Employee's State Insurance is a multidimensional & integrated social security system customized to offer ‘protection’ to the employees. This was introduced as per the ‘Employees State Insurance (ESI) Act, 1948’. According to this Act, the Employee's State Insurance Scheme will provide help in case of sickness, death due to employment, injury, maternity, and temporary/permanent disablement, etcetera.

 

Employee's State Insurance Scheme (ESIS) offers complete health care for the insured person as well as the dependents. This Employee's State Insurance Scheme offers cash benefits in case of any uncertainty resulting in a loss of income/disablement/confinement for women. Except, the Employee's State Insurance Scheme (ESIS) also offers a variety of cash benefits in the form of pension popularly known as dependents benefit. This is offered to the family members dependent on the insured, in case of death due to accidents caused due to workplace/ any injury suffered during working/someone who faced hazardous situation while on duty.

 

 

Features of ESI Scheme & What is covered in the ESI Scheme

 

 

Features of Employees State Insurance Scheme

 

• Includes medical care facilities for the insured individual as well as the dependent members of his or her family from the 1st day of insurable employment.

 

• Includes medical coverage during certain illnesses, as specified in the document of the scheme, which includes cash benefit during medical leave. This extends up to a maximum of 70% of the employee’s wages until 91 days. In order to qualify for this benefit, the injured worker or employee is required to contribute for 78 days in a contribution period of six months.

 

• Includes Maternity Benefit up to 26 weeks which is extendable by a further 1 month on medical advice at the rate of full wage subject to contribution for seventy days in the preceding Two Contribution Periods and ranging to a hundred percent of the average daily wages of employees in cash. This benefit is also applicable for miscarriages / medical termination of pregnancy of employees up to 6 weeks.

 

• Benefit for dependents include financial security during illnesses & injuries while at work, financially securing your dependents during emergencies arising from the sudden loss of income. In such unfortunate situations, the dependents are eligible for payments in the form of monthly installments.

 

• The unemployed are eligible for being insured for at least three years, provided they disclose details regarding their previous place of work & retrenchment / permanent invalidity. In such cases, employees can avail or benefit of a monthly payment of 50% of their wage in cash for a maximum of two years.

 

• Instances of temporary disablement of employees make them eligible for a monthly payment of 90% of their wage till the time of their recovery. Employees who are permanently disabled can avail or benefit from monthly payments of 90% of their wage for their entire life.

 

 

What is covered in the Employees State Insurance Scheme (ESIS)?

 

The Employees State Insurance Scheme (ESIS) was in force only in two Indian cities, Delhi & Kanpur when it was initially implemented in 1952. Since then, the scheme has spread in leaps & bounds across the country. Currently, it’s accessible in more than 843 centers in 33 States & Union Territories. The Employees State Insurance (ESI) Act has currently been adopted by more than 7.83 lakh factories & establishments & has a reach of over 2.13 crore insured individuals & families. It holds a record of over 8.28 crore beneficiaries.

 

According to notification by the govt., according to Section 1(5) of the Employees State Insurance (ESI) Act, shops & restaurants or hotels that are involved in sales are covered by the Employees State Insurance Scheme (ESIS)

 

The infrastructure of the Employees State Insurance Scheme (ESIS)

The progress in the infrastructure of the Employees State Insurance Scheme (ESIS) is commendable since it is an introduction in 1952. It has been growing quickly in order to meet the social security needs of the increasing population of the employees.

 

So far, the Employees State Insurance (ESI) scheme has made available 151 hospitals & 42 hospital annexes to take care of inpatient services. It also has set-up 954-panel clinics, 1450 or 188 ESI dispensaries, / AYUSH units.

 

In order to make the monthly payouts, ESIS has set-up a network of more than 628 or 185 branch offices or pay offices. The functioning of this department is further inspected/ managed by 62 regional or sub-regional & divisional offices.