Am I Eligible for Maternity Benefits Despite Confusion Over Contribution Periods?

I joined the office on 02/02/2017. I delivered my baby on 11/12/2017. Do I fulfill the eligibility conditions of contribution periods and benefit periods?

Contribution Periods:

From 02/02/2017 to 31/03/2017 - 58 days

From 01/04/2017 to 30/09/2017 - 181 days

The ESIC office says I am not completing the required contribution period of 70 days at the time of delivery. They are not considering the contribution period from 01/04/2017 to 30/09/2017 on the view that the benefit period for the latter period starts from 01/01/2018. But the rule is written as Rule 56 - Employees' State Insurance (Central) Rules, 1950.

Maternity Benefits:

(1) 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.

Please help and guide in this matter.

Eligibility for Maternity Benefits Under ESI Act

Your query is about whether you fulfill the eligibility conditions of the contribution period and benefit period, having joined on 02/02/2017 and delivered your baby on 11/12/2017.

As rightly pointed out, Rule 56 of the Employees' State Insurance (Central) Rules, 1950, states 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.

The ESI Headquarters issued Circular No.R-14/13/99-Bft.II dated 20th March 2018, clarifying the conditions for entitlement to Maternity Benefit under the ESI Act. The Circular admits under para 3 that several maternity benefit claims were rightly rejected. It further clarifies the condition for entitlement under para 5.

Clarification of Contribution Periods

Para 5 states that to determine the entitlement of maternity benefits, two consecutive contribution periods immediately prior to the actual or expected date of confinement should be considered. If the contribution was payable for not less than 70 days over these periods, the insured woman would be eligible. Even if she satisfies this contributory condition in one or the other of the said two contribution periods, she shall be entitled to maternity benefits.

In your case, you mentioned the date of delivery as 11th December 2017. The confinement might have taken place by February 2017 end or early March 2017. This is why the ESI authority has not considered the contribution period from 1st April 2017 to 30th September 2017.

A copy of the Circular is attached herewith for your kind perusal.

Maternity Benefit Act Requirements

While the ESI considers the date of actual confinement or expected occurrence in a benefit period for entitlement of Maternity Benefit, the Maternity Benefit Act stipulates under Section 5(2) that no woman shall be entitled to maternity benefit unless she has actually worked in an establishment of the employer from whom she claims maternity benefit for a period of not less than eighty days in the twelve months immediately preceding the date of her expected delivery.

The term used is "actually worked" and not "service." Explanation to Section 5(2) clearly states which days are included and excluded while computing the number of days actually worked. If the weekly holidays are holidays with wages under any law applicable to the establishment in which the woman is working, then she would be eligible to get maternity benefit after 2 months and 20 days if she had actually worked on all the days excepting the weekly holidays for which she is entitled to wages.

In your case, it seems that you have worked 80 days in your establishment before your date of delivery, and as such, you are entitled to claim the benefit from the Management.

As rightly pointed out by our friend Mr. Srinath Sai Ram, log in to the ESI IP Portal with your ESI Insurance number. If you are not eligible for Maternity Benefit, contact your employer to pay MB to the extent of 26 weeks' salary under The Maternity Benefit Act, 1961, with a printout of not eligible for Maternity Benefit downloaded from the ESI IP Portal.

Regards,
P S Lakshmanan
S. G. Management Services
Kolkata