Navigating ESIC Maternity Benefits: Is Eligibility Affected by Miscarriage?

I have one query related to the Maternity Benefit under ESIC. One of our female employees is covered under ESIC. She is pregnant now. However, in her two years of employment with us, she has not taken any ESIC benefits or even applied for TIC. She went on leave by simply submitting a leave application for prolonged leave. In the meantime, we arranged for TIC to provide her Maternity Benefit, which has not reached her yet. To my knowledge, she needs to visit the ESIC office once before the Expected Due Date (EDD) to claim the benefit. However, before she could do so, we received information about a miscarriage.

Kindly advise if she is still eligible for the said benefit under ESIC?

Thank you in advance.

Regards,
Maulik Dave

In order to be eligible for maternity benefits under the ESI Act, 1948, an insured woman should have contributed or have contributions payable for not less than 70 days in the last two consecutive contribution periods, i.e., one year (Section 56(1)). Therefore, in my opinion, as stated by you, the said female employee is eligible for maternity benefits. In the case of a miscarriage, she is eligible for maternity benefits for a period of six weeks immediately following the date of her miscarriage (Section 56(3)).

The main requirement is that the insured woman was required to visit her ESI dispensary, obtain certification from the IMO concerned, and should have submitted the same to her ESIC Branch Office.

Since, as mentioned by you, the appropriate procedure was not completed, I suggest that the said female employee may contact the appropriate branch office of ESIC or ESI dispensary and discuss the issue. They can help by issuing a certificate at this stage, considering the medical certificates or papers from the medical institute or doctor where she is presently receiving treatment.

Employer's Responsibility for ESI Card

The ESI card should be arranged by the employer immediately upon an employee's joining, not only when the employee needs to access benefits from ESIC. In this case, the employer is at fault.

You can visit the Branch Office of ESIC or the Insurance Medical Officer (IMO) and explain that she should receive benefits. If she does not receive benefits due to the employer's fault, she may claim the same directly from you under the Employees' Compensation Act.

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Regards,

Let me clarify this case. If an employee (male/female) has taken a long leave due to bad health or some other health issue and has undergone treatment under ESIC Benefits, are they eligible for a salary during their leave period? If yes, how many days will they be entitled to?

Kindly revert to me.

Regards,
Chandra
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An employee on ESI leave is not eligible for any salary from the employer. He/she will receive the monetary benefits from ESIC, subject to the conditions outlined in the ESI regulations/rules.

Regards,
Varghese Mathew

If I join the new organization on 16 Jan 2017 and contribute to ESIC from Jan 2017, and I discover I am pregnant in the month of March, am I eligible for maternity leave? Please reply.

Thank you, Mr. Harshkumar. I was not covered under ESIC in my previous organization. My tentative maternity leave starts from October 2017. Please advise on the procedure.

Dear member,

I have already suggested in my reply as above that the claimant insured woman/person should contact the appropriate ESI dispensary as well as ESIC Branch Office. Please do not forget to carry your ESIC Pehchan Card while visiting the above offices.

Dear member, you can visit the ESIS dispensary to which you are attached, show them your PEHCHAN CARD, and discuss the issues with the doctors and staff posted therein. In addition, you can also visit and approach the ESIC Branch Office to which you are attached, show your PEHCHAN CARD to them, and discuss the entire issues with them.

I think you will get suitable guidance and replies from the staff of the above offices. You can also download necessary literature on ESIC Benefits from the website of ESIC. In order to claim maternity benefit under the ESI Act, 1948, an insured woman must have contributed for the minimum number of days as required in the said Act and the rules/regulations framed therein.