ESIC benefit for new joining - Minimum 76 days work required for cash benefit towards ESIC leave?

Dear Sir,

Our new employee was scheduled to join on 01.11.2022; however, unfortunately, an accident occurred on 07.11.2022 while he was on a company tour. He received treatment at the hospital, incurring expenses of Rs. 75,000.

He was on ESIC leave until 31.01.23 and is expected to resume duty on 01.02.23. Subsequently, he visited the local ESIC office to claim cash benefits during the ESIC leave period, but he was informed that a minimum of 76 days of work is required to be eligible for cash benefits during ESIC leave.

We kindly request your guidance on this matter.

Ashok Sonar

For getting sickness benefits, there are a few contributory conditions like 76 days contribution and benefit period. However, his accident occurred during the course of employment. You should have uploaded the accident report, treating it as an accident while on duty. I understand that you have failed to do so, which is why he was not paid any cash benefits. In the case of accidents while on duty and during the course of employment, the insured will be entitled to cash benefits, which are even more than the cash benefits available for sickness benefits.

The remedy available is to convince the Manager at the Local Office and the person concerned in the Sub-Regional Office of the ESIC that due to oversight, you missed uploading the accident report. You should upload it now if possible. When you upload a report of an accident that occurred some days back (even three days back) on the online portal, a pop-up will appear to provide reasons for non-submission of the accident report in time, and you can submit your reply there itself. You can try this. Since it is an accident outside the plant, on a road, you have to prepare a sketch of the road where the accident occurred and attach the FIR, if available. These can be submitted offline separately with a covering letter explaining the delay.

If the employee does not receive benefits from the ESIC due to your negligence, then you, the employer, will have to cover the expenses, pay the salary for the period of absence, and compensate for the loss incurred following the provisions of the Employees' Compensation Act.