Please find below the Applicability, Eligibility, and Benefits.
Applicability:
1. All factories excluding seasonal factories employing 10 or more persons and working with electric power.
2. All factories excluding seasonal factories employing 20 or more persons and working without electric power.
3. Any establishment which the Government may specifically notify as being covered.
4. Shops employing 20 or more persons.
Note: As soon as the above conditions are fulfilled, the employer should furnish the details in Form-01 to the ESI office for registration under the ESI Act, 1948, and obtain the employer's Code No.
Eligibility:
1. Any person employed for wages (up to Rs. 6,500) in or in connection with the work of a factory or establishment.
2. Any person who is directly employed by the employer in a factory or through his agent on work which is ordinarily part of the work of the factory or incidental to the purpose of the factory.
Benefits:
1. Free medical treatment is offered to covered employees at hospitals and dispensaries run by the ESI Corporation.
2. About 7/12th of an employee's normal wage will be payable to them by ESI during sickness.
3. Maternity benefit for 12 weeks, of which not more than 6 weeks should precede confinement.
4. Injury during/in the course of employment resulting in temporary/permanent disablement entitles the covered employee to a regular payment to substitute lost wages.
Benefits at a Glance:
Benefits, Contributory Conditions, Duration, Rate, To Whom Payable:
a) Sickness Benefit: I.P. should work for wages for 78 days in the corresponding C.P. (wef 19-9-98). 91 days in any two consecutive B.P. As per S.B.R. Only to the insured person.
b) Extended sickness benefit for long-term diseases like TB, leprosy, etc.: Continuous employment for two years. 124 days, which may be extended up to 309 days in specified chronic cases during a period of three years. 25% above S.B.R. Only to the insured person.
c) Enhanced sickness benefit (for undergoing sterilization operation for family planning): Same as for Benefit (a) above. 7 days for vasectomy & 14 days for tubectomy, extended in cases of post-operative complications, etc. Twice the S.B.R. Only to the insured person.
2) Disablement Benefits (employment injury): No conditions. In case of temporary disablement: as long as incapacity lasts & in case of permanent disablement: for a lifetime. a) For temporary disablement: 40% above S.B.R. Only to the injured person.
EXPLANATION: Where more injuries than one are caused by the same accident, the rate of benefit payable under clauses (c) & (d) shall be aggregated but not so in any case as to exceed the FULL RATE and in cases of disablement not covered by clauses (a), (b), (c) & (d) at such rate, not exceeding the FULL RATE, as may be provided in the regulations.
3) Dependent's Benefit (employment injury): No condition. To the widow(s) during lifetime until remarriage. To the legitimate or adopted son(s) until he attains the age of 18 years. 3/5 of the FULL RATE. If there are 2 or more widows, the amount payable to the widows shall be divided equally between them. 2/5 of the FULL RATE. If there are 2 or more sons, the amount payable to the sons shall be divided equally between them. Subject to a minimum of Rs. 14/-.
To the legitimate or adopted unmarried daughter(s) until she attains the age of 18 years or until marriage, whichever is earlier.
In case the deceased person does not leave a widow or legitimate or adopted child, D.B. shall be payable to:
a) Parent or grandparent, for life 3/10th of the FULL RATE.
b) Any other male dependent, until he attains the age of 18 years. 2/10th of the FULL RATE.
c) Any other female dependent, until she attains the age of 18 years or until marriage, whichever is earlier.
N.B. An insured person whose PERMANENT DISABLEMENT has been assessed as final and who has been awarded permanent disablement benefit at a rate not exceeding Rs. 1.50 per day may apply for a lump sum payment, and such amount shall be determined by multiplying the daily rate of permanent disablement benefit by the figure indicated in Co. 2 of Schedule III of the Regulations.
4) Maternity Benefits: Payment of contribution for 70 days in one or two consecutive periods. 12 weeks, of which not more than 6 weeks can precede the expected date of confinement. Twice S.B.R. Subject to a minimum of Rs. 20/- p.d. Only to the insured person. 6 weeks for miscarriage or for medical termination of pregnancy. Additional payment for one month for complications (pre or post) arising out of pregnancy. Medical bonus of Rs. 250/- where ESI facility is not available.
5) Medical Insured Benefit: No condition. From the date of entry of an employee into insurable employment so long as he remains in insurable employment and three years after for a certain additional period. Full medical care including hospitalization. Person as well as his/her family members as defined u/s 2(11) of the Act.
6) Funeral Expenses: No condition (i.e., merely by virtue of being an insured person). One-time lump sum payment not more than Rs. 1,500/- to the eldest surviving member of the family of the deceased I.P. or to the person who actually incurs the expenditure on the funeral of an I.P.
7) Rehabilitation Allowance: No condition. For each day of which I.P. remains admitted in Artificial Limb Center for fixation, repair, or replacement of artificial limb. Same as at 1(a) Up to Rs. 15 L for Rehabilitation. Only to the I.P.
8) Medical Benefit to insured persons who cease insurable employment on account of permanent disablement: No condition, but an I.P. has to pay Rs. 10/- pm in lump sum for one year in advance every year. Till the date on which an I.P. would have attained the age of superannuation. Medical Benefit IP and spouse.
9) Medical Benefit to retired Insured Period: 1) Insurable employment for a period of 5 years and 2) Payment of Office of the Contribution @ Rs. 15/- PM in lump sum for one year in advance, each year. Till the time yearly contribution is paid to the Concerned Office of the Corporation. 3) Death during the course of employment entitles specified dependents to a regular payment. 4) One-time payment of Rs. 1,500 to help meet funeral expenses.
Thanks,
Srinivasan