Can Temporary School Employees Get ESI Benefits for Hospital Bills? Seeking Advice

Hi, my sister was working in a school, and she has been admitted to the hospital since last week. When I checked with the school for the ESI (Employee State Insurance) facility, they informed me that they don't provide those facilities for temporary employees, and ESI is only provided for employees who have completed 3 years. Is it possible to get the bills reimbursed, or can I raise an issue against the school for not providing the ESI facility? Please assist.

Applicability of ESI in Educational Institutions

This is a very interesting question. The Schools, Colleges, Universities, and other Educational Institutes, though considered "Establishments," are exempt from the state law relating to shops and establishments. However, in the state of Tamil Nadu, by a notification dated January 02, 2013, the state government extended the provisions of the ESI Act to Shops, Hotels, Restaurants, Road Motor Transport Establishments, Cinemas, Newspaper Establishments, Educational Establishments, and Medical Institutions, including hospitals, nursing homes, diagnostic centers, and pathological labs, where 10 or more persons are employed. Therefore, in the State of TN, the ESI act is now applicable to every such establishment employing 10 or more persons and located in the implemented part of TN State.

There is no such notification for the State of Maharashtra; at least, I have not come across one.

Many companies run schools and hospitals as a charity and for the benefit of the employees and society. Employment in such schools and hospitals, if shown as part and parcel of the manufacturing activity, would mostly make ESI applicable to schools and hospitals. If it is applicable, then it is to be applied right from the entry into employment. Another point would be whether a teacher can be considered an employee under the ESI Act. Teachers are not workmen under the ID Act but are covered under the Gratuity Act.

In conclusion, if ESI is applicable, it applies from the beginning of employment and not after the completion of 3 years.

The Employees' State Insurance Act, 1948 does not make any distinction between regular, casual, or temporary employees. All employees are coverable provided other conditions are satisfied, such as being within the wage ceiling and being employed in a unit covered under the said Act.

Entitlement of Medical Facilities in ESI Institutions

In order to examine the entitlement of medical facilities in ESI institutions, it is important to ascertain from the appropriate Branch Office or Regional Office of ESIC whether the provisions of the ESI Act have been extended to educational institutions by the State Government under section 1(5) of the said Act or not. In case the provisions of the said Act have not been extended by the State Government, then there is no question of coverage of such schools under the ESI Act and no scope for getting medical facilities from any ESI medical institutions.

Regards,
Harsh Kumar Mehta

Thanks for your reply. Must the school have provided the ESI facility in the beginning itself? Is it their fault for not providing it? Is it an offense? Can I claim an RTI?

As Mr. Kulkarni, Advocate, has indicated in his remarks above, the ESI Act has probably not been extended to private educational institutions in Maharashtra. Therefore, your request for information through RTI will not be helpful.

As previously suggested, please verify the coverage of educational institutions in Maharashtra where your sister is employed. You can do so by visiting or contacting the appropriate Branch Office or Regional Office of ESIC.

With regards,
Harsh Kumar Mehta

Definitely, you can file an RTI application with the ESIC Maharashtra. To find out the name of the CPIO, etc., please refer to their website. Please ascertain from them whether the ESI Act has been implemented in private educational institutions in Maharashtra. If so, confirm whether the particular school is covered or not.

As rightly pointed out by our fellow members, all employees—temporary, casual, or trainee—are covered under the Act.

There is no waiting period or infancy period under the ESI Act for any institution or individual employee once they qualify for coverage.

Thanks & Regards,

S. Sankaralingam
Retd. Sr. Dy. Director, ESIC
Advocate & Labour Law Advisor
Mail ID: [Email Removed For Privacy Reasons].

Please reply to the following questions:
1) Is any amount deducted from your sister's monthly salary/wage/pay towards ESIC employee contribution?
2) If yes, does she have an ESIC Pehchan card/temporary card?

Your issue/problem can be finalized after getting a reply to the aforementioned questions only.

Regards,
Binu V.R

Please go ahead and file a suit against them, along with informing the ESI authorities in writing. Don't forget to take acknowledgment from all.

ESI Act Applicability

The ESI Act is applicable to the whole of India. It is not related to any specific state. All places where there are more than 10 people working are mandatorily required to be covered under ESI. There are some institutions that are avoiding implementing this and giving excuses such as temporary or casual employees. This excuse is for those who are not aware of their rights. There is no need to file any RTI. Just go ahead and log the case with ESI and the court. If you require it, please send me your requirement for any judgment in this case to my email id [Email Removed For Privacy Reasons].

Thanks,

Harpreet Walia

Dear Mr. Harpreet Walia, There is a whisper in your post that the ESI scheme is applicable throughout the country and states. Factually, this is not the case. The ESI Scheme is not implemented in many districts of Maharashtra as a whole and in many tahasils of many districts. I am certain this is the position in many other states as well. However, the point is not that. The original post is from Mumbai, and Mumbai is certainly covered under the ESI Scheme. The question is whether a school where the lady is employed is covered under the ESI Act. As far as my information goes, schools are not so far covered under ESI. However, I certainly suggest what Mr. S. Sankaralingam has mentioned in his post. Unless you are sure of the coverage and other related facts, blind litigation never helps.

Regards.

Hi, thanks for your replies. There is no ESI amount deducted from my sister's salary, and no ESI card is available. My sister is working in Bangalore.

Thanks :)

ESI Coverage for Educational Institutions in Karnataka

The ESI scheme has been extended to educational institutions employing 10 or more employees in Karnataka, as per the ESIC Karnataka website. Therefore, the school where your sister was working is definitely covered. As an employee earning less than ₹15,000, your sister is also under ESI coverage, and all benefits are available to her.

My advice is that your sister may file a grievance representation to the Regional Director and seek redressal.

Thanks and Regards,
S. SANKARALINGAM
RETD. SR. DY. DIRECTOR, ESIC
ADVOCATE & LABOUR LAW ADVISOR