Madhu.T.K
Industrial Relations And Labour Laws
Harsh Kumar Mehta
Consultant In Labour Laws/hr
Jkct15
Deputy Manager - Hr
Anuj Trivedi
Hr & Admin
Pulipaka_ramarao
Manager - Hr & Ir
Pradeepa 14
Hr Coordinator
+1 Other

Thread Started by #Pradeepa 14

Dear Seniors,
We are a manufacturing company and currently we are having the facility of ESI.Is there any possibility where we can skip the ESI and get insured under group mediclaim policy.Pls guide me as many of the employees are exempted from ESI.Is there any provision in the labour law.
Thanks
Pradeepa
18th May 2014 From India, Bangalore
Dear Member,
If any employee is getting wages within coverable limit ( presently Rs. 15000/- per month), then he/she is definitely coverable under ESI Act, 1948 and there is no way for waiver. However, there are some provisions in said Act in Chapter VIII from Sections 87 to 91A under which on fulfilment of certain conditions the appropriate government can grant exemption. In practice, it is difficult and not possible to satisfy the conditions of such exemptions as laid down in said provisions of Act as mentioned above.
Further the facilities under any mediclaim policy of commercial insurance company are very limited in scope and are no match for benefits as available under above Act.
18th May 2014 From India, Noida
According ESI Scheme, employee coverage will be the persons drawing Rs.15000/-and below, cannot be avoided from ESI
But, any employee draws Rs.15000/- above will not be covered under ESI.. Such persons, you can avoid ESI
18th May 2014 From India, Hyderabad
Dear Pradeep,
As per Sec 2(1),it is the obligation on the part of employer to cover its employees under the provisions of ESI Act -1948 Rules whose wages are less than Rs.15000/- Per month.You cannot take any sort of exemption under the provisions for ESI Coverage. You have to exempt only those employees whose wages are above Rs.15,000/- Per Month.
Hope it is clear.
Thanks & Regards,
V R RAO PULIPAKA
19th May 2014 From India, Chennai
Dear Pradeepa,
As told by other members under the provisions ESIC Act there are certain conditions on which exemption may be taken by ESIC authorities. Mediclaim policies have certain limits. There are certain terms & conditions on which claim is being reimbursed. But in ESIC, employee is insured and get benefits which are not given by any mediclaim e.g. there is no limit of claim in ESIC which is used by the workers in case of prolonged and serious deceases. Large organisations which have there own hospitals can take exemption on ground of certain facilities which are better than given by ESIC.
20th May 2014 From India, Lucknow
Hi
Only ESI act is in force and there are no other laws which have cover mediclaim as part of it. There are many public and private sectors offering mediclaim services for corporates where it would be very less interns of premium and all disease and ailments are covered. So you can check with your management and get one for those who crossed the ESI limit.
As part of the exemption, one is to have a full fledged hospital and second one is, there are few areas/locations are not covered under the preview of ESI.
20th May 2014
Having own hospital is not the sole parameter for granting exemption from coverage of ESI for the establishment. If that is so, the private hospitals will not come under the purview of ESI Act. In order to get exemption from coverage of ESI the employer has to establish that his employees are in receipt of facilities and benefits better than that offered (just offered by ESIC and not necessarily be given by ESIC is enough!!) by ESIC in terms of medical, sickness, maternity, old age benefits, dependants' benefits etc. In many cases leave on the ground of prolonged illness, extension of medical facilities after retirement, dependent benefits etc are a few areas where the private organisations including hospitals fail to meet whereas there are lot of public sector companies which provide for these benefits and have taken exemption from ESI.

Medi Claim policies do not guarantee any benefit but do work with a lot of hidden parameters for admitting claims. I think only ESI will give free medical assistance (cashless) to an employee, his family members and dependents from his date of joining without going back to the history of illness and the age of the member or dependents. Medi claim policies will not cover existing diseases and your parents of a certain age but for ESI there is no such bar. You can not imagine a cashless surgery under medi calim if you have not paid premia for a certain period unless it is a tailor made one costing a handsome amount by way of premium.

However, you should not expect the same care and hospitality from the ESI Corporation as are highlighted in their website or publicity posters, perhaps due to administrative flops.

Madhu.T.K
21st May 2014 From India, Kannur
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