Can My Husband Use My ESIC Benefits for Medical Coverage? Seeking Advice

Dear All,

In our company, a lady is working and her ESIC is deducted. Her husband is working somewhere else, but his ESIC is not deducted as he is in a small company. Now the question is, can her husband avail medical facilities on her behalf? Can she provide her husband's name for ESIC coverage? Please suggest.

In ESI, family members are normally covered. For married individuals - spouses and children are covered, and for single individuals - mothers and fathers can be covered.

Gunjan

Sure, it covers all her family members.
For the husband until the end of her service, he can rejoin until death.
For her son up to 18 years.
For her daughter up to marriage.
Now you are clear, I think.
Any doubts, feel free to ask me.
Thanks & regards,
Ramesh

Hi,

It all depends on whether the said employee has declared the name of her husband in the ESI declaration form or not. Only if she has declared the name of her husband and also submitted the postcard-sized group photograph with her husband.

Amit Goyal

Hi dear,

That lady is a working employee in your company, as her husband is also employed (regardless of whether his ESI is being deducted or if his company is registered under the ESI Act). Her husband is self-dependent as he works in a company, being over 18 years of age. According to the ESI Act, since her husband is self-dependent, he will not be covered under her company's ESI card.

Furthermore, the ESI Act states:
1. Only dependent minors can be covered.
2. Adults can be covered if they are over 60 years of age and dependent on an employee covered under the Act.
3. Any dependent who is retired and availing medical benefits post-retirement cannot be considered dependent on the lady who is an employee.

YK Tyagi

Hi Tyagi,

There are many things said in the various acts, but not all are followed practically.

Hi,

There is no question of any practical or impractical issues. This is only the answer I tried to provide, as per her question. I replied to address the issues, considering that she is asking a practical or genuine question. Furthermore, I am neither a lawyer nor have I referred to any book - I responded based on my practical knowledge.

Even if you do not agree, you can certainly consider the impractical aspect because there are no restrictions. That's all.

YK Tyagi

Dear HR,

The broad issues are:
1. Her nomination and declaration of her family. It has to include her husband and show him as a dependent (dependent under the definition of the ESI Act).
2. Her husband must not claim ESI benefits (cardholder) in his office as a covered employee (ESI may/may not be able to trace his ID in their records, and thus a correct declaration is suggested). If these conditions are satisfied, he is covered.

My HR colleagues in the forum have answered the rest...

Rahul Kumar
9968270580

Dear All,

In our company, a lady is working and her ESIC is deducted. Her husband is working somewhere else, but his ESIC is not deducted as he is in a small company. Now the question is, can her husband avail medical facilities on behalf of her? Can she give her husband's name for ESIC facility? Please suggest.

Dear friends,

Her husband is eligible for receiving the benefits. That's all.

Regards,
Malladi_alps 😂😂😂

Hi,

Based on my understanding, her husband cannot avail of the ESIC benefit because he is working. Additionally, the husband is not considered a dependent of his wife if he is employed. In this scenario, the wife can be viewed as a dependent of her husband. Therefore, I believe he is not eligible to receive the benefit.

Thanks,
Uttama

Dear All,

YK Tyagi is absolutely right. Tyagi, just one further point to what you have said. Any major can be included in the list of dependents even if he/she earns, provided his/her earnings do not exceed Rs. 1,800 per month. I don't know if this amount has been revised; kindly check with the Local ESI Office. This rule is applicable to every adult, whether male or female.

Regards,
SC

Here we go again, giving replies based on our 'knowledge', 'belief', 'my company's practice', etc!

I would request the members of the Forum once again to desist from the potentially dangerous practice of giving free advice based on their belief and limited knowledge, and let the senior professionals answer such questions. Actual sharing of knowledge, which of course has no limitations due to age or experience, is always welcome.

The following is the definition of 'Family' under Section 2(11) of the Act.

Family means all or any of the following relatives of an insured person namely:

- a spouse

- a minor legitimate or adopted child dependent upon the insured person

- a child who is wholly dependent on the earnings of the insured person and who is:

(a) receiving education, till he or she attains the age of twenty-one years

(b) an unmarried daughter

- a child who is infirm by reason of any physical or mental abnormality or injury and is wholly dependent on the earnings of the insured person, so long as the infirmity continues.

- dependent parents

Thus, it is clear that the Act does NOT stipulate that the spouse needs to be unemployed or dependent on the employee concerned.

However, if any of the members of this Forum is aware of any such clarifications issued by the authorities or by any courts of law, kindly share it here for the information of all others. Otherwise, it can be safely taken that a spouse does not have to be dependent on the employee to avail medical benefits under ESIC.

The lady's husband can be covered under ESIC provided in the declaration form she has added his name and given a postcard size photo to get the Family Card. If she did not add her husband's name while giving her declaration form, now she can add her husband's name and give a postcard size photograph - husband and wife together and get treatment in ESIC.

For a married woman - her husband and children below the age of 18 years and her parents - dependent with a monthly income less than Rs. 1200/- can be covered. For a spinster - it is the girl's parents to be covered under the scheme.

In both cases, a postcard size photograph of all together - to be covered in the scheme is a must.

Hi all,

My question is, if a husband is not in a job and is working in a small business (without being a taxpayer), is he eligible for the benefits of ESIC on his wife's card if the income is below 10,000?