How Can Contract Employees Avoid ESI Deductions When Using Spouse's Medical Benefits?

Medical Facility Declaration for Contract Employees

A lady contract employee's husband is working in a Central Public Sector Undertaking (PSU), and she avails all medical facilities as a spouse from her husband's employer. The medical facilities provided by the PSU are definitely better than those of the Employees' State Insurance Corporation (ESIC). As a rule, the medical facility should be availed from only one organization, either from the husband's employer or her own employer.

My question is, how can she declare this fact regarding her availing medical facilities from her husband's employer to her Immediate Employer, Principal Employer, or ESIC Authorities so that her ESI contribution is not deducted from her salary?

Experts and seniors, please guide me in this matter.

Regards,
BB Behera

Rights and Entitlements Under the ESI Act

By being an insured person or insured woman as a result of coverage under the ESI Act, 1948, and the rules and regulations framed thereunder, the wife of an employee serving in a CPSU has her own rights and entitlements for various benefits under the said Act. She may be entitled to maternity benefits, temporary disablement, permanent disablement, and various other benefits. Her dependents may also be entitled, in the case of accidental death due to or in the course of employment, to dependent benefits and some other benefits. His spouse, who is working in the CPSU, may not be entitled to all such benefits. Coverage of an employee under the provisions of the above Act and rules and regulations is based on the fact of insurable employment and the level of wages he or she is receiving.

No Exemption Provisions

Under the above Act and rules and regulations, there are no provisions for the exemption of such employees from the purview of the said Act. Even if both the husband and wife are covered under the said Act and rules and regulations as an "employee/insured woman," there is no provision for exemption of the wife from the coverage of the said Act, rules, and regulations. Social security coverage and benefits are compulsory in nature and not optional.

Regards, BB Behera

Dear BB Behera,

It is not a question of availing any outside medical facility by an IP, but it is an insurance cover available under ESI Scheme to IP which takes care of the liability of the Employer in case of Temporary/Permanent Disablement to IP. You cannot do away with the insurance cover by saying medical facility is available to IP from other sources. I agree with HarshKumarji in this regard.