This act is SOCIAL SECURITY ACT provided to all INSURED PERSONS (EMPLOYEES) through a statutory body called ESI CORPORATION which is responsible for the administration of the above act.
This SOCIAL SECURITY ACT protects INSURED PERSONS (EMPLOYEES) from financial distress due to loss of work and wages due to death, disability or any other nature of sickness arising out of employment ( i.e sickness due to OCCUPATIONAL DISEASE arising out of and in the course of employment, and Other external factors) and also provides benefits in case of maternity
The Director-general shall be the CEO of the ESI CORPORATION. It is made of proper administrative structure with MEMBERS representing
· INSURED PERSON (EMPLOYEE)s
· Employers
· Central government
· State government
· Medical professionals
APPLICABILITY OF THIS ACT
· The ESI Act is applicable to all FACTORIES employing 10 or more persons; It does not apply to SEASONAL FACTORIES
· The State Governments have extended the coverage of this Act to COMMERCIAL ESTABLISHMENTS employing 10 or more persons
· The Central Governments have extended the coverage of this Act to COMMERCIAL ESTABLISHMENTS employing 20 or more persons where Central government is the appropriate authority
The ESI scheme is applicable to all INSURED PERSON ( EMPLOYEES)of FACTORIES AND COMMERCIAL ESTABLISHMENTS as specified by ESI ACT other than SEASONAL FACTORIES with 10 or more persons employed in such establishment and the beneficiaries’ monthly wage does not exceed ₹ 21,000.
The difference between FACTORY, SEASONAL FACTORY AND COMMERCIAL ESTABLISHMENT
1. FACTORY: This is defined as any premises where the manufacturing process is carried out and where on TEN OR MORE persons are employed (or) were employed on any day of the preceding twelve months, but does not include a MINES or RAILWAY RUNNING SHED
2. SEASONAL FACTORY: A factory is called a seasonal factory if it is involved in following manufacturing processes like
1. Cotton ginning
2. Cotton or jute pressing
3. Decortication of ground-nuts
4. The manufacture of coffee, tea, indigo, lac,
5. The manufacture of rubber, sugar
(AND) Includes a factory that is engaged for a period not exceeding seven months in a year
o Which involves the process of blending, packing or repacking tea or coffee
o The manufacturing process as specified by the Central Government
3. COMMERCIAL ESTABLISHMENT:
1. Shops, Hotels and restaurants
2. Road motor transport undertakings
3. Newspaper establishments
4. Private medical institutions
5. Educational institutions
6. Contract and Casual INSURED PERSON (EMPLOYEES) of Municipal corporation
BENEFITS OF THIS ACT
This is a self-financed scheme where both INSURED PERSON (EMPLOYEE)S and EMPLOYERS contribute money to the ESI SCHEME. This scheme helps the INSURED PERSON (EMPLOYEE)s who are registered with ESI CORPORATION to get the complete medical care and benefits and also medical care to the family members. The benefits are provided to the INSURED PERSON (EMPLOYEE)s
- SICKNESS BENEFIT: This benefit is provided to the INSURED PERSON (EMPLOYEE) by providing periodical payments of money to the INSURED PERSON (EMPLOYEE) during the time of his sickness certified by a medical practitioner as per the regulations specified by ESI Corporation. There are two sickness benefits provides
- ENHANCED SICKNESS BENEFIT: Enhanced Sickness benefit is provided to INSURED PERSON (EMPLOYEE) person eligible to sickness benefit, for undergoing sterilization operations for sterilization
- EXTENDED SICKNESS BENEFIT: This benefit is provided to INSURED PERSON (EMPLOYEE)s who have crossed the maximum number of days of sickness benefit payable, This Extended sickness benefit is provided to the INSURED PERSON (EMPLOYEE) who suffers from 34 Malignant and long-term diseases
- MATERNITY BENEFIT: This benefit is provided to the women INSURED PERSON (EMPLOYEE) by providing Periodical payments of money to the women for pregnancy, confinement, miscarriage and premature births for 26 weeks
- DISABLEMENT BENEFIT: This benefit is provided to the INSURED PERSON (EMPLOYEE)s by giving Periodical payments of money to the insured worker suffering from disablement as a result of employment injury. There are two types of disablements, based upon which the rate of payment is calculated.
· TEMPORARY DISABLEMENT: This means the INSURED PERSON (EMPLOYEE) who is injured requires medical treatment and makes the INSURED PERSON (EMPLOYEE) temporarily unfit of doing the work which is capable of doing the work before the injury
· PERMANENT DISABLEMENT: This is again classified into two types
o PERMANENT PARTIAL DISABLEMENT: This means the INSURED PERSON (EMPLOYEE) injured will have permanent disablement, which REDUCES THE EARNING CAPACITY of INSURED PERSON (EMPLOYEE) in every job he is capable of working at the time of the accident.
o PERMANENT TOTAL DISABLEMENT: This means the INSURED PERSON (EMPLOYEE) injured will have permanent disablement, which INCAPACITATES INSURED PERSON (EMPLOYEE) in every job he is capable of working at the time of the accident
- DEPENDANTS BENEFIT: If any INSURED PERSON (EMPLOYEE) dies due to an accident arising out of work, the dependants are paid the benefit.
- MEDICAL BENEFIT: This benefit of full medical care is provided to both the Insured person along with family members of the INSURED PERSONS (EMPLOYEES) from the date he/she enters the insurable employment. The range of services provided covers preventive, promotive, curative and rehabilitative services.
- This benefit applies to permanent disabled Insured persons and their spouses
- This benefit applies to retired insured persons and their spouses
- FUNERAL EXPENSES: This is the payment done to the eldest surviving member of the family of an INSURED PERSON (EMPLOYEE) who has died, towards the expenditure on the funeral of the deceased INSURED PERSON (EMPLOYEE)
- CONFINEMENT EXPENSES: This is the payment done to an Insured Woman or an Insured person in respect of his wife in case confinement occurs at a place where necessary medical facilities under ESI Scheme are not available.
- REHABILITATION BENEFIT: The ESI Corporation in addition to the benefits provided in this Act, promote measures for the improvement of the health and welfare of insured persons and for the reemployment and rehabilitation of insured persons who have been disabled or injured by providing training
Disclaimer: The information represented above is only guidance for students for getting some information relevant to the subject. The information represented above does not constitute professional advice and cannot be quoted or used for any application purpose (or) statutory requirements (or) dispute resolution
Article by PJ Mohan
Sr.Faculty, NIFS
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