Understanding ESIC vs. Workmen's Compensation: How Do They Affect Employee Claims?

Hi to All,

Can anybody help me with the following matters:

1) What is the difference between ESIC Act and Workmen's Compensation Act?
2) Where an employee is covered under ESIC Act, is the Workmen's Compensation Act applicable to him?
3) If an employee to whom the ESIC Act is applicable dies due to an accident during the course of his employment, will his dependents be entitled to claim under the Workmen's Compensation Act?
4) If not, what are the provisions for such dependents?

Regards,
Armaan

Can anybody help me with the following matters?

1) What is the difference between ESIC Act and Workmen's Compensation Act?

A: ESIC is the Employees' State Insurance Corporation, and the Workmen's Compensation Act is an act constituted by the Central Government in 1923.

2) Where an employee is covered under the ESIC Act, is the Workmen's Compensation Act applicable to him?

A: No. There are some places where ESIC is not available. The Workmen's Compensation Act of 1923 is applicable there.

3) If an employee to whom the ESIC Act is applicable dies due to an accident during the course of his employment, will his dependents be entitled to claim under the Workmen's Compensation Act?

A: No. They can claim only under ESIC.

4) If not, what are the provisions for such dependents?

A: Please understand that it is either ESIC or Workmen's Compensation. Either one of them is binding on the employer. Please check whether your area falls under ESIC.

Secondly, those drawing a gross salary up to Rs. 10,000 only are covered under ESIC. For others, the Workmen's Compensation Act of 1923 applies.

Regards!

To Mr. Andrew Rao,

Is there any section or clause in the Workmen's Compensation Act that defines the applicability and provisions for the above ESIC people's term?

Section 53 of the ESI Act reads as follows:

Bar against receiving or recovery of compensation or damages under any other law

An insured person or his dependants shall not be entitled to receive or recover, whether from the employer of the insured person or from any other person, any compensation or damages under the Workmen's Compensation Act, 1923 or any other law for the time being in force or otherwise, in respect of an employment injury sustained by the insured person as an employee under this Act.

Regards,

Madhu.T.K

Ans1: ESIC takes care of your insurance benefits, dependents benefits, maternity benefits, sickness benefits, extended sickness benefit, enhanced sickness benefit, dependents benefit, disablement benefit. The contribution is paid by the employee and the employer for availing these benefits.

Whereas, the Workmen Compensation Act covers accidents arising out and in the course of employment. It also discusses the notional extension theory. Workmen's Compensation Act is the oldest of the Acts and it also addresses social security. This is just a synopsis; there is much more.

Ans2: No, where ESIC is applicable, the Workmen's Act 1923 is not applicable because the benefits provided in the Workmen Compensation Act are also covered by ESIC. Therefore, one cannot avail the same benefits from two laws. Even the Maternity Benefit Act is not applicable where ESIC is in force.

Ans3: No, the dependents have to claim dependents' benefits from ESIC. The accident must have occurred when the individual was employed. Dependent benefits are provided at the rate of 70% of wages to the wife for her lifetime or until her remarriage, to children up to 18 years of age, and under certain conditions to parents. Dependents receive benefits within a maximum period of 3 months and then on a regular monthly basis.

Ans4: I hope I have explained the conditions in answer number 3.

Hope you will be satisfied.

Regards,

Vikas

Well, I would like to add on... The Maternity Benefits Act is applicable under ESIC if the contributions made by the female worker are 70 days or more in the two immediately preceding benefit periods. Also, a medical bonus of Rs. 250 is payable.

I have one doubt regarding whether the Workmen's Compensation Act is applicable, will ESIC be applicable as well? I am aware that the vice versa situation is not applicable.

Workmen's Compensation Act (to be renamed as Employees Compensation Act) is a legislation which directs the employer to pay compensation to an employee who suffers an injury while performing his regular nature of duty. By extending coverage to the establishment, the employer is shifting his obligation under the Workmen's Compensation Act to the Employees State Insurance Corporation. In other words, the ESIC takes over the liability of the employer in respect of employees who meet with accidents during the course of employment. It is important to remember that ESIC will not pay any compensation for an employee who is not covered by the ESI Act. Therefore, regarding employees who are not covered by ESI, the employer is still liable under the Workmen's Compensation Act. However, the employee shall not receive both benefits simultaneously, i.e., benefits as per the Workmen's Compensation Act and benefits from ESI.

Regards,
Madhu.T.K

As per Section 10, a notice for a claim should be given within 2 years of the accident. However, the Commissioner has the authority to entertain such claims given after 2 years if he is satisfied with the reasons for the delay in submitting the claim.

Madhu.T.K

Thank you all for the useful information shared and clarifications! Does this mean that any employee covered under the ESI Act does not need to take a separate insurance cover under the WC Act/Fatal Accidents Act, 1855, or any other law? Please confirm if my understanding is correct.

Yes, in respect of ESI-covered employees, you need not take any insurance to cover the risk of employment injuries. It will be taken care of by the ESIC. The only difference is that under the Workmen's Compensation Act, the compensation is a lump sum amount, whereas under ESI, it will be paid in the form of periodical/monthly pension to the dependants.

Madhu.T.K