Medical Care

Sickness BenefitExtended Sickness Benefit

Maternity Benefit

Permanent Disablement BenefiU

Temporary Disablement Benefit:

Dependants Benefit :

Rajiv Gandhi ShramikKalyanYojna

(Unemployment Allowance)

Incentive Scheme for persons

with disabilities

Primary, secondary and tertiary with no cap.

91 days - 70% of the average daily wages in a year.730 days (upto 2. years for specified 34 diseases)

84 days + 4 weeks (due to complications arising out ofpregnancy, confinement, premature birth of child etc.)

almost 100% of the average daily wages.

Based on loss of earning capacity as long as disability lasts.

About 90% of the average daily wages.On death of IP/lW to the wife till she is alivel

remarriage and to other

family members as per conditions w.r.t. agel marriage. About

90% of the average daily wages.

50% of wages upto 12 months of unemployment on account

of closure, retrenchment and permanent invalidity of not

less th~n 40% arising out of non-employment injury.

The employers' share of contribution is paid by government

for 3 years for providing employment to persons with

disabilities drawing monthly' wages ui:oRs.25,OOO.

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ervlces providedTnclude..primary. secondary aM

tertiary medical care.

Submission of rife certificate for DB once in year

instead of twice g..year. f.. .' ESIC-has-approved payment of conveyance :

allowance to be paid to IPs @Rs-:100 per visjt for

submission of Ufe Certificates in POB cases

No need for submission of claim for PDB/DB.

Calculation of benefit rales has been simplified.

Release of FrequenUy Asked Questions

(FAQs) to provide user-friel1dLy guide for our

e p 0 ers an InSlfl"ed peTSon.' J _

Minimum Dependant Benefit of Rs"12{)O p~rmonth per family unit w.e.f. 1.4.2012 .

Increase in POB and DB rates to compensate

for erosion in the value due to inflation

Renovation of f ield off ices With proper

accommodation and amenities to provide wai1ing

space and working environment for our

stakeholders ..

Provision of 24X7 Toll Free NO.1800112526'

IT Project Panchdeep has been launched for 'Any

Time Any Where' services

For Nor~h East States and other Hilly areas,

norms have been relaxed for s-etting up of

Dispensaries and Hospitals.

For provision Qf tertiary/ super speciality medical '

care, tie-up !:!as been made with 800+ reputedprivate and jovernment hospitals all over the

country and patients are free to opt for any ot..the

networked hospital for treatmen .

IT ROLL OUT

To connect all the stakeholders of the Scheme

to ensure speed)' and timely delivery in the form

of "Any Time Any Where services" is being

launched in collaboration with M/s. WIPR0 an

international acclaimed IT Company.

Issue of two Pehchan Cards (one for self & other

for family members).

LATEST INITIATIVES

Medical Care :

1. Modernization and upgradation of hospitals byprovioing modern equipments.

2. Ceiling on medical care reimbursement is being ,

enhanced from time to time now it is.US$28 per

famity per annum.

3. Expen