Harsh Kumar Mehta
Consultant In Labour Laws/hr
Korgaonkar K A
Ba,llb,mpm,dir&pm,dll&lw,d.cyber
+4 Others

Dear Sir,
I would like to share one incident of my company one of our contractual employee joined 4 months before in our company. One day suddenly while going to his home he met with an serious accident he was immediately admitted to nearby hospital. But as he was financially weak he was no longer allowed to the private hospital.He was unconscious & partial paralysed. Moreover he was declined through ESIC as he had not completed required 6 or more months. So please suggest me is it true to one should avail minimum 6 months to get benefits of ESIC.
27th August 2015 From United States, Cedar Knolls
Dear ,
The ESI Corporation can not deny medical benefit i.e. full medical care to the employee IP. Employee IP is entitled for medical benefit from the day he enters insurable employment.
However, sickness benefit in the form of cash compensation for his absence from duty and disablement Benefit, he may not get.
27th August 2015 From India, Mumbai
1. Sir, ESIC donot reject any case for treatment in its hospitals or dispensaries provided the claimant shows his identity card (Pehchan Card as issued by ESIC appropriate Branch Office) at the time he appears in any such institution to claims treatment or claim benefit from Branch Office and also that he /she should be entitled for said benefit.

2. As per provisions of ESI Act, 1948 and rules/regulations framed thereunder, the entitlement for Medical Benefit as well as Employment Injury Benefits -i.e. temporary disablement etc. starts immediately after the employee is taken on employment, declaration form is submitted and his insurance number is obtained and TIC is handed over to him/her. At present online procedure is there and the ESIC has extended such facility of issue of TIC at the level of employers itself.

3.The employer in order to make the worker entitled for disablement benefit should have submitted Accident Report to the appropriate branch office as well as to ESIC dispensary immediately after the accident. Now a period of 4 months has elapsed as reported by the initiator of this thread.

4. The requirement of 6 months waiting period for other benefits appears to be not correct. In the case of new employees in ESI scheme, the benefit period starts "on expiry of period of 9 months from the date of such employment."(Regulation 4 of ESI (Regulations),1952.

5. Accidents happening while commuting to the place of work and vice versa are covered as employment injury cases (Section 51-E of said Act). It is the legal right of the employee to get his benefits by virtue of his membership and entitlement to the said scheme and the issue that the said employee was "financially weak" has no relevancy.
27th August 2015 From India, Noida
He is eligible for treatment benefits and ESIC cannot reject to admit such cases.
He can take up the issues through court of Law if you have all the proof and evidence
against the ESIC.Treatment and medical benefit starts from day 1 of the joining the scheme.
MSKRISHNAN
9944479275
28th August 2015 From India, Madras
Hi, I have a query what happens if someone crosses the limit of eligibility (in terms of salary, say he earning more than Rs. 15,000 basic). Can he still be a member of the ESIC and if yes what formalities he is required to complete? For better understanding the Company has stopped deduced his share of ESIC amount for the above reason. Any guidance in this regard will be highly appreciated? Best regards, Ravinder Verma
28th August 2015 From India, Delhi
Rainier
It is not basic alone that is considered as wages for ESIC.If a person's salary cross Rs15000/-p m during contribution period deduction shall continue till the end of the CP.After that he is excluded from ESIC.
28th August 2015 From India, Thiruvananthapuram
Dear all,
Thank's for your suggestions & I would like to draw your minds towards one of the institution where more than 150 children from the age of 7 to 22 years are living together and spending their childhood from this institution the name of the institution is Don Bosco Ashalayam located in palam New Delhi. You all would be surprising having read this but this is factual you can find out in google through Don Bosco Ashalayam. I expressed this because from this Ashalayam 2 boys has completed their HM and they are trying to get a job in the best hotel to build their career in their respective field. Their education have been gone through charity in fact and this the time we can help them as a social course. I know this is not the good plat form to find out a job but I had a idea to post this in a public site. So if you have any spark of job please let me know.
Rakesh Das
9873966616
29th August 2015 From United States, Cedar Knolls
He can take only medical benifits i.e. medicines for some extent. Since he has not completed six month he is not eligible for Cash benifit or Sickness benifits. ESI act clearly states the above.
29th August 2015 From India, Mangaluru
MADANAGOPALASWAMY,
May I request you to kindly re-look at your above statement and give corrected version?
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31st August 2015 From India, Mumbai
#Anonymous
Dear ,
I made a mistake here.
By virtue of Amendment of 2010 by inserting new section 51E in ESI Act, an accident occurring to an employee while commuting from his residence to the place of employment for duty or from the place of employment to his residence after performing duty, is to be deemed to have arisen out of and in the course of employment if nexus between the circumstances, time and place in which the accident occurred and the employment is established.
Therefore, the injured employee is also eligible for sickness benefit in the form of cash compensation for his absence from duty and disablement Benefit.
You need to approach the ESI Branch office with facts of the matter to get the benefits to the injured employee, immediately.
Our leaned member Harsh Kumar correctly answered your query but somehow I missed it.
Dear Harsh Kumar ji,
I made a mistake but you would have pointed out it in specific words. Any way. Thanks for your correct answer.
31st August 2015 From India, Mumbai
1. Sir, one of the participants in this thread has expressed his views as "ACCIDENT HAPPENED WITHIN A RADIUS OF ONE KM, THE SAME CAN BE CONSTRUED THAT ACCIDENT ARISING OUT OF AND IN THE COURSE OF EMPLOYMENT" I may submit that there is no such condition or rule in ESI Act, 1948 and rules/regulations framed thereunder. Every case has separate facts and separate merits and I think, the same is examined accordingly by the concerned authorities. When the employer had not submitted the accident report and not complied with the procedure as laid down including medical certification, I think, due to these reasons and elapse of such long time, there is hardly any scope for acceptance of the case as that of employment injury. Please see Regulation 68 of ESI (General) Regulations, 1952.However, matter can be discussed with the appropriate authorities of ESIC as mentioned by me in my remarks as on prepage.

2. Being, as an ex-officer in ESIC, I always try to indicate my opinion based on various provisions of Acts and rules/regulations. It is, however, upto the participants, to evaluate my views in which way they desire. Some times, I had also felt that the views expressed by me on subjects other than ESIS were not in accordance with procedure/rules or practice followed in particular set of situation. I am thankful to all participants for appreciating my views in this thread.
1st September 2015 From India, Noida
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