Understanding ESI Benefits, Employee Registration, and Accident Reporting

Dear All,

One employee joined an organization, and within two days, he met with an accident. However, he did not receive an ESI card. Will the employee still be eligible for any benefits under ESI? Please clarify my doubt.

Thank you,
Siva

Shiva,

The accident happened after office hours. In what condition was he when he met with the accident? If he is covered under ESI, he is eligible for sick benefits if he undergoes treatment at an ESI dispensary.

Calvin.

Siva, if the employee's salary is below 15K, he is supposed to be under ESIC. At the time of joining, the HR department has to get the requisite forms filled up, viz. ESIC Declaration Form (Form 1), Nomination Form for PF (Form 2), and for the Factories Act - Nomination form.

For ESIC, you can now do online registration and get the Insurance No. of the employee. You can also download the Temporary card of the employee and use it to get him treated in any ESIC hospital/dispensary. In any case, please fill up the Accident form in quadruplicate and deposit it with the nearest branch office.

Also, refer to Calvin's reply.

Regards,
Swapan

Dear Siva,

In this case, the company hasn't received his insurance. Just need to apply for insurance now, whether the process is online or manual. Thereafter, he/she can get the ESI benefit. If still you have any queries, just drop me an email for any clarification.

Thanks,
Sunil Sharma
Email: ssmbahr@gmail.com

Dear Shiva,

If the employee joined before the 21st of that month, he has every right to demand the medical expenses because on the 21st of every month, you have to submit the application form to ESI for new employees.

Dear Shiva,

Please apply for the ESI Number. Since he has joined two days ago, there is no need to worry, as ESIC is giving a 10-day window to apply for ESIC for new joiners. Please address this matter with the ESIC manager so the employee can receive treatment. If the employee has a previous ESIC number, you can facilitate the transfer for them to avail of the benefits.

Additionally, approach the ESIC office for other necessary formalities. There is no need to panic.

Regards,
SIDMAN

Dear Members,

ESI allows 10 days of grace time to new employees for registration. Hence, there will not be any problem in getting medical benefits for any employee who met with an accident or fell ill, even without registering their name. It will still be advantageous if the HR department gets the declaration form filled and gets the employee's signature, even if the same has not been submitted to ESI Corporation.

I hope I am correct on this issue.

Regards,
PVVB.KUMAR

Dear SIVA,

Mr. Sidman and Mr. PWB Kumar are correct. As per ESI provisions, you need to fill out the form immediately, but the same can be submitted to ESIC within 10 days. During these 10 days, in case of any accident, that employee is considered registered even though their form has not been submitted to ESIC. Please note that filling out and signing the ESI registration form by all covered employees is mandatory before joining duty.

Regards,
GBVarik

If the accident sustained by your employee is an employment injury within the meaning of Section 2(8) of the ESI Act, 1948, irrespective of whether he obtained the insurance number or not due to his recent two days' appointment before the date of the accident, he is definitely entitled to all benefits under the Act, including TDB, PDB, and DB for dependents in case of expiration, as well as medical benefits, including super specialty treatment. Please approach the Branch Office Manager immediately and submit the Accident Report along with the Declaration Form if it has not been submitted earlier.

Regards,
Sanagapalli

To my knowledge...

For the first 3 months, an employee who is going to apply for an ESI Card is eligible for ESI benefits with their TIC (Temporary Identification Card), which has to be issued by the ESI Corporation.

Sundar

Dear Siva,

First of all, you need to make an entry in the accident register and report the accident to the ESIC local office using Form 16. Along with that, submit the Declaration Form and Form 86, confirming the person's employment status with the employer. Provide a letter from the employer detailing the person's monthly salary package. Upon receiving all these documents, the manager will promptly issue an insurance number and TIC to the employee, ensuring immediate treatment for the individual.

Ilyas Hungund

[QUOTE=Ilyas Hungund;1348375]
Dear Siva,

First of all, you need to make an entry in the accident register and report to ESIC local office about the accident on Form 16. Along with that, submit the Declaration Form and Form 86 declaring confirmation of the employment of that person from the employer. Also, provide a letter from the employer showing his salary package per month. After receiving all these documents, the Manager will immediately issue an insurance number and TIC to that employee, and treatment will be given to that person promptly.

Ilyas Hungund.

If an employee joins on 1st August 2011, can they avail the benefits from the ESIC? Secondly, can they take advantage of the ESIC leave encashment benefit?

Thank you.

Hi Mamta,

I would like to inform you that if an employee joins on 1st August 2011, then they will be entitled to ESI benefits, but they will not be entitled to any kind of leave cash benefit from ESIC. As per the ESI Act of 1948, if an employee has contributed for nine months to ESIC, then they will be entitled to ESI Cash benefits. For example, if someone joins on 5th January 2011, then their ESI cash benefits will start on 5th October 2011.

Thanks & Regards,

Sunil Sharma Sr. Executive HR V3S Group

Dear member,

The present wage limit for coverage under the ESI Act, 1948 is up to and including Rs. 15,000 per month. The term 'wages' has been defined under the said Act. However, for exemption, overtime is not to be considered.

Further details regarding coverage and how to calculate the term 'wages' can be seen and downloaded from the website of ESIC.

Dear sir, good morning...

I only have an ESI number; I don't have an ESI card or a Pehchan card. My father is suffering from back pain, etc.

We want to join the ESIC hospital. How do we go about this joining procedure? Please suggest to me. Urgently reply, please.

1. Sir, please inquire from your concerned department, viz. HR, regarding your ESIC Pehchan Card and also Family Card. It is the employer or his official who usually collects the same from the appropriate Branch Office of ESIC to which you are attached. If you or your employer have not initiated action to obtain the said Pehchan Card and Family Card, then you can start necessary action to obtain such cards so that there are no obstacles/difficulties in your getting benefits, including medical facilities.

2. Pehchan Card/Family Card is a must in order to claim any benefit under the ESI Act, 1948, and rules/regulations framed thereunder. Without a valid Pehchan Card, how can the authorities differentiate between entitled or non-entitled persons?

3. However, you can request your employer-HR or whosoever the same is named to issue you a Form (the number and name may be available to said officials) duly completed certifying that you are a covered employee and entitled to medical benefits along with your family members. I feel that, based on that completed form indicating therein the name of your father as one of your family members, he will be in a position to obtain medical benefits from the appropriate ESI Hospital or ESIS dispensary to which you are attached.

4. It will also be more appropriate and better if you visit your appropriate Branch Office of ESIC to which you are attached and discuss the issue and the procedure to be followed in the situation as mentioned by you.