The employees state insurance act, 1948

In detail about Employees state insurance act, 1948, and its benefits to employees and employers as well.

1. THE EMPLOYEES STATE INSURANCE ACT, 1948 Nivetha c IV TERM

2. OBJECTIVES AIM SCOPE ADMINISTRATION FINANCE BENEFITS TO EMPLOYEES BENEFITS TO EMPLOYERS OTHER BENEFITS

3. ESI ACT, 1948 It is a measure of Social Security and Health Insurance in the country. It provides certain cash and medical benefits to industrial employees in case of sickness, maternity and employment injury.

4. SCOPE

5. The ESI Act of 1948 All power using factories other than seasonal factories where more than 10 persons were employed.

6. The ESI (amendment) Act of 1975 Small factories employing more than 10 persons, irrespective of power usage. Shops Hotels and restaurants Cinemas and theatres Road-Motor transport establishments Newspaper establishments Private medical and educational institutions employing 20 or more in some states.

7. ADMINISTRATION

8. Beneficiaries: 602 lakhs by 31.3.11 Corporation has set up a wide spread network of service outlets. 1427 ESI dispensaries 2100 panel clinics 307 diagnostic centres . 143 ESI hospitals 43 hospital annexes with over 27,000 beds.

9. FINANCE

10. BENEFITS TO EMPLOYEES

11. Medical Benefit Full medical care including hospitalization, free of cost, to the insured persons in case of sickness, employment injury and maternity. Out Patient Care Supply of drugs or dressings Specialist services in all branches of medicine Pathological and Radiological investigations Domiciliary services Antenatal, Natal and Post natal services Immunization services Family planning services Emergency services Ambulance Services Health education Inpatient Treatment

12. Mode of Delivery of Medical Care

13. Sickness Benefit Periodical cash payment to an insured person in case of sickness, if his sickness is duly certified by an Insurance Medical Officer or Insurance Medical Practitioner. Payable Upto a maximum period of 91 days . EXTENDED SICKNESS BENEFIT : Incase of long term sickness, an insured person is entitled to Extended sickness benefit for a maximum period of 2 years . The insured person is protected from dismissal or discharge from service by the employer during the period of sickness.

14. SOME OF THE CHRONIC DISEASES INFECTIOUS DISEASES Tuberculosis, leprosy, chronic empyema, AIDS. NEOPLASMS Malignant diseases. ENDOCRINE, METABOLIC Diabetes mellitus with proliferative retinopathy/diabetic foot/nephropathy. DISORDERS OF NERVOUS SYSTEM Monoplegia , Hemiplegia, paraplegia, Hemiparesis, Parkinson’s disease, spinal cord compression, myasthenia gravis, glaucoma, detachment of retina. CVS CAD, CCF, Cardiac valvular diseases, Cardiomyopathies. CHEST DISEASES Bronchiectasis, Interstitial Lung Disease, COPD with CCF. DIGESTIVE SYSTEM Cirrhosis of liver with ascites, chronic active hepatitis. ORTHOPAEDIC DISEASES Dislocation of vertebra, prolapse of vertebral disc, non union or delayed union of fracture, post traumatic surgical amputation of lower extremity. PSYCHOSIS Schizophrenia, Endogenous depression, Manic depressive psychosis, Dementia. OTHERS More than 20% burns, Chronic renal failure, Raynaud’s disease.

15. Maternity Benefit Payable by cash to an insured women for: Confinement: 12 weeks Miscarriage: 6 weeks Sickness arising out of confinement: 30 days

16. Disablement benefit Cash Payment and free medical treatment, in the event of temporary or permanent disablement as a result of employment injury. In case of temporary disablement : 70% of wages during the period of disablement. In case of total permanent disablement : Life pension worked out on the basis of loss of earning capacity determined by the medical board.

17. Dependant’s Benefit In case of death, as a result of employment injury, the dependants of an insured person are eligible for periodic payments. Pension at the rate of 70% of wages is payable, shared by dependants in a fixed ratio, on a monthly basis. An eligible son or daughter is entitled to dependant’s benefit up to the age of 18; the benefit is withdrawn if the daughter marries earlier.

18. Funeral expenses Cash payment payable on the death of an insured person towards the expenses on his funeral, the amount not exceeding Rs.5000.

19. Rehabilitation On a daily payment of Rs.123 (w.e.f. 01.01.06), the insured person and his family members continue to get medical treatment after permanent disablement, or retirement.

20. BENEFITS TO EMPLOYERS Exemption from the applicability of Workmen’s Compensation Act 1923. Exemption from Maternity Benefit Act 1961 Exemption from payment of Medical allowance to employees and their dependants or arranging for their medical care. Rebate under the Income Tax Act on contribution deposited in the ESI account. Healthy work-force.

21. RAJIV GANDHI SHRAMIK KALYAN YOGNA New scheme provided for the employees under the ESI scheme. Came into effect from 1 st April, 2005. This scheme provides unemployment allowance for the employees who are rendered unemployed due to retrenchment/ closure of factory etc. after fulfilling certain eligibility conditions . Employed under the establishment for a minimum period of 5 years. Payable upto 6 months.

22. Other Benefits: Medical Bonus Money order facilities Prevention of HIV/AIDS

23. References Park’s textbook of Preventive and Social Medicine. www.esic.nic.in

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