ESIC ACT 1948 Applicability and Benefits
APPLICABILITY
• The Act is applicable to non-seasonal factories employing 10 or more persons.
• The Scheme has been extended to shops, hotels, restaurants, cinemas including preview theaters, road-motor transport undertakings, newspaper establishments, establishments engaged in Insurance Business, Non Banking Financial Companies, Port Trust, Airport Authorities and Warehousing establishments employing 10* or more persons.
• The Scheme has been extended to Private Medical Institutions, Educational institutions and to contract and casual employees of Municipal Corporation/Municipal Bodies employing 10* or more persons in certain States/UTs.
• The existing wage limit for coverage under the Act effective from 01/01/2017 is Rs.21,000/- per month.
Note: 1. Rs. 25,000/- per month in the case of persons with disability.
2. However the threshold for Coverage of establishments is still 20
Employees in Maharashtra.
#Benefits
1- Medical #benefit
2- Sickness benefit
3- Maternity benefit
4- Disablement benefit
5- Dependents benefit
6- Funeral expenses
7- Rehabilitation allowance
1. Medical benefit
Full medical care is provided to an Insured person and his family members from the day he enters insurable employment. There is no ceiling on expenditure on the treatment of an Insured Person or his family member. Medical care is also provided to retired and permanently disabled insured persons and their spouses on payment of a token annual premium of Rs.120/- .
1. System of Treatment
2. Scale of Medical Benefit
3. Benefits to Retired IPs
4. Administration of Medical Benefit in a State
5. Domiciliary treatment
6. Specialist consultation
7. In-Patient treatment
8. Imaging Services
9. Artificial Limbs & Aids
10. Special Provisions
11. Reimbursement
2. Sickness Benefit
Sickness Benefit in the form of cash compensation at the rate of 70 per cent of wages is payable to insured workers during the periods of certified sickness for a maximum of 91 days in a year. In order to qualify for sickness benefit the insured worker is required to contribute for 78 days in a contribution period of 6 months.
1. Extended Sickness Benefit(ESB) : SB extendable upto two years in the case of 34 malignant and long-term diseases at an enhanced rate of 80 per cent of wages.
2. Enhanced Sickness Benefit : Enhanced Sickness Benefit equal to full wage is payable to insured persons undergoing sterilization for 7 days/14 days for male and female workers respectively.
3. Maternity benefit
Maternity Benefit for confinement/pregnancy is payable for Twenty Six (26) weeks, which is extendable by further one month on medical advice at the rate of full wage subject to contribution for 70 days in the preceding Two Contribution Periods.
4- Disablement benefit
1. Temporary disablement benefit (TDB) : From day one of entering insurable employment & irrespective of having paid any contribution in case of employment injury. Temporary Disablement Benefit at the rate of 90% of wage is payable so long as disability continues.
2. Permanent disablement benefit (PDB) : The benefit is paid at the rate of 90% of wage in the form of monthly payment depending upon the extent of loss of earning capacity as certified by a Medical Board
5- Dependents benefit
DB paid at the rate of 90% of wage in the form of monthly payment to the dependents of a deceased Insured person in cases where death occurs due to employment injury or occupational hazards.
6- Funeral expenses
An amount of Rs.15,000/- is payable to the dependents or to the person who performs last rites from day one of entering insurable employment.
7- Rehabilitation allowance
2,500/- per case. Not more than 45 years of age and disability not le than 40% due to Employment Injury All the days of training in Vocational Rehabilitation Center Rs. 123/- per day or the actual amount charged by Vocational Rehabilitation Center, whichever is higher. An I.P.
#ESI #LAW #EMPLOYEE