Navigating Maternity Benefits for ESIC-Covered Employees: What Steps Should We Take?

We are an SME and have a lady under ESIC cover who wishes to avail maternity benefits. She has applied for leave from 1st Jan 18, where her due date is the last week of Jan or the 1st week of Feb. What is the procedure that we need to follow? Do we need to inform ESIC about her maternity leave? How will the benefit be given? Does ESIC give it to the company and then we provide it to her, or does ESIC give it directly to the employee? She will most likely go for delivery in a private hospital and not in ESIC network hospitals.

Please find details as below:

What is the procedure that we need to follow?

Employees who want to take benefit under ESIC for maternity need to have a minimum of 2 years' contributions to ESIC. Also, she needs to register with the nearest ESIC dispensary for the same.

Do we need to inform ESIC about her maternity leave?

No need to inform from the employer's end.

How will the benefit be given?

Does ESIC give it to the company and then we give it to her, or does ESIC give it directly to the employee? ESIC will pay the benefit directly to the employee.

Eligibility for Maternity Benefit Under ESIC

1. Sir, it is incorrect to suggest that in order to claim maternity benefits, one needs to have a minimum of 2 years' contributions to ESIC. I hope the Senior HR Executive will reconsider this statement. Please refer to Rule 56 of the ESI (Central) Rules, 1950, which states the eligibility condition for maternity benefit as "not less than seventy days in the immediately preceding two consecutive contribution periods." A contribution period spans 6 months.

Procedure for Claiming Maternity Benefits

2. Furthermore, ESIC has its own procedure for determining eligibility for various benefits, including maternity benefits. The claimant must present themselves with their Pehchan Card to the ESIS doctor they are assigned to for examination. The ESIS doctor issues medical certificates periodically during each visit, and benefits are calculated and disbursed by the ESIC Branch Office Manager directly to the insured individuals.

Advice for Insured Women

3. Therefore, it would be better to advise the concerned insured woman to contact her ESIS dispensary and the ESIC Branch Office to which she is attached. The principal employer's duty is solely to ensure compliance on behalf of the insured woman, and most importantly, to provide her with a Pehchan Card received from the appropriate Branch Office.