What are the ESI’s benefits for the contract labour of Nashik
This legislation is the most comprehensive social security legislation in the country, covering medical care, sickness, maternity, employment injury, disablement, dependants and unemployment. Government establishments in receipt of benefits substantially similar to those available under the Act were excluded from its purview.
It applied initially to non-seasonal factories but has subsequently been extended to other categories of establishments, particularly in the services sector. At present, it also applies to shops, hotels, restaurants, cinemas, road transport undertakings, newspaper establishments, and educational and medical institutions with more than 20 employees.
In several states, the minimum number of employees to come within the ambit of the Act has been reduced from 20 to 10 in the case of shops and establishments.
The threshold in respect of the number of workers for factories has also been reduced from 20 to 10, irrespective of whether power is used in the manufacturing process or not. The ceiling wage of employees covered by the Act is Rs 15,000 per month, which has been relaxed to Rs 25,000 per month for employees with disability.
The ceiling wage is revised from time to time to take care of inflation, but once an employee has been covered, she remains covered for the entire service period.
To implement the Employees’ State Insurance scheme, the Government of India has established a corporate body, known as the Employees’ State Insurance Corporation (ESIC). Employees of covered establishments are referred to as insured persons.
The ESI scheme is financed by contributions mainly from employers and employees, with the former paying 4.75 per cent and the latter 1.75 per cent of the wages. Expenditure on medical care is shared between the ESIC and state governments in the ratio of 7:1, with a ceiling of Rs 2000 per insured family (as on April 1, 2014).
State governments are expected to share expenditure outside the ceiling to purchase equipment and vehicles for ambulances, to provide training for nurses and dispose of biomedical waste.
The annual reports of the ESIC show that the programmes are well funded and savings from contributions are utilised to make capital investments. The ESIC has set up a network of hospitals, including super-specialty hospitals, and is in the process of setting up new ones.
The Corporation also has tie-up arrangements with private hospitals for investigation and treatment.
The following are the main benefits available to insured persons from the ESI scheme:
Medical benefit – Medical care under the ESIS includes preventive, curative and rehabilitative services, and is provided in clinics for outpatients and in hospitals for in-patients.
For in-patient services, tieup arrangements have been made with reputed institutions, which also provide sophisticated diagnostic services. Medical care is also provided in lieu of a small charge to retired persons as well as to permanently disabled persons.
Sickness benefit – Sickness benefit is paid @ 70 per cent of the daily wage, provided qualifying contribution has been paid for a minimum period of 78 days. The maximum duration of sickness benefit is 91 days spread over two benefit periods.
Persons suffering from diseases like tuberculosis or mental diseases can get extended sickness benefit for a period of two years at a higher rate of 80 per cent of the average daily wage, provided they have been employed for a period of two years and paid contribution for 156 days in four contribution periods.
Maternity benefit – Maternity benefit is payable @ 100 per cent of the daily wage for a maximum period of 12 weeks for confinement, six weeks for miscarriage, and another one month for sickness arising 5 from pregnancy.
In places where necessary medical facilities are not available under the ESIS, a medical bonus of Rs 5,000 becomes payable for meeting confinement expenses, subject to a maximum number of two confinements.
Disablement benefit – When the disability is temporary, cash benefit is payable @ 90 per cent of the average daily wage for the period of such disability, after the initial period of three days.
When the employment injury is permanent, whether partial or total, a periodic cash payment is made for the whole life, on the loss of earning capacity as certified by a medical board constituted for the purpose. The payment is revised from time to time to take inflation into account.
Dependants’ benefit – As in the Employees Compensation Act, 1923, the ESI Act has a very inclusive definition of dependants, and besides the spouse and minor children, a widowed mother, unmarried daughters, sons below 25 years in age, a widowed daughter-in-law, a parent other than widowed mother, a minor child of a predeceased son, and a paternal grand-parent are also covered.
In the event of death as a result of employment injury, dependants’ benefit becomes payable @ 90 per cent of the average daily wage of the employee at the time of death and is divided among the dependants in the ratio prescribed in law.
It is provided that the minimum amount of monthly payment to eligible dependants shall not be less than Rs 1200.Further, as in the case of disablement, the rate of monthly payment is revised from time to time to neutralise the effect of inflation.
Unemployment Allowance – Under the ESI Act, 1948, the Government of India has also introduced an unemployment insurance scheme known as the Rajiv Gandhi Shramik Kalyan Yojana (RGSKY) with effect from April 1, 2005. This scheme entitles the insured persons to receive an unemployment allowance equal to 50 per cent of the average daily wages for a maximum period of twelve months if the concerned person loses employment involuntarily as a result of retrenchment from or closure of the factory or establishment.
Insured persons who have become invalids (to the extent of more than 40 per cent) as a result of injury not related to employment are also entitled to unemployment allowance. A condition of eligibility for unemployment allowance is that the ESIS contribution in respect of the insured person should have been paid for a minimum of three years prior to the loss of employment.