1. THE EMPLOYEESSTATE INSURANCEACT, 1948Nitin ChalwadiAsst. Prof.

2. CORPORATION,STANDING COMMITTEE ANDMEDICAL BENEFIT COUNCIL 3. 3. Establishment of EmployeesState Insurance Corpora-tion Employees State Insurance Corporation The Corporation shall be a body corporate perpetual succession a common seal sue and be sued in its own name. 4. 4. Constitution of Corporation(a) a Chairman(b) a Vice-Chairman(c) 5 persons nominated by Central Govt.(d) 1 person each representing each of the in which thisAct is in force(e) 1 person to represent Union territories(f) 10 employers representative(g) 10 employees representative(h) 2 qualified medical practitioners(i) 3 members of parliament : 2 Lok sabha, 1 Rajya Sabha(j) the Director-General of the Corporation, ex-officio 5. 5. Term of office of the membersof the Corporation Except a, b, c, d, e and ex-officio member- four years Members (a), (b), (c), (d) and (e) - during the pleasureof the Government 6. 6. Eligibility for re-appointment orre-election Outgoing member eligible for re-appointment, re- election 7. Authentication of orders,decisions, etc authenticated by the signature of the Director-General of the Corporation 8. 8. Constitution of StandingCommittee(a) a Chairman(b) 3 members(bb)3 members of the Corporationrepresenting suchthree State(c) 8 members elected by the Corporation as follows : (i)3 members representing employers ; (ii) 3 members representing employees ;(iii) 1member from medical profession ; and (iv) 1member from Parliament ;(d) the Director-General of the Corporation, ex-officio 9. 9. Term of office of members ofStanding Committee Except members in (a), (b), (bb) term of all membersshall be 2 years cease to hold office when he ceases to be a member ofthe Corporation. Members in (a), (b), (bb) - during the pleasure of theCentral Government 10. 10. Medical Benefit Council (a) the Director General, the Employees State Insurance Corporation, ex-officio as Chairman ; (b)the Director General, Health Services, ex-officio as Co- Chairman (c)the Medical Commissionesr of the Corporation,ex-of-ficio ; (d)one member each representing each of the States (other than Union territories); (e)three members representing employers (f ) three members representing employees (g)three members, of whom not less than one shall be a woman, representing the medical profession 11. 11. Resignation ofTerm of officemembership Except member resign his office by (a) to (d) 4 yearsnotice in writing to the Central Government 12. 12. Cessation of membership fails to attend three consecutive meetings ceased to represent such employers, employees or themedical profession, Member of Parliament - when he ceases to be aMember of Parliament 13. 13. Disqualification (a) of unsound mind ; or (b) undercharged insolvent ; or (c) any interest except as medical practitioner orshare holder (d) convicted of an offence involving moral turpitude 14. Powers of the Standing Committee administer the affairs of the Corporation exercise any of the powers and perform anyof the functions of the Corporation in its discretion, submit any other case ormatter for the decision of the Corporation 15. 19. Corporations power to promote measuresfor health, etc., of insured persons promote measures for the improvement of the healthand welfare of insured persons rehabilitation and re-em-ployment of insured personswho is disabled 16. Meetings of Corporation, StandingCommittee and Medi-cal Benefit Council. Corporation, the Standing Committee and the MedicalBenefit Coun-cil shall meet at such times and places asspecified in regulation Observes rules of procedure given in regulation 17. Supersession of the Corporation andStanding Committee supersede the Corporation supersede in consultation with the Corporation, theStanding Committee Reasonable opportunity of hearing all the members of the Corporation or the StandingCommittee,, as from the date of such publication, bedeemed to have vacated their offices. Constitution of new standing committee 18. When the Corporation has beensuperseded, the Central Government may (a) appoint or elect new members ofCorporation (b) appoint agency to exercise powers andfunctions (5) full report of any action taken andcircumstances within 3 months beforeParliament 19. Duties of Medical Benefit Council. The Medical Benefit Council shall (a) advise to Corporation and the StandingCommittee the administration of medical benefit, thecertification for purposes of the grant of benefits andother connected matters ; (b)powers and duties of investigation regardingcomplaints against medical practitioners inconnection with medical treatment and attendance ;and (c) duties in connection with medical treatment andattendance as may be specified in the regulations. 20. Duties of Director-General and theFinancial Commis-sioner powers and duties as prescribed 21. Acts of Corporation, etc., not invalid byreason of defect in constitution, etc. No act invalid by reason of any defect in theconstitution of the Corporation, theStanding Committee or the Medical BenefitCouncil, or on the ground Of disqualification Irregularity of member 22. FINANCE AND AUDIT Employees State Insurance Fund held andadministered by the Corporation accept grants, donations and gifts all moneys accruing or pay-able to the saidFund shall be paid into the Reserve Bank ofIndia or such other bank Operation of fund by special officer 23. Purposes for which the Fund may beexpended.(i) Benefits(ii)fees and allowances(iii) salaries, leave and joining time allowances, travellingand compensatory allowances, gratuities andcompassionate al-lowances,pensions,contributions to provident or other benefit fundand meeting the expenditure(iv)establishment and maintenance of hospitals,dispensaries andother institutions and theprovision of medical and otherancillary 24. (vi) expenses of auditing the accounts(vii) Emplo-yees Insurance Courts set(viii) payment of any sums under any contract enteredinto(ix) payment of sums under any decree, order or award of and Court or Tribunal (x) charges of instituting or defend-ing any civil or criminal proceedings(xi) on mea-sures for the improvement of the health and welfare and for the rehabilitation and re- employment(xii) ETC 25. Holding of property etc acquire and hold property, both movableand immovable, sell or otherwise transferany movable or immovable property Invest money Raise loans and take measures fordischarging loans provident or other benefit fund 26. Audit Annual audit by the Comptroller and Auditor-Generalof India 2 more person can be appointed by Auditor-General ofIndia for audit Same authority, rights and privilleges right to demand the production of books, accounts,con-nected vouchers and other documents and papersand to inspect any of the offices of the Corporation Submission of report on audit to the CentralGovernment 27. . Annual Report The Corporation shall submit to the Central Government an annual report of its work and activities 28. Budget, audited accounts and the annualreport to be placed before Parliament annual report, the audited accounts of the Corpo-ration, and the budget as finally adopted by the Corporation shall be placed before Parliament 29. Contribution 30. 38. All employees to be insured.all employees in factories or establishments to which this Act applies shall be insured 31. 39. Contributions contribution by the em-ployer andcontri-bution by the employee paid to the Corporation paid at such rates as may be prescribed bythe Central Government 32. Contribution Last day of wage period Each Wage Period 33. where an employee is employed for-part of the wage period, or-employed under two or more employersduring the same wage period -the contributions shall fall due on such daysas may be specified in the regulations. 34. If principal employer fail to pay contribution then liable to pay simple interest at the rate of twelve per cent. per annum or at such higher rate as may be specified inthe regulations till the date of its actualpayment No interest rate beyond rate of interest byscheduled bank. 35. Interest may be recover-ed as an arrear of land revenue or under section 45-C to section 45-I. 36. 40. Principal employer to paycontributions in the first instance The principal employer shall pay in respect of everyemployee Recovery of employees contribution by reduction fromhis wages and not otherwise No reduction of employers contribution from thewages of employee Any sum deducted by the principal employer from thewages of employee deemed to be contribution The principal employer shall bear the expenses ofremitting the contribution 37. 41. Recovery of contributions fromimmediate employer A principal employer entitled to recover the amount ofthe contribution from the immediate employer The immediate employer shall maintain a register ofemployees the immediate employer shall be entitled to recoverthe employees contribution from the employee 38. 42. General provisions as to paymentof contributions No employees contribution whose average daily wages are below such wages as may be prescribed by the Central Government Contribution both the employers contribution and the employees contribution) shall be payable by the principal employer 39. 43. Method of payment of contribution Corporation may make regulations for any matter relatingor incidental to the payment and collection ofcontributions- And the such regulation may provide for-1. the manner and time of payment of contributions2. the payment of contributions by means of adhesive orother stamp affixed3. Evidence of contribution should be received by thePrincipal employer4. the entry in or upon books or cards of particular ofcontribu-tions paid and benefits distributed5. the issue, sale custody, production, inspection anddelivery of books or cards and the replacement of booksor cards which have been lost, destroyed or defaced. 40. 44. Employers to furnish returns andmaintain registers, in certain cases Every principal and immediate employer shall submit to the Corporation returns 41. . Determination of contributions in certaincases Where in respect of a factory or establishment no returns, particulars, registers or records are submitted, furnished 42. Appellate Authority prefer an appeal to an appellate authority as may be provided by regulation, within sixty days 43. Recovery of contributions. Any contribution payable under this Act may be recovered as an arrear of land revenue 44. . Issue of certificate to theRecovery Officer Issuance of certificate by authorise officer (a) attachment and sale of the movable or immovableproperty (b) arrest of the employer and his detention in prison (c) appointment of a receiver 45. 45-D. Recovery officer to whomcertificate is to be forwarded certificate forwarded to the Recovery Officer withinwhose jurisdiction the employer (a) carries on his business or profession or within whose jurisdiction the principal place of hisfactory or estab-lishment is situate ; or (b) resides or any movable or immovable property ofthe factory or establishment or the principal orimmediate employer is situate 46. 45-E. Validity of certificate and amendmentthereof no dispute before the Recovery Officerregarding cor-rectness of the amount, and no objection to the certificate power to withdraw the certificate or correctany clerical or arithmetical mistake 47. 45-F. Stay of proceedings under certificateand amendment or withdrawal thereof Autorised officer may grant time for thepayment of the amount stay the proceedings until the expiry of thetime so granted 48. 45-G.Other modes of recovery Director-Gen-eral or any other officer authorisedrecover the amount- If any amount is due from any person to any factory orestablishment, such person to deduct from the saidamount the arrears due from such factory orestablishment and shall pay the sum so deducted tothe credit of the Corporation By notice in writing to a person from whom anyamount is due to factory or who holds money onbehalf of factory etc.. 49. 46. Benefits Purpose of ESI Scheme : Benefits to the insured persons or their dependent 50. Sickness Benifit Periodical payment certified sickness Qualification : the rate and period as prescribed by the Central Government 51. Maternity Benefit periodical payments to an insured woman in case of- Confinement, Miscarraige or sickness arising out ofMaternity Confinement premature birth of child or miscarriage certified to be eligible for such payments by anauthority specified in this behalf by the regulations Qualification : the rate and period as prescribed bythe Central Government 52. Disablement Benefit periodical payments Employment injury certified by an authority 53. Disablement BenefitTemporary Disablement Permanent disablement, For not less than three days Whether total or partial(excluding the day ofaccident) Periodical payment as per therate and period specified by Periodical payment as per the the Central Governmentrate and period specified bythe Central Government 54. Determination of question of disablement (a) whether the relevant accident has resulted inpermanent disablement ; or (b) whether the extent of loss of earning capacity canbe assessed provisionally or finally ; or (c) whether the assessment of the proportion of theloss of earning capacity is provisional or final ; or 55. References to medical boards and appeals to medical appeal tribunals and Employees Insurance Courts permanent disablement benefit shall be referred bythe Corporation to a medical board for determinationof the disablement question the insured person or the Corpo-ration may appealwithin the prescribed time to (i) the medical appeal tribunal (ii) the Employees Insurance Court 56. Review of decisions by medical board or medical appeal tribunal Any decision under this Act of a medical board or a medical appeal tribunal may be reviewed at any time by the medical board or the medical appeal tribunal, 57. Dependent Benefit periodical payments to dependent of Insured personwho dies as a result of an employment injury As compensation dependants benefit shall be payable at such rates andfor such periods and subject to such conditions as maybe prescribed by the Central Government If no dependent alive then benefit to other dependent 58. Review of dependants benefit The Corporation may review dependants benefit at any time 59. Medical Benefit An insured person or a member of his family whosecondition requires medical treatment and attendanceshall be entitled to receive medical benefit Medical Benefit in form of- out-patient treatment andattendance in a hospital or dispensary,clinic or other institution or by visits to the home of the insured per-son or treatmentas in-patient in a hospital or other institution 60. medical benefit during any period for which contributions are payable in respect of him or in which he is qualified to claim sickness benefit or maternity benefit 61. Scale of medical benefit medical benefit only of such kind and on such scale as may be provided by the Government 62. Provision of medical treatment by State Government The State Government shall provide reasonablemedical, surgical and obstetric treatment to insuredperson and insured families Arrangement of medical treatment at clinics ofmedical practitioner The Corporation may enter into an agreement with aState Government in regard to the nature and scale ofthe medical treatment that should be provided toinsured persons 63. Establishment and maintenance of hospitals, etc., in Corporation establish and maintain in a State such hospitals, dispensaries and other medical and surgical services 64. Medical and para-medicaleducation establish medical colleges, nursing colleges and training institutes for its para-medical staff and other employees 65. Funeral Expenses payment to the eldest member of the family If no family or was not living with his family at thetime of his death, to the person who actually incursthe expenditure on the fu-neral 66. . Occupational disease If employee contracted with any disease in Part A or Bor C be deemed to be an employment injury arising outof and in the course of employment. 67. Bar against receiving or recovery ofcompensation or dam-ages under any other law No compensation from any person under the Workmens Compensation Act, 1923 68. Benefit not assignable or attachable right to receive any payment of any benefit notassignable No cash benefit subject to attachment 69. Benefits not to be combined An insured person shall not be entitled to receive forthe same period (a) both sickness benefit and maternity benefit ; or (b) both sickness benefit and disablement benefit fortempo-rary disablement. (c) both maternity benefit and disablement benefitfor tem-porary disablement. 70. Benefit payable up to and including day of death Cash benefit up to the day of death to the nominee of the diseased insured employee 71. Repayment of benefit improperlyreceived Repay the value of the benefit or the amount of suchpayment, or in the case of death his representative shall be liable torepay the same from the assets of the deceased, if any,in his hands. 72. ADJUDICATION OF DISPUTEAND CLAIMS 73. 74. Constitution of Employees Insurance Court Constitutes as per the notification in official gazzatte Number of judges as Government specified Qualification: Any person who is or has been a judicial officer or is a legal practitioner of five years Two or more court for the same area, or One court for two or more areas Distribution of work in case of two or more courts forsame area 74. 75. Matters to be decided by the Employees Insurance Court Whether within the meaning of employee or not Liability to pay employees contribution Rate of daily wages or average daily wages The rate of contribution payable by a principalemployer To decide the principal employer Right of any person to any benefit, amount andduration Review order dependent benefit issued by corporation Any other dispute 75. Claims to be entertained by ESI Court (a) claim for the recovery of contribution from theprincipal employer ; (b) claim by a principal employer to recovercontributions from any immediate employer ; (c) claim against a principal employer under section68 ; (d) claim under section 70 for the recovery of thevalue or amount of the benefits received by a personwhen he is not lawfully entitled thereto ; and (e) If any claim for the recovery of any benefitadmissible under this Act. 76. Dispute between employer and corporation regardingcontribution of due- compulsion to deposit 50%amount Court may reduce the said percentage Jurisdiction of Civil court is barred 77. 76. Institution of proceedings, etc All proceeding before ESI Court of the concerned area To deal the matter conveniently transfer of matterfrom one ESI court to other ESI court in the same stateor out of state The Government may transfer matter 78. 77. Commencement of proceedings Application to commence proceeding Limitation: Three years form the date of cause ofaction Must be in form , particulars and fees as prescribed bythe State Government 79. 78. Powers of Employees InsuranceCourt Civil Court Cost Enforcement of order in the same manner as if it were a decree of court 80. 79. Appearance by legal practitioners, etc a legal practitioner or by an officer of a registered trade union authorised inwriting by such person or, with the permission of the Court, by any other personso authorised 81. 81. Reference to High Court. Question of law 82. 82. Appeal To High Court if question of substantial question oflaw involved Limitation : 60 days 83. 83. Stay of payment pending appeal withhold the payment of any sum directed to be paid by the order 84. PENALTIES 85. Punishment for false statement : imprisonment for sixmonths or fine not exceeding 2 thousand, or with both Punishment for failure to pay contributions, etc :Imprisonment minimum 1 year up to 3 years and fine upto Rs. 10000/- 86. Bibliography Labour Laws- Prof. S. N. Mishra