The Employees' State Insurance Act, 1948 provides medical benefits, cash benefits, maternity and disability benefits, benefits for dependents at the time of loss of life, and an insurance scheme for an organised sector worker. The exposure is controlled under the management of the Employees' State Insurance Corporation with the Ministry of Labour and Employment of the country.
Features:
- Applies to employees working in factories and certain establishments such as shops, hotels, and cinemas and have more than 10 employees.
- Shares the contribution from employers and employees towards the ESI fund monthly deduction.
- It renders benefits in the form of:
- Free medical treatment to an insured person and their family members.
- Wages for sick leave.
- Maternity benefit for women.
- Compensation for injury or death that occurred at work.
- Pension for dependants when the worker dies.
Contribution rates:
- Employee – 0.75% of wages
- Employer – 3.25% of wages
FAQs – Employees’ State Insurance (ESI) Act, 1948
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1. What is the ESI Act, 1948?
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The law was framed to provide social security benefits such as medical care, salary during sickness, maternity, or accident benefits to employees.
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2. Who manages the ESI Scheme?
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The ESI Scheme is managed by the Employees' State Insurance Corporation (ESIC), which is under the Ministry of Labour and Employment, Government of India.
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3. Who are the beneficiaries under the ESI Scheme?
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Employees working in factories or establishments with 10 or more workers, drawing an income of up to ₹21,000 per month (₹25,000 in the case of persons with disabilities), are beneficiaries.
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4. What benefits are provided by ESI?
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- Free medical treatment to the worker and family
- Wages during sickness (sick leave)
- Maternity benefits to women
- Disability benefit for injuries
- Dependent's benefit in the case of the worker's death
- Funeral expenses
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5. Does ESI cover the workers of private sector companies?
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Yes, provided that the organisation employs more than 10 employees and the worker's salary is within the limit.
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6. What is the contribution of an employee?
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The employee contributes 0.75% of the monthly wages.
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7. What is the contribution of the employer?
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The employer contributes 3.25% of the monthly wages of the employee.
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8. Where will I get ESI medical treatment?
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At ESIC hospitals, dispensaries, and empanelled private clinics.
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9. Do family members also get treatment under this plan?
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Yes, the treatment is available to the spouse, children, and dependent parents too.
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10. What is Sickness Benefit?
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If you get sick, you can get up to 70% of your wages for 91 days per year while recovering.
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11. What is Maternity Benefit?
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Insured women can get 26 weeks of paid leave during pregnancy with full wage replacement.
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12. What if I am injured while working?
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You will be given the full treatment and compensation. If it leads to a disability, you may get a monthly payment (pension).
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13. What is the Dependant’s Benefit?
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If an insured worker dies due to an injury at work, his dependents (spouse and children) will receive monthly pension payments.
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14. Can the ESI benefits be availed after a job change?
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Yes, your ESI number remains permanent, and benefits continue so long as the new job also extends ESI benefits.
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15. Are contract workers entitled to ESI benefits?
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Yes, provided the contract worker works in an establishment that qualifies for ESIC and meets the salary limit.
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16. How to apply for an ESI card?
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You or your employer may do online registration on the ESIC portal, which will generate an ESI e-Pehchan card for medical treatment.
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17. May a retiree claim benefits under ESI?
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Yes, under the ESIC "Extended Medical Benefit" scheme, retired employees can continue to obtain medical care by paying a nominal fee.
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18. What if my salary goes over ₹21,000 later?
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Once you are covered, you shall be eligible for all benefits till the completion of the contribution period even if your salary crosses the limit.
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19. Can I go to a private hospital for treatment?
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Yes, but it should be an emergency case approved by the authority, or else it should be the private hospital empanelled by ESIC.
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20. What is the importance of the ESI scheme?
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It extends financial and medical protection to the workers and their family members at the time of need so that they can bear the expenses in sickness, accident, or maternity, and that too at a very low cost.
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