67th ALL INDIA COMMERCE CONFERENCE OF INDIAN COMMERCE ASSOCIATION.

Organised by

KIIT University, Bhubaneswar in association with

P.G. Department of Commerce; Utkal University, Bhubaneswar

Title of the Paper:- "HEALTH INSURANCE AS SOCIAL SECURITY-A STUDY ON SERVICE DELIVERY OF EMPLOYEES’ STATE INSURANCE CORPORATION (ESIC) IN ASSAM”

Submitted inTechnical session IV Insurance Business: Issues & Perspective

jointly by-

1. Sri Bidyut Bikash Baishya, Assistant Professor. Dept. of Economics, Pragjyotish College, Guwahati, Assam, Mobile- +919864269787, email- bidyut78@gmail.com

2. Sri Dipanjan Chakraborty, Associate Professor, Dept of Commerce, Darrang College, Tezpur, Assam, Mobile- +919435711142, email- dipjan_2005@rediffmail.com

3. Dr. Ratan Borman, Associate Professor, Dept. of Commerce, Assam University, Diphu Campus, Karbi Anglong, Assam; Mobile- +919435166864, email- rborman62@gmail.com

Corresponding Author:- Dr. Ratan Borman, Associate Professor, Dept. of Commerce, Assam University, Diphu Campus, Karbi Anglong, Assam; Mobile- +919435166864, email- rborman62@gmail.com

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HEALTH INSURANCE AS SOCIAL SECURITY-A STUDY ON SERVICE DELIVERY OF EMPLOYEES’ STATE INSURANCE CORPORATION (ESIC) IN ASSAM

ABSTRACT

The Indian health insurance scenario is a mix of mandatory Social health Insurance

(SHI), Voluntary Private Health Insurance and Community-Based Health Insurance (CBHI). The

existing mandatory health insurance scheme in India for Organized Sector is – Employees’ State

insurance Scheme (ESIS) and Central Government Health Scheme (CGHS). The Employees’

State Insurance (ESI) Scheme is more relevant because this was the first social insurance

measures introduced in India and is executed and administered through Employees State

Insurance Corporation (ESIC). ESI Scheme of India is a major multi-dimensional social

insurance programme that has over the last six decades emerged with its phenomenal growth in

terms of geographical reach, demographic coverage, multi-faceted services and an infrastructure

that has no parallel. Despite all the endeavours made by the Corporation for the effective

functioning of the ESI Scheme in the country, public discernment of the Corporation has not

been very positive. The insured persons often allege that the Corporation has not given any

regard for the quality of services and benefits provided to the beneficiaries and their dependents.

Besides the working mechanism of the corporation is also and always questioned. Therefore, this

paper studies a study on the perception of insured persons as to delivery of services by ESIC.

The findings suggest that the insured persons are largely not satisfied with services particularly

medical care and cash benefits and a lot of efforts are to be made in this regard for improvement

which is vital for success of ESI schemes and to cure the various maladies that afflicted.

Key Words: Health Insurance, Factory & Establishments, Insured Persons, Medical Care, Cash

Benefit

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HEALTH INSURANCE AS SOCIAL SECURITY-A STUDY ON SERVICE DELIVERY OF EMPLOYEES’ STATE INSURANCE CORPORATION (ESIC) IN ASSAM

1. INTRODUCTION: Social Security has now become a fact of life for millions of people throughout the world.

It is a major aspect of public policy and extent of its prevalence is a measure of the progress

made by a country towards the ideal of a welfare state. The International Labour Organization1

(1942) defines social security as “the security that the society furnishes, through appropriate

organizations, against certain risks to which its members are exposed. These risks are essentially

contingencies against which the individual of small means and meagre resources cannot

effectively provide by his own ability. These risks being sickness, maternity, invalidity, old age

and death. It is the characteristics of these contingencies that they imperil the ability of the

working man to support himself and his dependents in health and decency.”

India’s population, mainly consisting of middle and low-income groups, necessitate the

provision of social security, although their capacities to pay insurance premiums are very low. In

India, only 3% of population is covered by some form of health insurance, either social or

private. The Indian health insurance scenario is a mix of mandatory Social health Insurance

(SHI), Voluntary Private Health Insurance and Community-Based Health Insurance (CBHI).

The Social Health Insurance (SHI) is based on income-determined contributions

from mandatory memberships. The existing mandatory health insurance scheme in India for

Organized Sector is – Employees’ State insurance Scheme (ESIS) and Central Government

Health Scheme (CGHS). The Employees’ State Insurance (ESI) Scheme is more relevant

because this was the first social insurance measures introduced in India.

2.EMPLOYEES’ STATE INSURANCE (ESI) SCHEME:

The ESI Act of 1948 was the first social insurance measures introduced in India

encompasses certain health related eventualities that the workers are generally exposed to, such

as sickness, maternity, temporary or permanent disablement, occupational disease or death due to

employment injury, resulting in loss of wages or earning capacity-total or partial. The provisions

made in the Act to counterbalance or negate the resulting physical or financial distress in such 1 The International Labour Organization, Approaches to Social Security, 1942, pg 1.

contingencies are, thus, aimed at upholding human dignity in times of crisis through protection

from deprivation, destitution and social degradation while enabling the society the retention and

continuity of a socially useful and productive manpower. The ESI Act applies to Non-seasonal

factories using power and employing ten or more persons and Non-seasonal and non-power

using factories and establishments employing twenty or more persons.

3. EMPLOYEES’ STATE INSURANCE CORPORATION [ESIC]:

The administration of the ESI Scheme as per the ESI Act has been entrusted to the

Employees’ State Insurance (ESI) Corporation. The ESI Corporation is a body corporate set up

by the Government of India on 24th February 1952, under the provision of the ESI Act, 1948 to

administer and execute the Scheme of Employees’ State Insurance. The ESI Act provides

various powers to the Corporation for its proper functioning. The Corporation comprises

representatives of employees, employers, the Central Government, State Governments,

medical profession and the Parliament. At the State level, Regional Boards is to constitute in

each State where the ESI Scheme is implemented and at the grass-root level, Local

Committees to be formed as advisory bodies for smooth functioning of the Scheme. The

Regional Boards and the Local Committees should have representation, both from employers

and employees. The main source of fund of the Corporation is the contributions raised from

employees covered under the ESI Scheme and their employers, as a fixed percentage of wages.

The Corporation may accept grants, donations and gifts from the Central Government or any

State Government, local authority or body whether incorporated or not, for all or any of the

purposes of the ESI Act. The following table exhibits the ESIC at a glance as on 31-03-2013.

Table 1: A Glance of ESIC

Items INDIA NORTH EAST INDIA

ASSAM STATE

ESI Hospitals 148 01 01

ESI Dispensaries 1402 29 25

No. of Centres 787 38 33

No. of Employees 13912400 104199 59921

No. of Insured Person 14301550 104586 85102

No. of Employers 406499 3938 3251

Total Beneficiaries 55490000 406000 -

Inspection Offices 360 04 04

Branch Offices/Pay Offices

610/187 14/3 10/ 3

Source- compiled from Annual Report of ESIC, 2013-14

4. THE EMPLOYEES’ STATE INSURANCE (ESI) BENEFITS:

The ESI Corporation provides benefits to the insured persons and their dependents under

the ESI Scheme in three categories-

a] Medical Benefits: Corporation provides full range of medical care to insured persons and

family members through a network of ESI dispensaries, hospitals and panel clinics set up all

over the country.

b] Cash Benefits: This benefit represents periodical payments in cash to a registered member

in case of Sickness, Maternity benefit to insured women in case of pregnancy, confinement,

premature birth of child, Disablement Benefit or Employment Injury Benefits for suffering

from disablement as a result of an employment injury and Dependents’ Benefit if an insured

person dies as a result of an employment injury or occupational disease

c] Other Benefits: Other benefits include the Funeral Expenses on death of insured person,

Rehabilitation allowance, Vocational Rehabilitation, Medical Bonus, Un-employment Allowance

and free supply of aids and appliances etc. which are provided both in cash and kinds.

5. THE PROBLEM STATEMENT:

ESI Scheme of India is a major multi-dimensional social insurance programme that has

over the last six decades emerged as the largest social security setup in South-East Asia with its

phenomenal growth in terms of geographical reach, demographic coverage, multi-faceted

services and an infrastructure that has no parallel. Despite all the endeavours made by the

Corporation for the effective functioning of the ESI Scheme in the country, public discernment

of the Corporation has not been very positive. Such as, they felt that the Corporation has not

given any regard for the quality of services and benefits provided to the beneficiaries and their

dependents. Further, no adequate steps are being taken to improve and popularise the Scheme

among the beneficiaries and employers. Besides the working mechanism of the corporation is

also and always questioned. Therefore, a study on the perception of insured persons as to

delivery of services by ESIC is vital for success of ESI schemes and to cure the various maladies

that afflicted.

6. REVIEWS OF LITERATURE: Pachman, J.A. et.al, studied the major aspects of the social security system in the US, its

benefits, structure, and its relationship to the retirement decision, methods of determining costs

and its financing. They also presented explicit or implicit recommendations for changing the

system. These recommendations comprise an agenda for reform. The proposal was presented in

three dimensions. The first dimension regards the historical development and the present

institutional setting of social security. The second dimension was the modest proposal to improve

social security within the present framework. Finally, a list of immediate and urgently needed

changes that could be consistent with the longer terms goals was presented for consideration in

the next round of social security legislation, more modest changes should be enacted to move the

system in the desired direction. Such changes would stress adjustments in the minimum benefits

and in the benefits paid to widows and survivors.2

James H. Dulebohn and Brian Murray of Michigan State University and College of

Business, University of Dallas, in an article stated that, many have noted the lack of human

resource management research on employee benefits, which is surprising because employer-

sponsored benefits are a primary concern of executives and employees alike. Moreover, of

special interest to scholars, benefits provide a unique opportunity to examine fundamental

theoretical and empirical questions about employee behaviour and contemporary employment

relationships. They laid a foundation by providing an overview of the context from which U. S.

2 Pachman, J. A. and others, Social Security Perspective for Reform, The Brookings Institutions, Washington, D.C. 1968.

employer- provided benefit programs evolved and the contemporary state of benefits research

like the ESI Corporation in India in human resources management3.

International Labour Organization monograph concerned primarily with the five

principles of social security schemes, now in force in Great Britain, these consist of National

Insurance, Industrial Insurance, Family Allowances, National Assistance and the National Health

Service.4

Speaking on the occasion of the golden jubilee celebration of the Employees’ State

Insurance Scheme, Atal Bihari Vajpai5, the then Prime Minister emphasized the need to increase

the reach of social security to the large number of workers in the unorganized sector. He stated

that the Employees’ State Insurance Scheme should endeavor for providing social security

umbrella to the poorest of the poor workers and people in the unorganized sector for

achievement of national goals set by Mahatma Gandhi.

Dr C.S. Kedar, IAS, Director General, ESIC said that the improvements in the

performance of ESIC are attributable to the valuable cooperation and active participation

received from its various stakeholders i.e. IPs, Employers, State Governments, Corporation

members and the employees of the Corporation. The Corporation has made several provisions

like Self-certification, Amnesty Scheme for settlement of Legal Disputes, relaxation in

inspections policy to meet the needs of the Employers. The burden on State Govt. has also been

eased out in certain cases like in Super Speciality treatment. He further said that, ESI

Corporation during this Diamond Jubilee Year would like to extend coverage to other States of

the North Eastern Region namely Sikkim, Manipur, Mizoram and Arunachal Pradesh.6

7. THE OBJECTIVES: In the light of above statement of problems and review, this paper tries to examine the

perception of insured persons in Assam Region regarding efficiency of ESIC in delivering

various services as mandated by ESI Act. More specifically, the objective of this paper is-

3 www.esic.com available online 25th November, 20104 International Labour Organization of Social Security-Great Britain, ILO, Geneva, 1957.

5 Employees’ State Insurance Scheme Golden Jubilee Celebration, 2002, New Delhi.

6 Addressing the National Conclave at Guwahati on 23-06-2011, on the occasion of celebrating The Diamond Jubilee of the ESI Corporation.

a. To study the level of satisfaction of insured persons on the benefits provided by the ESI

Dispensaries

b. To study the level of satisfaction of insured persons on the benefits provided by the ESI

Hospitals

c. To study the level of satisfaction of insured persons on the cash benefits provided under

ESI Scheme.

8. HYPOTHESIS:

H01: There is no significant difference in the level of satisfaction among the insured

persons in factories and establishments with regard to the services and facilities provided in the

ESI Dispensaries.

H02: There is no significant difference in the level of satisfaction among the insured

persons in factories and establishments with regard to the services and facilities provided in the

ESI Hospitals.

H03: There is no significant difference in the level of satisfaction among the insured

persons in factories and establishments with regard to the cash benefit provided under ESI

Scheme.

9. METHODOLOGY: The study is primarily a descriptive and analytical. The study is undertaken on the

functioning of ESIC in Assam Region.

Sample Size:In Assam there are altogether 85102 insured persons (as on 31-03-2014) under ESIC. Of

these, a sample of 382 has been selected by applying the formula for selecting the sample size is

one by Krejcie & Morgan (1970)7; which are selected randomly consist of factory organisation and

other establishments.

Source of Data:Primary data are collected from the sample insured persons working in different

establishment/factories and registered under the Branch Offices of ESIC on 31-03-2014 through

7 Krejcie, R.V., & Morgan, D.W. (1970), “Determining Sample Size for Research Activities”, Educational and Psy-chological Measurement, Vol.30, pp. 607-610.

questionnaire. Discussions with the officials of ESI Corporation, leaders of various trade unions

and office bearers are also done. 

Secondary data are collected from Library work, Visiting dispensaries and offices, collecting

information from internet sources, consulting persons of related matters etc.

Analysis of Data The collected data has been analyzed with the help of five point scale from strongly

satisfied to strongly dis-satisfy and hypotheses are tested by applying chi-square test.

10. FINDINGS & ANALYSIS:

Under the ESI Scheme, all insured persons and their dependents are entitled to free, full

and comprehensive medical care. The package covers all aspects of health care from primary to

super-specialty services. Whereas, the primary, outpatient, inpatient and specialist services are

provided through a network of ESI dispensaries and hospitals. Super specialty services are

provided through a large number of empanelled medical institutions on referral basis.

Since the medical benefit is the kingpin of the ESI benefits, the effectiveness of the

benefits under the ESI scheme can best be judged by the level of satisfaction on medical benefits

(medical care) as perceived by the beneficiaries. The level of satisfaction is assessed in terms of

services/facilities provided in ESI DISPENSARIES and ESI HOSPITAL.

It is found, during the study that 225 IPs of sample respondents (58.90%) have visited

various ESI Dispensaries located in the state during the year 2013-14 for medical care. The

responses of these sample as to level of satisfaction is depicted in the Table 2.

Table 2: Level of Satisfaction of the Insured Persons in the

Services/Facilities in ESI DISPENSARIES

Level ofSatisfaction

Services ofDoctors

Nos. %

Availment of Drugs & Dressing

Nos. %

Quality of Drugs

Nos. %

Laboratory Tests

Nos. %

Family Welfare

Nos. %

Strongly Satisfied

5 2 14 06 14 06 6 03 6 03

Satisfied 25 11 31 14 37 16 31 14 34 15

Neither Satisfied nor Dissatisfied

45 20 46 20 53 24 58 25 57 25

Dissatisfied 140 62 125 56 113 51 124 55 121 54

Strongly Dissatisfied

10 05 09 04 8 03 6 03 7 03

TOTAL 225 100 225 100 225 100 225 100 225 100

Calculated

Value of x2

(Chi square) at 4 df

2.625 0.50 1.490 0.625 1.177

Result/Conclusion

Not Significant Not Significant Not Significant Not Significant Not Significant

Compiled from field study

In any medical institutions the services delivered by the doctors are regarded as the main

indicator for the development and growth of the institutions. The above table reveals that 62% of

the insured persons (respondents) are Dis-satisfied in the services of doctors in ESI dispensaries.

The availing of drugs and dressing at an easiest and also at a reasonable rate gives

priority for a medical institutional for treatment. In ESI Dispensaries there are provisions of

drugs and dressing, some of them are free of cost and some them are a reasonable rate.

Regarding the availability of drugs and dressings in ESI dispensaries, most of the insured

persons were Dis-satisfied. The insured persons opined that the qualities of drugs that are

provided in the ESI dispensaries are not satisfactory [51%]. During the study, the insured persons

expressed that, sometimes they were receiving the drugs that are beyond expiry date. The

availability of laboratory tests facility is an integral part of health care management and ESI

dispensaries also provide such facility. While examining satisfaction level of beneficiaries, it is

found that majority are not satisfied with the facilities in terms of quality of test and service

delivery within stipulated time. Further, efforts have been made in the study to know about the

satisfaction level of the insured persons regarding the family welfare programmes like promotion

of small family norms, immunizations programmes, promotion of Indian System of Medicine

etc. found that the level of dissatisfaction is appears to be highest [54%].

Thus, from the above, it is observed that a large number of insured persons were not

satisfied in the various services and facilities provided in ESI dispensaries for medical care. The

chi-square test on the significance in the level of satisfaction among the insured persons with

regard to the services and facilities is found to be not significant. Thus, the hypothesis that there

is no significant difference in the level of satisfaction among the insured persons with regard to

the services and facilities provided in the ESI Dispensaries may be accepted.

Level of Satisfaction of the Insured Persons in the Services/Facilities in ESI HOSPITALS

The insured persons who are under treatment in ESI dispensaries may be referred to ESI

hospitals for further treatment especially for in-patient treatment, which is not provided in ESI

dispensaries.

The ESIC in entire north eastern region has only a single hospital situated at Beltola,

Guwahati. During the study, it is found that 143 (63.55%) of total insured persons visited to ESI

Dispensaries were referred to ESI Hospitals for further treatment. Of these, only 92 (64% of

referred) IPs have taken further treatment in ESI Hospitals. Here, an attempt has been to assess

the level of satisfaction of the insured persons regarding services in the hospitals in terms of

services of doctors, quality of drugs, laboratory services, specialty treatment etc. as exhibited in

Table 3.

Table 3: Level of Satisfaction of the Insured Persons in the Services/Facilities in ESI Hospital.

Level ofSatisfaction

Services ofDoctors

Nos. %

Specialty Services

Nos. %

Quality of Drugs

Nos. %

Laboratory Tests

Nos. %

FamilyWelfare

Nos. %

StronglySatisfied

3 3 2 2 2 2 6 7 5 5

Satisfied 15 16 18 20 20 22 7 8 21 23

Neither Satisfied nor Dissatisfied

21 23 17 18 23 25 33 35 22 24

Dissatisfied 53 58 49 53 44 48 42 46 38 41

Strongly - - 6 7 3 3 4 4 6 7

Dissatisfied

TOTAL 92 100 92 100 92 100 92 100 92 100

Calculated value of x2

(Chi square) at 4 df

0.953 1.867 3.881 2.206 1.092

Result/Conclusion

Not Significant Not Significant Not Significant Not Significant Not Significant

Compiled from field study

The table reveals that, 58% respondents are found to be dis-satisfied in the services of

doctors in ESI hospital. Regarding specialists’ service in ESI hospitals, a large majority was

found to be dis-satisfied. They revealed that only a few specialist departments and doctors were

there in the hospital. Moreover, in some serious and critical case the patients were referred to

some other hospital (other than ESIC Hospital) with whom they have a tie-up.

Further it is observed that, the insured persons were mostly dis-satisfied with the quality

of drugs provided in ESI hospitals, even revealed that they had even got the medicines, after the

expiry-date as well as after long formalities. Similar is the case of laboratory facilities where,

they had to go to the private laboratories for most of the tests, though expensive. Regarding

family welfare measures, the effort of ESI hospitals are not found to be satisfactory as opined by

the beneficiaries. An enquiry was also made among the insured persons to find out the reasons

for not taking treatment from ESI hospitals and reveals that Lack of doctors, inadequacies of

medicines & medical facilities, lack of confidence and Inconvenience to go to ESI hospitals are

some of the reasons.

From the above, it is observed that a large number of insured persons were not satisfied

in the various services and facilities provided in ESI Hospitals for medical care. The chi-square

test on the significance in the level of satisfaction among the insured persons with regard to the

services and facilities is found to be not significant. Thus, the hypothesis that there is no

significant difference in the level of satisfaction among the insured persons with regard to the

services and facilities provided in the ESI Hospital may be accepted.

Level of Satisfaction among the Insured Persons Regarding Cash Benefits

Providing Cash Benefit in certain cases within the scope of ESI Schemes to the insured

persons as per entitlement, is consider as an important coverage under the insurance scheme. An

attempt has been made to assess the level of satisfaction of beneficiaries as to Cash Benefits with

reference to Sickness Benefit, Maternity Benefit, Disablement Benefit and Other Benefit, as

shown in Table 4.

Table 4: Level of Satisfaction among the Insured Persons Regarding Cash Benefits

Level of Satisfaction

Sickness BenefitNos. %

Maternity BenefitNos. %

Disablement BenefitNos. %

Other BenefitNos. %

Strongly Satisfied

1 1 - - - - - -

Satisfied 11 5 29 67 2 2 - -

Neither Satisfied nor Dissatisfied

23 10 - - 14 14 15 25

Dissatisfied 79 36 14 33 22 22 46 75

Strongly Dissatisfied

105 48 - - 64 62 - -

TOTAL 219 100 43 100 102 100 61 100

Calculated value of x2

(Chi square) at 4 df

0.0405 1.867 1.787 2.0018

Result/Conclusion

Not Significant Not Significant Not Significant Not Significant

Compiled from field study

The analysis shows that number of IPs strongly satisfied or even satisfied is very

negligible with the amount and discharge of sickness benefits provided by the Corporation under

the ESI Scheme. While the cash benefit in respect of Maternity benefits, it is found that majority

of respondent insured persons [women] are found to be satisfied. The dissatisfaction was

observed in respect of Disablement Benefit and other benefits. The reason attributable for such

state of affairs, as opined by the beneficiaries, are delay in settlement of benefits, cumbersome

procedures, requirement of frequent visits claim office at the cost of wage cut etc. Thus the

hypothesis formulated that there is no significant difference in the level of satisfaction among the

insured persons with regard to the settlement of cash benefits stands accepted.

11. SUGGESTIONS:

Since the ESI schemes are governed under self-financing mode, the success of ESIC is

largely dependent on level of satisfaction of prime stakeholder, i.e. the Insured Persons. Hence

any attempt to minimize grievance from such stakeholder will increase the satisfaction level.

Therefore, ESIC should make effort to -

a. Enhance the awareness among the insured persons and the employers about the ESI

Scheme.

b. Activate grievance handling mechanism to address effectively and efficiently.

c. Improve health service delivery quality in terms of services of Doctors, availability of

quality medicines, adequate laboratory testing facilities. At least in some cases,

specialist care should be provided with reimbursement facilities regarding some

diseases, where the insured persons seek treatment of their choice hospitals.

d. Train personnel working in ESIC to deal with their clients very sensitively as they

visit ESIC for services with some expectations.

e. Improve functioning of various boards like Regional Board, Local Board and

departments like Inspectorate, Employees Insurance Court etc. to develop better co-

ordination among various stakeholders and expedite settlement of Cash Benefits.

12.  CONCLUSION:

The Employees’ State Insurance Scheme is a unique multidimensional self-financing

social security scheme in which every contributor is a benefactor and a beneficiary. The ESI Act,

1948 provided the conceptual breakthrough in the development of a social security scheme that

has over the years metamorphosed into the country’s largest worker welfare programme in terms

of geographical reach, demographic coverage and multi-faceted services. The ESI Scheme,

today, is a national phenomenon and one of the few largest social security programmes in the

world. Hence, any effort to improve service delivery quality deserves appreciation from all

corners.

@@@@@13. BIBLIOGRAPHY:

BOOKS:Ganguly, A, Insurance Management, new Age International (P) Limited, New Delhi, 2002.Gupta, B, K, Employer’s Guide, Employees’ State Insurance Corporation, New Delhi,1997,pg 2.Gupta, S. P, Statistical Methods, Sultan Chand and Sons, New Delhi, 1990.Malik. P. L., Employees’ State Insurance, Eastern Book Company, Lucknow, 2001.Sharma, R., International Economics, Lakshmi Narain Agarwal, Educational Publishers, Agra-3, 2001-2002.

REPORTS:Government of India, Report of the Committee on perspective Planning, Delhi, 1972, pg. 59-62.Annual Reports of ESIC 

ARTICLES (FROM NEWS PAPERS AND JOURNALS):Dr. Alakananda Goswami, The Assam Tribune, “Health for all in India”, Guwahati, Assam, March 11, 2010. Gautam Prasad Barua, The Assam Tribune, “Health Insurance must for all family members”, Guwahati, Assam, February, 08, 2010.Praful Bidwai, The Assam Tribune, “Reviving the Healthcare System”, Guwahati, Assam, February, 21, 2010.S. Thomas, ESI Samachar, Employees’ State Insurance Corporation, New Delhi, December, 2005, pg 1. Economic & political Weekly, Vol XLIV No 23, June6-12, 2009.Economic & political Weekly, Vol XLIV No 33, August 15-21, 2009.Economic & political Weekly, Vol XLIV No 38, September 19-25, 2009.

CD ROMS AND WEBSITES:Encyclopedia Britannica, Deluxe Edition, Britannica.com India Pvt. Ltd, New Delhi, 2004.www.esic.comwww.esicnerghy.org.