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CA.Leela Kumar

CA.Leela Kumar (Querist)

15 June 2012 What are the total benefits of ESI

RAMESH KUMAR VERMA

RAMESH KUMAR VERMA (Expert)

15 June 2012 ESI Scheme for India is an integrated socialsecurity scheme tailored to provide SocialProduction to workers and their dependents, in the organised sector, incontingencies, such asSickness, MaternityandDeathor Disablement due to an employment injury or Occupationalhazard .

COVERAGE…

The ESI Act 1948 applies to•Non – seasonal Factories using power inand Employing ten (10) or More persons•Non – seasonal and non- power usingfactories and establishments employingtwenty(20) or more perso

Benefits to Employees
•ESI Scheme Major Social Security Benefits inCash and Kind include …

1.Medical Benefit– for self & Family

2.Sickness Benefit– for self

3.Maternity Benefit- for self

4.Disablement Benefit
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a). Temporary Disablement Benefit – for self

b). Permanent Disablement Benefit – for self
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5.Dependents’ Benefit – for dependents in case of death due to employment injury

BENEFITS
, ,
Subject to the provisions of this Act the insured persons
82
[
their
,
dependants or the persons hereinafter mentioned as the case may
,] , ,-
be shall be entitled to the following benefits namely
.
1
.
2

Sickness Benefit
.
3

Maternity Benefit
.
4
/
Accident Disablement benefit
.
5

Dependant benefit
.
6

Medical Benefit
.
7

Funeral Benefit

Medical Benefit …
•Medical Benefit means Medical care of IPs and their families,wherever covered for medical benefit.
•
•The Standard medical care consists of out-door treatment, in- patient treatment, all necessary drugs and dressing, pathological and radiological specialist consultation andcare, ante-natal and post natal care, emergency treatmentetc.,

•Out-door medical care is provided at the state InsuranceDispensaries or Mobile Dispensaries manned by full-timedoctors (service’ system) or at the private clinics of Insurance Medical Practitioners (Panel System)

Medical Benefit …

Sickness Benefit …
•Sickness signifies a state of health necessitatingMedical treatment and attendance and abstentionfrom work on Medical grounds. Financial supportextended by the corporation i such a contingency iscalled sickness Benefit
•
•Sickness Benefit represents periodical paymentsmade to an Insured Person for the period of certified sickness after completing 9 Months ininsurable employment.

Benefits to Employees …

Extended Sickness Benefit
…
•Extended Sickness Benefit is a Cash Benefit paid for prolonged illness (Tuberculosis /Leprosy, Mental and Malignant diseases)due to any of the 34 Specified diseases
•
•The IP should have been in continuousemployment for a period of 2 years andshould have contributed for atleast 156 daysin 4 preceding contribution periods..

Maternity Benefit…
•Maternity Benefit is cash payable to an Insuredwomen for the specified period of abstentionfrom work for •1. confinement or mis-carriage or for sicknessarising out of pregnancy,•2. “confinement” “premature birth of child or miscarriage” “confinement”•connotes labour after 26 weeks of pregnancywhether the result issue is alive or dead.

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