ESI: ESI Contribution And Claim ESI Benefit 

What Is The Contribution For ESI?

As per the latest rules laid out by ESIC, the employees get 0.75% deducted from their respective gross salaries, whereas the employers make an ESI contribution of 3.25% of the employee’s gross pay towards ESI. Thus, a total of 4% (employee + employer) is deposited as the ESI contribution in the account of the employee that he/she can withdraw in case of any medical emergency such as disability, maternity, unemployment among others.

Why do employees need ESI?

Working professionals registered under the Employees' State Insurance (ESI) Act, 1948 are offered full medical care at the time of incapacity to work. Financial assistance is given to cover the loss incurred from the absenteeism from work due to sickness, maternity, disability, or injury during employment. The ESI scheme also provides medical help to the family members of the registered employees.

How to get an ESI card?

The government ESIC portal gives an option to the registered employers to download the ESI application form online & fill in the employee details. The employee then needs to do some needful like attaching a family photograph to the form & duly attesting it. After performing the relevant verifications, the Employees’ State Insurance Corporation (ESIC) office issues an ESI card to the applicant.

How to Claim ESIC Benefit?

One can get ESIC Form-9 to make a claim in case of Sickness, Disablement, and Benefit as provided by the Employees’ State Insurance Corporation, Ministry of Labour & Employment, and Government of India.

There are 2 types of benefits that one can claim as a beneficiary of the Employees’ State Insurance (ESI) scheme, as mentioned below:

•Medical Benefits: The employee and his/her dependents can avail medical care. To avail of this, they need to visit any of the ESI impaneled hospitals.

•Cash Benefits: Employees or workers who are beneficiaries of the ESI scheme can avail of cash benefits in the case of sickness, disablement (temporary/permanent), maternity, unemployment, dependent, funeral costs, and vocational or physical rehabilitation.

Can I Claim ESI In A Private Hospital?

Yes, it’s possible to claim ESI in a private hospital. As mandated by the Employees’ State Insurance (ESI) Act, treatment has to be taken only from the Employees’ State Insurance Corporation (ESIC) hospitals. However, in case of emergency, if the treatment is taken from a private hospital, one can raise a claim with the Employees’ State Insurance Corporation (ESIC) subject to ESIC approval & only then the reimbursement of the expenses will be processed.

The Employees’ State Insurance Corporation (ESIC) has collaborated with a no. of hospitals in PAN India available on the Employees’ State Insurance Corporation (ESIC) online portal where one can claim the ESI amount.