Am I Eligible for Maternity Payments and Leave with My ESIC Coverage?

I have joined a new organization in January 2015 and have been provided with ESIC facilities since April 1, 2015. I am currently six months pregnant, with my due date in December 2015. I would like to inquire about eligibility for maternity payments and the duration of maternity leave that I am entitled to.

Thank you.

Yes, you are eligible for the maternity benefit. Any female employee who has served the company for at least 80 days preceding the date of delivery is entitled to the benefit. Speak to your HR... Congratulations :)

Dear member, it is not clear from the facts mentioned by you since when contributions under the ESI Act, 1948, and the rules/regulations framed thereunder have been paid by your employer in your case. When you joined the organization in January 2015, it is unclear whether contributions have been paid from January 2015 itself. If contributions were paid from April 2015 onward only, then why the gap?

Further, I am doubtful whether you are eligible for maternity benefits under the ESI Act in December 2015 (the due date as mentioned by you) or prior to this period. The reason being that "an insured woman shall be qualified to claim maternity benefits for a confinement occurring or expected to occur in a benefit period if the contributions in respect of her were payable for not less than seventy days in the immediately preceding two consecutive contribution periods" (Section 56(1) of the said Act). If you started contributing w.e.f. 01/04/2015, the first benefit period in your case will start from 01/01/2016 only (though you can get only medical treatment prior to this date). Please see Regulation 4 of the ESI (General) Regulations, 1950.

I will, however, suggest you visit your appropriate Branch Office of ESIC to which you are attached and discuss the issue with the Branch Manager concerned so that you may be able to get the correct position regarding your eligibility for the said benefit. While visiting the Branch Office, please ensure you have your Pehchan Card (as issued by the Branch Office, ESIC). Furthermore, I hope you will also ensure to get proper medical certification from the ESIC Dispensary to which you are attached.

Eligibility for Maternity Benefits

To be eligible for maternity benefits, a woman must have worked for at least 80 days in the 12 months immediately preceding the expected delivery date.

Calculation of Maternity Benefit

Maternity benefit is paid at the rate of the average daily wage for the period of her actual absence. The average daily wage is calculated based on the woman's wages payable for the days she worked during the three calendar months immediately preceding the date from which she absents herself.

Components of Wages

Wages include all remuneration such as cash allowances, Dearness Allowance (D.A.), House Rent Allowance (HRA), incentive bonus, and the money value of any concessional value of food grains supplied. However, it does not include any bonus other than the incentive bonus, overtime (OT), gratuity, or Provident Fund (PF).

As mentioned above, I have to make it clear that 70 workdays are required under the ESIC Act for maternity benefits. These days are required in the preceding two consecutive contribution periods, not just one. The benefit period starts from January 2016.

Hello, I am Rahul from Pune. My wife delivered on Nov 3, 2015, in Ahmednagar. I am working in Pune, and my salary is 13,500. The company deducts ESIC from my salary. I have submitted all documents to HR in my office, but they have not said anything about a refund. Do I get any benefit, or am I late in receiving the benefit? What is the time period and clause for receiving benefits from ESIC? Please reply and help.

1. Sir, please clarify the type of refund you are claiming or wish to claim from ESIC.

2. When claiming any benefits from ESIC, the appropriate Branch Office to which you are attached is the office responsible for determining the admissible benefits for any insured person or their dependents. The HR department of any unit is not the relevant office for this purpose. It would be better if you address this matter with the appropriate branch office of ESIC.

Accessing ESIC Benefits

To check the benefits available, IPs can check the same on the ESIC portal. On the ESIC web portal, there is an IP Portal on the left side under the ESIC link. Click on the IP Portal, and a dialogue box 'User Login' will appear. Log in using your IP No. as your username. IPs will find their complete details along with the 'entitlement of benefits' available to IPs as of the date, calculated based on contributions.

Please note that ESIC benefits can be claimed if treatment is routed through an ESI Hospital.

Hope this information will help.

I have joined a new organization in October 2020 and have been provided with ESIC facilities since 5th October 2020. At that time, I was a few months pregnant, and my due date was at the end of April 2021. I have recently given birth to a baby girl on 16th April 2021. I would like to inquire whether I am eligible for maternity payment benefits now.

Sir, I am Rahul Chourasia from Mumbai. My wife gave birth to a baby girl on 16th April 2021 in Palghar. She joined a new organization on 5th October 2020 and was provided with ESIC facilities from October 2020. At that time, she was 2 months pregnant, and her due date was in April 2021. From October 2020 to April 2021, the company deducted the ESIC payment from her salary. So, I would like to know if she is eligible to receive maternity payment benefits.