Madhu.T.K
Industrial Relations And Labour Laws
Nelsonthomas9102
Hr Executive

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Hi,
We have identified recently that one of our employee is getting ESI benefits for her spouse too. This is okay as family is covered. The question is, this employee is getting ESI benefit whereas her husband
1. is not dependent on her
2. is earning Rs. 700,000 per year (works in a telecom Company)
I could not find any reference which restricts such benefit. Can you please shed some light on it...
regards,
Amit Sharma
HR Manager
Pioneer Health

From India, Sonipat
In respect of spouse (and children) their income is not considered for ESI benefits. Therefore, the spouse of an insured will get all the admissible benefits from the ESIC even if she/ he is not financially/ economically depended on the insured employee.
From India, Kannur
Hi Amit,
I agree with Madhu here, as I have also not heard of any provision restricting spouse benefits for ESI on the basis of income.
I also don't think this creates any increase in the employer or employee contribution. So it is not clear on what is the reason to check on provisions for any such restriction.
Sometimes it happens that when a parallel private insurance coverage is introduced for employees, a number of them refuse the coverage citing that they are already covered under ESI. This puts the employer at a disadvantage to bring down the premium costs for the group insurance coverage, because the assured business of the majority of employees cannot be committed to the health insurance service provider.
By any chance is this such a situation?

From India, Bengaluru
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