Employees’ State Insurance Scheme of India, is a multidimensional social security system tailored to provide socio-economic protection to worker population and their dependents covered under the scheme. Besides full medical care for self and dependents, that is admissible from day one of insurable employment, the insured persons are also entitled to a variety of cash benefits in times of physical distress due to sickness, temporary or permanent disablement etc. resulting in loss of earning capacity, the confinement in respect of insured women, dependents of insured persons who die in industrial accidents or because of employment injury or occupational hazard are entitled to a monthly pension called the dependents benefit.
Benefits at a Glance
|BENEFITS||ELIGIBILITY CONDITIONS||DURATION AND SCALE OF BENEFITS|
|1. SICKNESS BENEFIT
(a) Sickness Benefit
|Payment of contribution for 78 days in corresponding contribution period of six months.||Upto 91 days in two consecutive benefit periods at 70% of the average wages for 91 days in a year.|
|(b) Enhanced Sickness Benefit||Same as above||14 days for Tubectomy & 7 days for Vasectomy, extendable on medical advice. Rate of payment is 100% of the average daily wages.|
|(c) Extended Sickness Benefit||For 34 specified long term disease. Continuous insurable employment for two years with 156 days contribution in four consecutive contribution periods||124 days which may be extended up to two years on medical advice during a period of two years I insurable employment. Rate : 80% of the average daily wages approx.|
|2. DISABLEMENT BENEFIT
|From day of entering insurable employment & Disablement benefit irrespective of having paid any Contribution for disablement due to employment injury.||As long as temporary disablement lasts. Rate : about 90% of the average daily wages depending upon loss of earning capacity.|
|(b) Permanent Disablement Benefit||Same as above||For whole life. Rate : about 90% of the average daily wages depending upon loss of earning capacity.|
|3. DEPENDENTS BENEFIT||From day of entering insurable employment & Disablement benefit irrespective of having paid any contribution is case of death due to employment injury.||For life to the widow or until her re-marriage. To dependent children till the age of 25 years. To dependent parents for life. Rate : about 90% of the average daily wages approx. shareable in fixed proportion.|
|4. MATERNITY BENEFIT||Payment of contribution of 70 days in two Preceding contribution periods (one year)||Up to 12 weeks in case of normal delivery. Up to 6 weeks in case of mis-carriage. Extendable by 4 weeks on medical advice. Rate : Almost 100% of the average daily wages|
|5. MEDICAL BENEFIT||Full medical facilities for self and family from day one of entering insurable employment.||Full medical care till disease or disablement lasts. No ceiling on expenditure. Retired insured persons who have been in insurable employment for at least five years before retirement on superannuation or under VRS or premature retirement and Disabled Insured Persons are entitled to full medical care for self and spouse only on payment of Rs. 120/- as annual contribution.|
|6. OTHER BENEFIT
|An Insured Woman or an IP is respect of his wife in case medical for confinement occurs at a place where necessary medical facilities under ESI Scheme are not available.||Up to two confinements only. Rate : Rs. 5000/- per case. For defraying expenses on the funeral of an Insured Person|
|- Funeral Expenses||From day one of entering insurable employment||Rate : Actual expenses subject to a maximum of Rs. 10000|
|- Vocational||In case of physical disablement due to employment injury.||As long as vocational training lasts. Rate : Actual fee charged of Rs. 123/- a day whichever is higher.|
|- Physical||In case of physical disablement due to employment injury.||As long as a person is admitted in an artificial limb centre. Rate : 100% on the average daily wages.|
| -Unemployment Allowance
|In case of involuntarily loss of employment due to Allowances (RGSKY) closure of factory, retrenchment or permanent invalidity due to non-employment injury and the contribution in respect of him have been paid/payable for a minimum of three years prior to loss of employment.||Maximum twelve months during life time.
Rate : 50% of the average daily wages.
|- Skill up-gradation Training under RGSKY||Same as above||For a short duration-maximum up to 6 months.|