EMPLOYEE STATE INSURANCE ACT IN COMMUNITY

ESI is a multidimensional social security system tailored to provide socio-economic protection to the worker population and their dependents covered under the scheme. ESI is completely different from insurance that is provided for the general public. It supports full medical care and reasonable economic assistance to the beneficiaries for benefits like sickness, maternity, disablement and death due to employment injury. It is one of the most effective measures available to employees in a working environment.

1. WELCOME MISS RAJOSI KHANRA ROLL- 2288004 ; M.Sc. Nursing 2nd year KINS, KIIT DU

2. ESI ACT (EMPLOYEE STATE INSURANCE)

3. ESI is a multidimensional social security system tailored to provide socio-economic protection to the worker population and their dependents covered under the scheme. What is ESI Act ?

4. PURPOSES

5. In March 1943, The government of India appointed B. P. Adarkar to create a report on the health insurance scheme for industrial workers. The report became the basis for the ESI Act of 1948 . The Scheme was first implemented at Kanpur and Delhi on 24 February 1952. The act was initially intended for factory workers but later became applicable to all establishments having 10 or more workers. The act was amended in 1975,1984,1989 and 2010 . HISTORY

6. ADMINISTRATION

7. Autonomous body ESI Corporation Chairman Union Minister of Labour Vice-Chairman Secretary to Govt of India Ministry of Labour Representatives of central government 5 Representatives from each state 1 Representatives from each UT 1 Representatives of employees 5 Representatives of employers 5 Representative of the medical profession 2 Representatives of parliaments 3

8. The corporation has appointed Regional Boards in the states, local committees and Regional and local Medical benefit councils with the power to administer the scheme in states. It has also appointed an inspector to inspect factories regarding benefits given to workers. Regional offices - 23 Sub-regional offices - 26 Divisional offices- 2 Branch offices - 624 Cash offices - 197 Inspection offices - 406 Director general of ESI- Chief executive officer Medical commissioner Insurance Commissioner Financial commissioner Actuary

9. Under Section 1(5): The Scheme has been extended to Shops, Hotels, Restaurants, Cinemas including preview theatres, Road motor transport undertakings and Newspaper establishments employing 20 or more persons. Under Section 2(12) : The Act applies to the “Factories” employing 10 or more persons irrespective of whether power is used in the process of manufacturing or not. APPLICABILITY OF ESI ACT

10. The Scheme has been extended to Private Medical Institutions and Educational Institutions employing 20 or more persons in certain States. The existing wage-limit for coverage under the Act is Rs. 15,000/- per month (excluding remuneration for overtime. ESI Act is applicable across the length and breadth of the India.

11. CONTRIBUTION PERIODS AND BENEFITS PERIODS There are two contribution periods each of Six months and two corresponding benefit periods of Six months duration as under. Contribution Period - 1st April to 30th Sep., 1st Oct to 31st March ● Benefit Period - 1st Jan to 30th June, 1st July to 31st Dec. As per the ESI Act, the employer contributes 3.25% of the wages and the employee contributes 0.75% of the wages to the contributory fund, which is then used to provide insurance cover to the employees in difficult times.

12. HOW TO CALCULATE ESI The calculated wages of Mr X as per the ESI Act, 1948 is INR 20,000. Then the contributions will be calculated using the ESI calculation formula as below. PARTICULARS CALCULATION AMOUNT Employer’s Contribution (3.25%) 20,000*3.25% 650 Employee’s Contribution (0.75%) 20,000*0.75% 150 Total Contribution   800 After calculating the contributions and deduction of Rs. 150 from Mr. X’s wages, the employer is responsible for depositing the total contribution, i.e., Rs. 800, to the corporation within the stipulated time.

13. Address proof of the business Business PAN Card Details about shareholders, partners and directors.  Business licences Employee details and the details of their salary structure Bank account details Memorandum of Association, Article of Association, the partnership deed or other business deeds. DOCUMENT REQUIRED FOR REGISTRATION

14. MEDICAL BENEFITS SICKNESS BENEFITS MATERNITY BENEFITS DISABLEMENT BENEFITS DEPENDENT BENEFITS FUNERAL BENEFITS REHABILITATION BENEFITS

15. The ESI Scheme provides a full range of Medical Care to all Insured person and their family, through a network of ESI Dispensaries, Hospitals and panel clinics, Diagnostic Centers and super Speciality. MEDICAL BENEFITS Services comprise outpatient care, inpatient care, domiciliary care, specialist service, ambulance service etc. There is also a provision of supply of appliances like dentures, hearing aids, spectacles, artificial limbs, walking callipers, spinal braces, hernia belts etc. free of cost. Super speciality treatment such as Open Heart Surgery, Neuro Surgery, Bone Marrow Transplant, Kidney Transplant or specialized investigations like CAT scan, MRI, Angiography etc.

16. It consists of periodical cash payment to an insured person in case of sickness if that is certified by an Insurance Medical Officer or Practitioner. SICKNESS BENEFITS The insured persons suffering from long-term diseases like : Tuberculosis, leprosy, chronic empyema, AIDS, malignant diseases, diabetes mellitus, nervous system disorders, coronary artery diseases, congestive heart failures and various other diseases of the cardiovascular system, respiratory diseases, psychotic diseases. Duration: benefit is payable for a max. Period of 91 days in a year. This benefit is given to an insured person who has been working continuously for 2 years. The benefits are payable at the rate of 50% of average daily wages.

17. The benefit is payable in cash to an insured woman for confinement/miscarriage or sickness arising out of pregnancy/confinement or premature birth of a child or miscarriage. The benefit is paid as follows: For child delivery - for a total period of 12 weeks beginning not more than 6 weeks before the expected date of childbirth. For miscarriage - for a period of 6 weeks following the date of miscarriage. For sickness arising out of pregnancy - for 30 days. The rate of confinement expenses has been increased from Rs. 2500 to Rs. 5000. The benefit is allowed at about full wages. The benefit is paid for Sundays also. MATERNITY BENEFITS

18. The ESI Act provides for cash payment besides free medical treatment in the event of temporary and permanent disablement as a result of employment injury as well as occupational diseases. DISABLEMENT BENEFITS Benefits for temporary disablement are paid at the rate of about 90% of wages for the duration of disablement. For permanent total disablement, the life pension payment is made based on the loss of earning capacity determined by the medical board.

19. Eligible Members: A widow can receive this benefit on a monthly basis for life or till her Remarriage. A son or daughter can receive this benefit till 18 years of age. Other dependants like parents including a widowed mother etc. can also receive this benefit under certain conditions. Dependents benefit is paid as a family pension to the dependants of a deceased insured person in the event of death due to employment injury or occupational disease and is equivalent to about 90% of the wages. DEPENDENT BENEFITS

20. The maximum amount of rs. 10,000 for funeral expenses is given to the eldest surviving member on the death of an insured worker. FUNERAL BENEFITS REHABILITATION BENEFITS Ensured workers who required artificial limbs are provided with artificial limbs and also the cash allowance equivalent to the sickness benefit rate at the time when they are admitted for provision/replacement of artificial limbs. Ensured workers who are permanently handicapped or retired continue to get medical treatment on payment of 10/- per month.

21. This program, launched on April 1, 2005, is designed for individuals enrolled in the Employee State Insurance (ESI) scheme. Under this initiative, employees within the ESI scheme who experience unemployment due to factory closure or retrenchment are eligible for unemployment allowance. 50 % of the average daily wages is payable for a maximum period of twelve months during a lifetime. Additionally, those covered under this scheme are entitled to receive medical care for themselves and their families. Such healthcare services can be availed at ESI dispensaries, panel clinics, and ESI hospitals associated with the individual. RAJIV GANDHI SHRAMIK KALYAN YOJNA

22. SUMMARY

23. RESEARCH STUDIES

24. The Employee State Insurance (ESI) Scheme is a huge social security for the employees in the organization. ESI is completely different from insurance that is provided for the general public. It supports full medical care and reasonable economic assistance to the beneficiaries for benefits like sickness, maternity, disablement and death due to employment injury. It is one of the most effective measures available to employees in a working environment. The purpose of the study is to analyse the awareness and effective Utilization of Employee State Insurance (ESI) policy in Tata International. The study also attempts to review the varied Employee State Insurance (ESI) benefits available to the workers within the organization. A study questionnaire was framed and given to the workers to seek out awareness and therefore the effects of utilization of Employee State Insurance (ESI) policy in Tata International using tools through SPSS software. Awareness and effective utilization of ESI benefits in Tata International.

25. Employees’ State Insurance Scheme of India is an integrated social security scheme tailored to protect workers in the organized sector and their dependants in contingencies, such as sickness, maternity and death or disablement due to an employment injury or occupational disease. Towards this objective, the scheme provides free full medical facilities to insured persons and their dependants, as well as, cash compensation for any loss of wages or earning capacity of an insured person. ESI scheme is a very large social security network. The scheme encompasses basic economic risks namely health, sickness, disability, death and maternity. It is different from other types of insurance like health insurance in that it provides a full amount of medical bills irrespective of the premium contribution. In this direction researcher attempted to study the nurses’’ perception towards ESI concerning select hospitals in the Udupi District. Nurses’ perception towards ESI Scheme: a study with references to select hospitals in Udupi district.

26. The Employee State Insurance (ESI) Scheme is a huge social security for the employees in the organization. ESI is completely different from insurance that is provided for the general public. It supports full medical care and reasonable economic assistance to the beneficiaries for benefits like sickness, maternity, disablement and death due to employment injury. It is one of the most effective measures available to employees in a working environment. CONCLUSION

27. REFERENCES Gulani K.K., Community Health Nursing, Kumar Publishing House (2022), 3rd edition, page no: 454-457. “Employees State Insurance Act 1948” of India. [Internet]. www.slideshare.net. 2012 [cited 2023 Dec 17]. Available from: https://www.slideshare.net/AnshuSingh2/ppt-on-esi-act-1948 . ‌ESI Act [Internet]. www.slideshare.net. 2016 [cited 2023 Dec 17]. Available from: https://www.slideshare.net/PreetikaMaurya/esi-act-63470325 . S Sowmya Sai, Dr. Kumar N., awareness and effective utilization of ESI benefits in Tata International, IJCRT (2021), Volume 9, Issue 5 May 2021, ISSN: 2320-2882. Maiya Umesh, Nurses' Perception Towards Esi Scheme: A Study with Reference to Select Hospitals in Udupi District, Asia Pacific Journal Of Research(2016), Volume 1, ISSN: 2320-5504.