What Options Do I Have for Employees Exempted from ESIC Benefits? Seeking Advice on Personal Accident Policies

Dear All,

Employees covered under ESIC receive benefits. However, can anybody let me know what I should do for employees exempted from ESIC? Can I opt for a personal accidental policy? Could anybody provide me with the details for that?

Regards,
Amit Bhogal

The employees exempted from ESI are covered under the Employees' Compensation Act. You can take an Unnamed/Named Workmen Compensation Policy from General Insurance Companies for these employees' coverage.

Regards,
S. Sethupathy
Excellent HR Services, Erode.

Very well defined by others. You can go for the GPA with any of the General Insurance Company. Also, if your group size is bigger, then you can opt for the Mediclaim Policy for the exempted employees.

Regards,
Amit Seth.

Dear Amit, GPA will not cover normal medical expenses or hospitalization. For non-ESIC staff, it is better to take a Mediclaim policy. If the person is hospitalized, they can reimburse the money or show the ID card if it is a covered hospital, and most illnesses are covered.

GPA and workmen compensation can apply to all if your company is willing to do so.

Regards,
C P R Das

As pointed out by our members, you can opt for both GPA and Mediclaim. GPA covers accidents around the globe 24x7 and will include compensation in the event of death to the member. On the other hand, if he suffers Temporary Total Disablement (loss of wages due to an accident suffered by him), he will be compensated to the extent of 1% of the sum insured, subject to a maximum of Rs. 3,000 per week (if my memory serves me right). While arriving at the GPA sum insured, simultaneously work out your liability under the Employees' Compensation Act to ensure that your liability is fully covered.

Mediclaim will be an additional cover for illness for inpatient treatment.

Regards,
M.V. KANNAN

Difference Between ESI and Other Policies

Kindly note that the ESI coverage is different from all Mediclaim, GPA, and workmen compensation.

1. Please note that the ESI is a statutory act and covers areas in all regions of India. There are uncovered areas as well; the information will be available with the ESI regional offices.

2. The ESI is applicable to all factories, shops, hotels, cinema halls, schools, and medical institutions where 10 or more employees are engaged either by contract or direct employment. Previously, this requirement was 20 or more employees, but an amendment was made on September 18, 2010, reducing it to 10 employees. Hence, schools are covered.

3. Workmen compensation is different from the ESI. In areas where the ESI does not cover, the workmen compensation policy will provide benefits to employees to some extent but will not replace ESI.

4. GPA is very different from the ESI. It provides additional benefits to employees but does not substitute for ESI.

5. The Gratuity scheme is also different from the ESI. This act is applicable even if you are covered under the ESI act.

6. Mediclaim is an entirely different policy. It offers additional coverage to employees, but ESI regulations must still be followed. Mediclaim is a voluntary and discretionary policy, whereas ESI is compulsory under the statute. Therefore, ESI coverage is mandatory in ESI-covered areas.

Regards,
JAGANMOHAN

Dear Amit,

Employees who are not covered under ESIC need to have a mediclaim policy, which should be provided by the employer as a medical benefit. Workmen's compensation applies only to those employees who are covered under ESIC, but ESIC dispensaries are not available within a 35 KM radius from the workplace.

Regards,
Amit Bhogal

Dear Ramesh, could you provide support for your statement above with any circular or notification issued by ESIC?

Amit, you can go with a personal and mediclaim policy if yours is a service-based company. If it is manufacturing, you need to go with the Workmen Compensation Act, 1923.

Regards,
Amit Bhogal

Employees Exempted from ESIC

Are ex-servicemen from the Navy, military, etc., exempted from the ESIC Act? If they are, do they have to produce certain documents for that?

Thank you.

Are retired Armed Forces servicemen exempt from the ESIC Act? If they are, do they have to submit relevant documents to their new employer?

Regards,

I have corrected the spelling, grammar, and added proper paragraph formatting to the user's input.