Understanding ESIC Benefit Periods: How Do You Handle Delayed Accident Reports?

Understanding Benefit/Contribution Periods

I am always confused by the way Benefit/Contribution periods are used. I find it difficult to estimate the amount that goes to the beneficiary. I was faced with a problem when one of the IPs was involved in an accident, and we were informed of this after 2 months. What am I supposed to do? Please guide me!

Regards,
M S V R K S

There are two contribution periods, namely, April to September and October to March of the following year. Corresponding to these, we have two benefit periods—the periods during which sickness benefits (cash benefit) and maternity benefits are made available, i.e., January to June (for the October-March contribution period) and July to December (for the April-September contribution period). The benefit period will be 9 months from the commencement of the contribution period. Therefore, an employee who joined in the middle of a contribution period can have their first benefit period after nine months of joining.

An insured employee is entitled to cash benefits only during the benefit period. At the same time, in the case of employment injury or an accident while on duty, the above ruling is not applicable, and they are eligible to receive benefits from day one of their joining. The same applies to medical benefits (hospital facilities, treatment, etc.), which are also available to the insured employee's family.

Since the accident report is expected to be delivered within two days of the accident, it is not possible to receive accident benefits in your case. However, you may write to ESI about your failure to send the report and request them to consider it.

Regards,
Madhu.T.K

I am not understanding about ESIC contribution or benefit period sir. Can you give me a brief description of what is the benefit of this period and how it is helpful for employees? Why is it required for us, or what are the criteria of this period?

Understanding Contribution and Benefit Periods in ESI

1. Kindly refer to Regulation 4 of the ESI (General) Regulations, 1950, which defines Contribution Periods and corresponding Benefit Periods. To be eligible for certain benefits under the Benefit Period, the employee concerned should have contributed for a minimum number of days in the relevant contribution period. For example, if an employee has not contributed for the minimum number of days during the contribution period from April to September, they will not be eligible for benefits during the benefit period starting from January next.

2. The three-month period from October to December is treated as a time during which the records of the employee/insured persons are updated to determine eligibility for the next benefit period.

3. Social security schemes like ESIS operate on the principle that the eligibility of an insured person/employee depends on their contribution during the relevant contribution period.

Regards,
[Username]