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Importance of ESIC Account

Employee State Insurance Corporation (ESIC): Scheme has been formulated to provide security in the form of financial protection to an employee for any health-related issues. ESIC features include maternity benefits, medical benefits, disability benefits, and so on.

Employee State Insurance Corporation Scheme is based on the first legislation passed by the Parliament, focusing on the betterment and social security of all workers named Employees' State Insurance Act, 1948. This Act ensures the health-related issues an employee is exposed to daily.

Benefits of ESIC

ESIC incorporates six primary social securities, along with other extended benefits, which are mainly need-based. An impressive characteristic of this scheme is that it does not make any distinction when it comes to providing financial support to an employee, even though the percentage of contribution an employee makes is kept fixed. It is dependent on his/her work wages. An ESIC account, thus, provides the following social securities:

Medical Benefit: An insured employee and his family members begin to receive total medical benefits from the day he/she starts an insurable job. The ESIC insurance is also applicable for insured retired persons and permanently disabled employees along with their spouse for a token premium amount of Rs. 120 which is paid annually.

Sickness Benefit: This ESIC benefit insures an amount which is 70% of the daily average wage earned by an employee to be dispensed to them during a medical leave for a maximum of 91 days in a year. To access this benefit, the employee needs to serve his employer for 78 days in a half-yearly contribution period. Under this category also comes the Extended Sickness Benefits, which is beneficial in supporting the medical expenses for malignant and long-term diseases at an enhanced rate of 80% of the daily wage average.

Maternity Benefit: This benefit provides an insured 100% of the average wage for twenty-six weeks of maternity leave from the time of labour, and it can be further extended for a month. The employee needs to contribute for 70 days in the preceding two contributions. It also provides 6 weeks of benefits in the case of miscarriages and 12 weeks for adoption cases.

Unemployment Allowance: This allowance comes under the Rajiv Gandhi Shramik Kalyan Yojana, which provides financial support to an insured person who has become unemployed due to circumstances like the shutting down of the company, permanent invalidity, retrenchment, etc. if he/she has worked an insurable job for three years. Under this benefit, the insured employee having an ESIC account will receive medical assistance from ESI hospitals or dispensaries, where the allowance equals 50% of wages for a duration of up to two years. ESIC also insures the expenditure of travelling for vocational training.

Disablement Benefit: The disablement benefit covers financial support for both permanent as well as temporary disability of an insured employee. 90% of the wage earned is payable to the person if he suffers any disablement due to an occupational hazard; plus, the same amount is also applicable for the person's family or dependent in the form of Dependent's Benefit, in the event of the death of the insured employee.

Other Benefits: If an employee holds an ESIC account, they will also be supported with additional benefits, such as:

  • Funeral Expenses: The dependents of an insured employee are paid an amount of Rs. 15,000 as funeral expenses.
  • Confinement Expenses: In case an insured female employee or an insured person with a wife receives financial support of Rs. 5,000 if they are confined in a place where medical aid under the ESI scheme is not readily available.
  • Vocational Rehabilitation is provided to permanently disabled employees having an ESIC account.
  • Physical Rehabilitation is provided to employees suffering from physical disablement due to occupational hazards.
  • Old Age Medical Care covers superannuated insured employees.

Recommended Link:All about the Ministry of Health and Family Welfare?

Occupational Diseases Centres

There are four zonal centres and one IOHER (Institute of Occupational Health, Environment, and Research) centre set by ESI Corporation to provide medical support to employees and monitor the improvement of their occupational health.

North ZoneIOHER, ESIC Hospital, Basaidarapur, New Delhi
South ZoneK.K. Nagar, Chennai
East ZoneJoka, Kolkata
West ZoneAndheri, Mumbai
Central ZoneNandanagar, Indore

Why Is It Important to Have an ESIC Account?

An employee may face various kinds of hazards while on the job. It is the duty of the nation, and of course, the employer to provide employees with benefits for their well-being as well as that of their dependents. In the wake of this, the State enacted the ESI Act. ESIC is a "multi-dimensional social security scheme" crafted to provide health benefits and medical assistance during a period of distress. And to hold an ESIC account, an employee needs to be working under an insurable establishment.

Eligibility Criteria for ESIC

An employee will be considered eligible to avail an ESIC account when he/she duly reflects the following criteria:

• Under section 2(12) of the ESI Act, 1948, an employee must be a part of a non-seasonal establishment having more than ten employees. • The ESI Act ensures support to an employee who earns a wage/salary of Rs. 21,000 every month.

Guidelines for Employers to Register Their Establishment for ESIC

Under section 2A of the Act, it is a statutory responsibility of an employer to register their establishment for ESIC for the betterment of their employees. The following steps show how to register a factory/establishment of this scheme:

  • Visit the official portal at www.esic.in
  • Register by creating an ESIC account.
  • Within 15 days of applying, complete the sign-up process by providing the name of the factory/establishment, name and address of the principal employer, bank account number, PAN card details, insights of power consumption in case of factories, state and region of the establishment, and e-mail address.
  • The system would send a registration ID and password to the mail ID provided, automatically.
  • Using the registration ID and password, login into www.esic.in
  • After successful registration, a unique 17-digit code will be generated in the name of the company. After receiving this unique code, the establishment will now be able to start ESI filings.
  • The said establishment must intimate the addition of employees to ESI Corporation. An employee is given insurance of ESIC benefits as soon as they join their respective job in an insured establishment. But they need to provide their personal and family details along with their latest photographs to receive their ESI card.

Documents Required

To create an ESIC account:

  • Certification of registration (for private establishments)
  • A detailed list of employees and their monthly compensations
  • A detailed list of directors, shareholders, and partners of the company
  • The bank statements of the company as evidence for the commencement of operations
  • Address proof and PAN details

To receive ESI returns in ESIC account:

  • Register of attendance
  • Inspection book
  • Wage/salary register
  • Register of occurrence of any occupational hazard
  • Monthly challans
Mistakes to Avoid
  • The insured employee must not include ineligible persons into his or her ESIC scheme to exploit benefits.
  • ESIC or Pehchan card must not be tampered with or damaged in any way.
  • The card is your property and must not be transferred to anyone else as it is a punishable offence.
  • An insured employee must not undertake deceptions of any kind to claim medical support.
  • An insured employee must not deceive the authority by producing forged medical certificates. Detection of the same shall reflect punishment.
  • The forms for ESIC account are available for free in the branch offices of ESI. Avoid paying imposters for this procedure.
  • An insured employee must report the birth/death of dependents by adding/deleting family members, respectively.

Budget Estimates for 2018-2019

Given below is the budget estimate provided by ESIC for the year 2018-19, along with income/expenditure of ESI Corporation for two consecutive years of 2016-17 and 2017-18:

Income

Head of AccountActual (2016-17) *in croresActual (2017-18) *in croresEstimate for 2018-19 *in crores
Contribution13662.4420077.1820900.00
Interest3069.193196.893926.35
Fees, fines, and forfeitures32.2236.4836.00
Rates, rents, and taxes55.7157.5289.41
Other32.83112.30125.00
Total Income16852.3823480.3725076.76

Expenditures

Head of AccountActual (2016-17) *in crores Actual (2017-18) *in crores Estimates for 2018-19 *in crores
Medical Benefits6256.576867.7312642.96
Cash Benefits1517.93642.841339.16
Other Benefits2.452.523.58
Total Benefits7776.957513.0913985.70
Administrative Expenses1732.041031.061740.03
Contribution to Capital Construction Fund136.62200.77209.00

Head of AccountActual (2016-17) *in crores Actual (2017-18) *in crores Estimates for 2018-19 *in crores
Total Expenditure9645.618744.9215934.73
Other Provisions (Prior period items)82.10416.44-
Grand Total9727.719161.3615934.73

FAQ's On Importance of ESIC Account

How is the ESIC scheme funded?

ESIC scheme is contributory in nature. The funds are accumulated by the contributions made by employers and employees from their wages. The state governments also bear 1/8th share of the cost of medical benefits. '

Which establishments come under the coverage of ESI Corporation?

Factories/establishments having more than ten employees can register for ESIC account under the ESI Act, 1948. The scheme has also been extended, in some states, to the following establishments:

  • Shops
  • Cinema halls and preview theatres
  • Restaurants and hotels which are only engaged in sales and not manufacturing
  • Road Motor Transport companies
  • Newspaper establishments
  • Private Educational Institutions
  • Medical Institutions

What happens if the employee count falls below the required strength even though the company has been insured previously?

The ESIC scheme covers the company irrespective of a decline in employee strength after registration.

When can a company be exempted from creating an ESIC account?

A company is permitted to be exempt from registering for ESIC if it already provides its employees medical benefits substantially similar or more than what ESI offers. The company must apply for exemption, and if granted, the exemption shall remain valid for a year. However, the company will be permitted to renew the exemption three months prior to its expiration.

What is the consequence of unpaid/delayed contribution?

An Unpaid or delayed contribution is a punishable offence under IPC 406 and 409 and also under section 85 of the ESI Act, 1948, as it is considered to be a 'breach of trust.'

How to contact ESIC for grievances?

Please refer to the given table.

AddressEmployees' State Insurance Corporation, Panchdeep Bhawan, Comrade Indrajeet Gupta Marg, New Delhi, 110 002.
Phone011-23234092, 23234093, 23234098, 23235496, 23236051, 23235187, 23236998 (EPBAX)
Toll-free1800-11-2526 1800-11-3839 (For medical-related queries)
Emails
  • pg-hqrs@esic.nic.in (for suggestions/grievances)
  • itcare@esic.nic.in (for IT-related issues)
  • Websites
  • https://www.esic.nic.in/ (for general information)
  • https://www.esic.in/ (for online application)
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