Confused About ESI Maternity Benefits? Seeking Clarity on Eligibility and Claims

My company is entitled under ESI, and I maintain our company accounts. Recently, I have checked all employees' entitlement benefits from the ESIC Employee Portal. There is a list of benefit types and entitlement statuses. I noticed there is an option for maternity benefits. All of our employees are currently not availing of this benefit (Maternity benefit status - No). This has left me confused.

Questions About Maternity Benefits

I would like to know:
- What is the maternity benefit?
- How can one avail of this benefit?
- Can only women Insured Persons (IPs) claim or receive this benefit?
- Some employees have spouses, and one employee's wife is pregnant. Can he (his wife) avail of this benefit?

I am eagerly waiting for your reply.

Thanks in advance,

Regards,
Titan Sheikh

The term "maternity benefit" has been defined under section 46(1)(b) of the ESI Act, 1948. There are certain terms and conditions of eligibility under which the same is paid to the insured women who are covered under the said Act. It is admissible only to the insured women covered under the said Act and is not available to the wife of any male insured person covered. However, the wife of an insured person covered is entitled to medical facilities arising out of such maternity as a member of the family.

In addition, an insured woman or an insured person in respect of his wife can claim "confinement expenses" up to Rs. 5000/- as mentioned under Rule 56-A of ESI (Central) Rules, 1952 under certain circumstances as mentioned in the said Rule.

To learn more about the facilities, terms of entitlement, and conditions available under the ESI Act, 1952, and the rules/regulations framed thereunder, I hope you will download the literature from the website of ESIC.