Navigating ESIC Benefits After an Employee's Tragic Road Accident: What Should HR Do Next?

Dear All,

An employee in our Delhi branch died in a road accident on 28th February 2008, and we informed the local office of the accident within 48 hours of his dismissal. We stated that the accident occurred while he was returning to the office after inspection.

Please help me with the following queries:

1. Can the dependant of the deceased employee avail any kind of medical facility anymore? His wife is pregnant, do we have any rules/benefits under ESIC to help her?
2. Do we need to continue his contribution to ESIC any further?
3. What should be my next step as an HR?
4. What documents do I need to keep ready for any kind of inspection from the ESIC?

Please help.

Thanks & Regards,
Shraboni

In order to be eligible for accident (death) benefit, he should be on duty. He should have gone out of the factory/office during office hours and after making entries in the Staff Movement Register (if maintained).

Get a copy of the FIR/Mahazar prepared by the local police. Make entries in the Accident Book, which is under your custody. Ensure that the employee had signed in the muster roll on the day. If there was any witness from your company who was accompanying the deceased employee, take his statement (that will be done by the ESI Inspector also).

Also, ensure that the company has been regular in respect of remitting the ESI contributions. The rest is according to the ESI Act. The benefits, as applicable, will be given to the dependants of the deceased.

Hereafter, his name will be removed from the roll. The same should be stated in the Muster roll. No salary accrues hereafter, and hence no deduction and contribution of ESI/EPF.

Regards,
Madhu.T.K

Dear Shraboni,

The replies given by Madhu are correct.

Firstly, as an HR officer, it is the moral (more than official duty) of HR to ensure that everything needed is done for the dependents, to get ESI and other accident insurance, Motor vehicle tribunal claim, gratuity, PF and PF pension to family, Deposit linked pension from EPF, accident insurance from EPF (I think about 60000), salary and bonus arrears, and any other special schemes that the company has in case of such death while on duty. Your house journal or bulletin board should inform all others as to what all you/Company did to help the family. This is important not only for the dependants but also the co-employees, who should know about the commitment of the Employer in such cases to build up morale and loyalty.

As for ESI law, if he was returning from duty, I believe he was either traveling in a Company vehicle or was authorized to take a hired vehicle at Company expense since he was coming back after some inspection. Hence this is duty travel, and his family is entitled to get death benefit, which will be approximately 70% (I think it is 75% now) of the last wage. If travel outside the factory wa

Documents required are FIR, Post mortem report, if any, scene mahazar, etc. (which are obtainable from Police), copy of his wage and attendance register for the day, documents to prove that he was sent on duty and was returning from duty (such as delivery challan, inter-office memo, inspection report, a letter from the party where he has gone for inspection to confirm at what time he reached, duration of inspection, time leaving that place, which should reconcile with the time of the accident), your time office or other movement register where the employee has to take out a pass for moving out while on duty, a statement from the concerned superior stating that he was sent on duty at such and such place, and that inspection was his duty, the voucher showing advance for travel expense paid if any, previous vouchers of similar TA/DA, etc. In other words, the ESI department should satisfy that he was indeed on official work only. His salary till the date should be paid to the family, and this record also needs to be shown.

No further contribution needs to be paid from the day next to the death. However, salary to be paid on the date of death.

As for the medical benefit, Maternity Care in ESI Hospital, his family will get this provided he was enjoying "Benefit Period." This means if he was working for over Nine months and had a minimum 78 days contribution period during the half-year. He died on 28.2.2008, which means he will come under Benefit Period starting from 1 Jan 2008 to 30 Jun 2008, for which the relevant contribution period is April 2007 to 30 Sep 2007. If ESI contribution in respect of him was paid at least for 78 days during April 2007 to Sep 2007, then his family will get all medical care including confinement from ESI hospital for the wife during the period up to 30 Jun 2008, and no thereafter.

Please also help the family to file MV Tribunal case and follow up separately.

You are welcome to contact me at [Login to view] or 09944190441 if you need further advice.

O. Abdul Hameed
Formerly Additional Commissioner, ESIC New Delhi
Presently Group General Manager, Corporate group

Dear Shraboni,

The replies given by Madhu are correct.

Firstly, as an HR officer, it is the moral (more than official duty) of HR to ensure that everything needed is done for the dependents to get ESI and other accident insurance, Motor Vehicle Tribunal claim, gratuity, PF and PF pension for the family, Deposit-linked pension from EPF, accident insurance from EPF (approximately 60000), salary and bonus arrears, and any other special schemes that the company has in case of such death while on duty. Your house journal or bulletin board should inform all others about what you/Company did to help the family. This is important not only for the dependents but also for the co-employees, who should know about the commitment of the Employer in such cases to build up morale and loyalty.

Regarding ESI law, if he was returning from duty, I believe he was either traveling in a Company vehicle or was authorized to take a hired vehicle at Company expense, since he was coming back after some inspection. Hence, this is duty travel, and his family is entitled to get death benefits, which will be approximately 70% (now 75%) of the last wage. If travel was outside the factory, the documents required are FIR, post-mortem report, if any, scene mahazar, etc. (obtainable from Police), a copy of his wage and attendance register for the day, documents to prove that he was sent on duty and was returning from duty (such as delivery challan, inter-office memo, inspection report, a letter from the party where he has gone for inspection to confirm the time he reached, duration of inspection, time leaving that place - reconciling with the time of the accident), your time office or other movement register where the employee has to take a pass for moving out while on duty, a statement from the concerned superior stating that he was sent on duty at such and such a place, and that inspection was his duty, the voucher showing advance for travel expense paid (if any), previous vouchers of similar TA/DA, etc. In other words, the ESI department should be satisfied that he was indeed on official work only. His salary till the date should be paid to the family, and this record also needs to be shown.

No further contribution needs to be paid from the day following the death. However, salary should be paid on the date of death.

As for the medical benefit, Maternity Care in ESI Hospital, his family will get this provided he was enjoying the "Benefit Period." This means if he was working for over nine months and had a minimum 78 days contribution period during the half-year. He died on 28.2.2008, which means he will come under the Benefit Period starting from 1 Jan 2008 to 30 Jun 2008, for which the relevant contribution period is April 2007 to 30 Sep 2007. If ESI contribution in respect of him was paid for at least 78 days during April 2007 to Sep 2007, then his family will get all medical care, including confinement from ESI hospital for the wife during the period up to 30 Jun 2008, and not thereafter.

Please also help the family to file an MV Tribunal case and follow up separately.

You are welcome to contact me at oahamid@yahoo.com or 09944190441 if you need further advice.

O. Abdul Hameed

Formerly Additional Commissioner, ESIC New Delhi

Presently Group General Manager, Corporate Group

Dear Mr. Hameed,

It is very good! Experienced people like you will make all new entries in the HR easier to face the risks. Keep the answers in an explanatory manner for any ESIC query. Thank you once again.

Regards,
Keshav Reddy.

Dear Shraboni,

Apart from the statutory benefits, I think all employee members of your organization should also contribute and help the deceased employee's dependents.

Thanks,
Rashmi Pandey

Dear Abdul Hameed Sir,

Your information is too valuable for all those working in HR. However, I could not find information on how a company's HR should complete all formalities and provide support directly to the family, especially when they are unable to be present due to circumstances such as pregnancy or elderly parents' ill health. As HR professionals, we should assist our subordinates' families with compassion. I kindly request your guidance on the following:

1. What financial aids should the company provide to the family, in addition to gratuity and PF voluntarily?

2. What procedures are involved in handling police cases and other formalities?

This support not only fosters goodwill towards the company and HR but also encourages employees to contribute wholeheartedly. Without such assistance, employees may not hold the same respect for HR, leading to a lack of cooperation. Your guidance on this matter is greatly appreciated.

Thank you.

Sathish

Assistance Needed for Deceased Employee's Family Benefits

One of our employees had gone to his native place. Unfortunately, he died in a private hospital on 18.08.2014. He has two children and a wife. Kindly help me out with the following queries:

1. Can the dependents of the deceased employee get medical facilities from ESIC?
2. What documents should be submitted for PF claims and pension for dependents, and how much pension can they receive?
3. After how many days can the deceased's wife file claim forms following the deceased's death?
4. Can she claim a pension from ESIC?
5. What kind of benefits can she receive from ESIC and EPFO?

Please assist us.

Thanks and Regards,
R.L. Pal

Clarification on ESI Act Benefits

1. Regarding claims for benefits under the ESI Act, 1948, it needs to be clarified whether the worker/employee was covered as an employee under the said Act at the time of his death.

2. Was the employee's death a result of an accident or employment injury that occurred during the course of his employment at the unit where he was working?

3. Was the private hospital, where the employee received treatment, affiliated with ESIC, and was his case referred by ESIC for treatment?

Thank you.

Amendment to the ESI Act and Its Implications

In the 2010 amendment of the ESI Act, the scope of employment injury was extended. Accordingly, accidents that occur while coming to or going from the place of work will also be considered as accidents during the course of employment. The only condition attached is that the nexus between the time of the accident and the place of the accident (notional extension) should be established. Therefore, if the time of the accident is the same time the employee travels normally and the place is the same place through which they commute regularly, then the accident will be regarded as an accident during the course of employment.

The thread was started in 2008 when the above incidents were out of the scope of workmen's compensation or compensation under ESI.

Regards, Madhu.T.K