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The Employees State

Insurance Act 1948

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objects

The Act Provides certain cash benefits to employees

in case ofsickness, materni ty and employment

in juryand to make provisions for certain other

related matters. Its is applicable to employees in a

wide range of establishments drawing monthly

wages up to Rs. 1600 (as per 1985 amending Act.)

The dependants also are now covered for medicalbenefits and they receive pension if a worker dies of

an employment injury.

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Main Provisions

The important benefits provided under the Act

are:1) Sickness benefit

2) Maternity benefit

3) Disablement benefit

4) Dependents benefit

5) Medical Benefit

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Main Provisions

All employees covered under the Act and drawing

wages of less than Rs. 6 per day are now entitled to

receive free medical care. In respect of other,

contributions have to be made by both employee

and employer. The employees share in the

contribution is to be deducted from his wages by the

principal employer. The rates of contribution are laiddown in Schedule I of the Act and the Government

can revise them, if necessary.

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Sickness Benefit

Sickness signifies a state of health necessitating Medical

treatment and attendance and abstention from work on Medicalgrounds. Financial support extended by the corporation is such

a contingency is called sickness Benefit

Sickness Benefit represents periodical payments made to anInsured Person for the period of certified sickness after

completing 9 Months in insurable employment.

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Sickness Benefit

The Maximum duration for availing sickness

Benefit is 91 days in two consecutive benefitperiods

Standard benefit ratethis ratecorresponds to the

average daily wage of an Insured person duringthe corresponding contribution period and is

roughly half of the daily wage rate.

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Extended Sickness Benefit

Extended Sickness Benefit is a Cash Benefit paid for

prolonged illness (Tuberculosis / Leprosy, Mental andMalignant diseases) due to any of the 34 Specifieddiseases

The IP should have been in continuous employmentfor aperiod of 2 years and should have contributed foratleast 156 days in 4 preceding contribution periods

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Maternity Benefit

Maternity Benefit is cash payable to an Insured women for the

specified period of abstention from work for confinement ormis-carriage or for sickness arising out of pregnancy,confinement premature birth of child or miscarriageconfinement connotes labour after26 weeks of pregnancywhether the result issue is alive or dead

The daily benefit rate is double the sickness Benefit rate and isthus roughly equivalent to the full wages. Benefits is paid forSundays also.

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Disablement Benefit

Temporary disablement benefit :

In case of temporary disability arising out of an employmentinjury or occupational disease.,

Disablement benefit is admissible to insured person for theentire period so certified by an Insurance Medical officer /

Practitioner for which IP does not work for wages. The benefit is not subject to any contributory condition and is

payable at a rate which is not less than 70% of daily averagewages.

However, not payable if the incapacity lasts for less than 3 days

excluding the date of accident.

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2. Permanent disablement benefit

In case an employment injury or occupational disease

results in permanent, partial or total loss of earningcapacity,

Periodical payments are made to the IP for life at a ratedepending on the actual loss of earning capacity as may bedetermined and certified by a duly-constituted Medical

Board. The rates of Disablement Benefits are determined in

accordance with the provisions of Rule 57 of ESI(Central) Rules, 1991.

Disablement Benefit

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Dependants Benefit

Dependents Benefit is a monthly pension payable to the eligible dependentsof an insured person who dies as a result of an Employment Injury or

occupational disease Beneficiaries and Duration of benefit

a). Widow / widows during life or until remarriage

b). Legitimate or adopted son until age 18 or if legitimate son is infirm, tillinfirmity lasts.

c). Legitimate or adopted unmarried daughter until age 18 or until marriage,whichever is earlier, or if infirm, till infirmity lasts and she continues to beunmarried.

In the absence of any widow or legitimate child, the benefit is payable to aparent or grandparent for life, to any other male dependent until age 18 or toan unmarried or widowed female dependent until age 18.

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Main Provisions

The standard benefit rates prescribed under various

schemes also can be revised. Medical care is

provided through hospitals set up under the Act asalso through reservation of beds in existing

hospitals.

The Act also provided for setting up special courts by

the State Governments to decide disputes and toadjudicate claims.

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Administration

The Employees State Insurance Corporation

is created under the Act to administer thevarious provisions.

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Assessment

At the end of march 1983, 88950 employers

and 62.72 lakh employees were coveredunder the Act.