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ESIC ACT-1948

What is the ESIC Act.

The Employees State Insurance Act 1948, is encompasses certain health relatedeventualities that the workers are generally exposed to; such as sickness, maternity,temporary or permanent disablement, Occupational disease or death due to

employment injury, resulting in loss of wages.

EMPLOYERS COVERAGE UNDER ESIC ACT 1948,:-

The Act was originally applicable to non-seasonal factories using power and

employing 20 or more persons; but it is now applicable to non-seasonal power usingfactories employing 10 or more persons and non-power using factories employing 20

or more persons.

Under Section 1(5) of the Act, the Scheme has been extended to shops, hotels,restaurants, cinemas including preview theatre, road motor transport undertakings

and newspaper establishment employing 20 or more persons.

The existing wage-limit for coverage under the Act, is Rs.15,000/- per month (with

effect from 1.05.2010).

EMPLOYERS RESPONSIBILITIES:-

The employer's will submit Declaration Form-1 in respect of all coverable employee's within 10days under DOJ.The Employer will submit Form 01 A in respect of Iits unit/establishment every year in Branchoffice.

The employer will maintain an Accident Book and submit accident reports to the Branch Officeon the job, within 24 hours of an accident.

Remittance:- (Monthly)

The Employees contribution 1.75%The Employers contribution 4.75%Total Contribution = 6.5%

Last due date is remittance 21st of every month

Halfyearly Return

Contribution periodsDue date ofsubmission

Form

April to September 11th November Form-5 &employee's

listOctober to March 12th May

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EMPLOYEES BENEFITS

1. MEDICAL-BENEFIT

2. SICKNESS-BENEFIT

3. DISABLEMENT-BENEFIT

4. DEPENDENTS-BENEFIT

5. MATERNITY-BENEFIT

MEDICAL BENEFIT: - An insured person and his dependant family members become eligible toclaim medical facilities under ESI Scheme from day one of entering insurable employment.

For availing the medical facility for self or any of the declared dependants an insured

person and his dependant family menters has to produce the temporary card issued

by ESIC local office on taking insurable employment. (TIC)

SICKNESS-BENEFIT: - Sickness benefit is payable for a maximum period of 91days in any two consecutive benefit periods.

A claim for Sickness Benefit can be made only on the basis of Medical Certificate

issued by the authorized doctors under the Scheme.

Sickness Benefit is paid in cash to the insured persons to compensate their loss of

wages in the event of sickness certified by an authorized medical officer. It is

admissible for 91 days in an year and the cash benefit is equal to 50% of the wages.

Subject Forms Issued by

Notice ofSickness

Form-9 by Insured person

ClaimingForm-10

by employer(if required by ESI

office)

DISABLEMENT-BENEFITS:-

Temporary :- An insured person who sustains employment injury has to give anotice of such injury to the employer immediately has given the accident report to

the concerned Local office well in time in the prescribed form-form-16.

Subject Forms Issued by

AccidentReport

Form-16

by employer

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Permanent :- An insured person should submit an application for reference toMedical Board on plain paper to the Local office Manager after the termination of

temporary disablement benefit This may be done at the time of submitting the finalcertificate or within twelve months from the termination of temporary disablement

Temporary Disablement benefit is paid in cash till the incapacity due to employmentinjury lasts at the rate of 70% of the wages. In case of permanent physicaldisablement due to employment injury or occupational disease, disablement benefit

is paid for life at a rate proportionate to loss of earning capacity as determined by

the medical board.

Dependents Benefit:- Dependents Benefit is a monthly pension payable to the eligibledependents of an insured person who dies as a result of an Employment Injury or occupational disese.

Dependants entitled to the benefit could be:-

a) Widow/Widows during whole life or until remarriage

b) Legitimate or adopted son until age 18 or if legitimate son is infirm, till infirmity lasts.

(In the absence of any widow or legitimate child, the benefit is payable to a parent or grandparent for wholelife)

Subject Forms Issued by

Declaration & Certificate forDependants benefit

Form-24 by claimant

Funeral ExpensesForm-17 by claimant

Dependant benefit for claimForm-18 by claimant

MATERNITY-BENEFIT: -Maternity Benefit is payable to insured women in case of confinement ormiscarriage or sickness related thereto. For claiming the benefit an insured woman should have paid

contribution for at least 70 days in two consecutive contribution periods i.e. one year.

Claiming for MaternityBenefit

FormsIssued by ESI

office/Employer

Notice of PregnancyForm-19 by Insured person

Certificate of PregnancyForm-20 by Authorised doctor (ESI)

Claim for maternity benefitForm-22 by Insured person