Partner - Risk Management
Harsh Kumar Mehta
Consultant In Labour Laws/hr
Hr, Ir, Law, Disc. Matters
Hr Professional
Bandna Jamwal
Hr Executive
+4 Others

Dear Seniors,
Kindly advise me in one accident case. Our company driver met with an accident on 08.12.2013. He was not on duty that time.
1. Should I submit his Accident Report to the nearest branch office so that he can get the ESIC benefits.
2. Should I show in the reports that he was on duty at that time.
Kindly guide me in this matter.
9th December 2013 From India, Delhi
Dear Bandana,
Following documents need to submit to the ESIC office immediately.
1) Accident report (Online)
2) Witness statement
ESIC inspector will ask for further document
You can show him on office duty but should have proof like signature on attendance register (If movement done from office) and record state that he is in office job.
9th December 2013 From India, Faridabad
What was he actually doing at the time of the accident ?
There are already many court judgements that have stated that travelling to and from work is accident in course of employment. Does your case fall in this category ?
10th December 2013 From India, Mumbai
I think that this case doesn't fall in this category because he had come back after dispatching the goods at the destination. He had come in the factory. After that there was no goods for dispatching till night. In between he has gone to his home for personal work which is far from factory just 3 to 4 km. He went from his home to his farm for his own work & He was on bike & hit with a car & injured.
Kindly advise me that it is right to manupulate a case for getting ESIC benefits. If No then Why???? If Yes then WHY???? Kindly help me.
Thanks & Regards
Bandna Jamwal
10th December 2013 From India, Delhi
I think this case might fall in the rule.
Since he was on way home from work (being officially allowed to leave)
Manipulation of records is not something I condone, but it's done all the time when the management wants to help out a worker at no cost to himself

10th December 2013 From India, Mumbai
Hello Bandna et al, This is not a case of accident arising out of employment as has been clarified by you since he was on a private visit to his farm when the accident occured. The presumption under Section 51-A as well as 51-E are not attracted in this matter. It will be ethically and morally wrong to give a false statement besides being punishable under Section 84 of the ESI Act 1948. KK
11th December 2013 From India, Bhopal
Mr K K Nair is correct.Converting it into Employment injury is not correct,as it may invite action by ESC against the employer u/s 840of the ESI Act. Varghese Mathew 9961266966
11th December 2013 From India, Thiruvananthapuram
Either he was on duty or he was comming for duty or going from duty then he si lible for Esic.
Other wise you can show on duty bu punching or attandance register on behalf of thease you can take benifite for this you have to register online accident report form no.12.
11th December 2013 From India, Bhopal
The Accident was not happened during duty time. He may take treatment in ESI hospital. But he cannot claim any benefit except leave benefit
11th December 2013 From India, Sivakasi
If the accident was happened non duty hours, he may take treatment at ESIC Hospital. But he is not eligible for other benefits except leave benefits
11th December 2013 From India, Sivakasi
Are you talking of free treatment ? If free treatment and leave is available, then what is left ?
11th December 2013 From India, Mumbai
Dear Mr. Bandna,
You are clearly admitting that, your Company Driver was NOT ON DUTY. I think you also know that, this case is not eligible for getting the benefits from ESIC. Then why you are trying to make the fake records for the sake of getting benefits from ESIC. ESIC can take penal action against you when the real facts comes forward during the investigation and it will create bad impression about you & your organisation also.
Prakash Salunkhe

11th December 2013 From India, Pune
I fully endorse the views of Mr. Nair & Mr. Mathew as above because submission of any false information or false claim is an offence punishable under section 84 of Employees' State Insurance Act, 1948.
Further it may also not be ignored that ESIC Branch Manager after receipt of Accident Report will ask you to submit a copy of FIR registered with Police Authorities and also Investigation Report / findings of Police Authorities.
11th December 2013 From India, Noida
he can take medical benefit from esic and leave benefits, but u must not submit any accident report qs he was not on duty
u have duty towards your employess but not at the cost of esic.
If he not died or have got any permanently disability then what kind of others benefits u are looking at?
11th December 2013 From India, Patiala
Dear Friends,
As per the situation he was not on duty while accident happened.
But you can directly meet the branch manager of ESIC & say all correct detail about his death.
As he his covered under ESIC so ESIC cant denined to give benefit to his depents,I agree that its not accour during the course of employment but you can bring all relevent documents which proves that he was working with your organisation.
There is no requirement to make fake records.Just go & meet the branch manager for calrification.
18th December 2013 From India, Mumbai
All seniors thank you very much for your support..
I have submitted the accident report to ESIC & presented a clear picture in front of Branch Manager. He is also saying that he is not eligible for getting claim. But he can get leave benefit.
Please can you explain what is the actual rate of leave benefit from ESIC. ? Branch manager said that they will send the case to the head office. If the case is acceptable by the head office then what kind of benefits he can get.????
Thanks & Regards
19th December 2013 From India, Delhi
Dear Member,

(1) Leave Benefit, as you have mentioned is called "Sickness Benefit" under ESI Act and is payable @ 70% of Standard Benefit Rate ( Rule 55 of ESI (Central) Rules,1950). Standard Benefit Rate is further defined as average daily wages obtained by dividing the total wages paid during the relevant contribution period by the number of days for which these wages were paid (Rule 2(7A). Further there is limitation of 90 days for payment of said benefit in said Rule.

(2) In case the accident case is admitted as that of "employment injury" (which, I think is not possible as you have mentioned as per views of Branch Manager), then it can be called as 'Temporary Disablement Benefit" (TDB). TDB rate is 90% of Standard Benefit Rate as mentioned above (Rule 57). If there is any permanent disability, then the case can further be sent for medical board to assess the permanent disability as laid down in said Act.

I will suggest you go through the provisions of ESI Act, 1948 and rules/regulations framed therein and also study the literature on ESIC. You can download the same from the website of ESIC also. Perhaps, this will remove your doubts in the matter for future also.
19th December 2013 From India, Noida
Dear Seniors,
There is another question in my mind. Suppose the injured person's daily wage is Rs. 291/- (From May-11 to Sep-11) then according to leave benefit he can get 70% benefit from esic. His contribution period is from May-2011 to till then how much amount he can get from the ESIC as a sickness benefit. Please guide for for calculatiing it
Thanks & regards
27th December 2013 From India, Delhi
Dear Seniors,
Greeting of the day!!!
I have calculated his sickness benefit Which is given below:-
His daily wages From Oct-2012 to March-2013 is 381
Sickness benefit- 70%
So 70% of daily wages- 267
He was on ESI leave from 14th Dec-13 to 1st Jan-14 (Total days- 19)
Now calculated sickness benefit is:- 267*19= 5073
Kindly tell me is it ok or not. If any mistake then please guide me.
Thanks & regards
7th January 2014 From India, Delhi
Dear Member,
In the period as shown by you, two different benefit periods falls i.e. first- December, 2013 ending and second -June, 2014 ending. Therefore, in these 2 different benefit periods, the rates of sickness or eligibility to benefits may differ.
Further in respect of payments of Sickness Benefit, the benefit for first 2 days is not paid by ESIC and deducted as "waiting days". So, I think, your calculation may not be correct.
It is good aspect that you are calculating the benefits amount payable to employee under ESI Act. However, I will suggest you to ask the employee to show the slip issued by ESIC Branch Office regarding payments of benefits as and when he approaches to ESIC for receiving his cash benefit. From slip of benefits paid to the employee, you can get correct idea as to how the benefits are calculated under above Act and what were/are his rates of sickness benefits.
7th January 2014 From India, Noida
Dear Mr. Mehta,
Thanks for reply....
ESI Branch has not issued any slip to employee. Employee has submitted his ESI leave at branch office which is given by doctor from ESI dispensary on weekly basis.
Thanks & Regards
12th January 2014 From India, Delhi
Dear Member,
When employee of your company visited ESIC Branch Office, he could have got idea of his entitlement for such cash benefits and duration and amount of such benefit due. Now, as and when payment is made by Branch Office, the said employee can make all such inquiries from said Office.
12th January 2014 From India, Noida
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