Employee State Insurance Corporation (ESIC)

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Administrative & Operational Benefits of ESIC Act – Employers and Employees, Retired and Disabled Persons

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Role of ESIC in Delivery of Benefits for Employees/Workers

The ESIC is instrumental in delivery of benefits for wage-earners/employees of factories and commercial organizations across India by ensuring that:-
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Bullet The quality and quantity of benefits is based on the norms and standards as laid down by the ESI Corporation for the purpose.

Bullet The benefits are made readily available within the given time frame to insured persons and beneficiaries under this scheme.

Bullet No harassment is caused to the beneficiaries of this scheme across the counter at the grass root level by way of word or deed.

Bullet All requisite information, procedural norms and guidance etc. are made available to the beneficiaries for availing benefits.

Bullet All types of forms etc. are made available to the beneficiaries of ESIC scheme which is free of cost as such forms may be required by such individuals for filing their medical claims

Bullet No beneficiary is exploited at any level in the process of delivery of benefits.

Bullet As notified for ESIC/ESIS establishments, office hours are strictly adhered to by the staff. This is indeed essential in order to avoid any inconvenience being caused to the beneficiaries of ESIC scheme for the purpose of smooth flow of benefit process.

Bullet Drugs, injections, dressings, etc. as prescribed by the authorised doctors are made available in a timely manner.

Role of ESIC in Servicing Employers

ESIC plays an important role in servicing the employers of factories, commercial establishments, shops etc. This is done with a view to reduce the employer’s responsibility pertaining to the healthcare issues concerning their organizational employees and in turn the issues regarding employees’ welfare is assumed by ESIC.

Bullet To develop a purposive, responsive and productive relationship with the employers.

Bullet Seek their active involvement in the improvement of the scheme as a confidence building measure.

Bullet Provide the employers necessary guidance in fulfilling their lawful obligations under the ESIC Act.

Bullet Make available to them all the requisite Forms and proformae free from all hassles as may be required by them from time to time.

Bullet To ensure that any lax medical certification on part of ESIC does not bring down the productivity of a factory or commercial establishment.

Bullet To ensure that in case of any doubt, difficulty or misunderstanding the employer is given an opportunity to be heard at an appropriate level.

Bullet To ensure that all the correspondences emanating from the employer is responded to in a timely manner and objectively.

Bullet To ensure that an employer is not being unnecessarily harassed by any official of the ESIC who have been authorized to inspect the commercial premises or the records.

Bullet To ensure that any grievances received from employers are looked into promptly and pointedly for speedy disposal of cases.

Medical Benefits – For Retired & Disabled Persons (Rules 60 & 61 of ESI Central Rules, 1950)

Insured Persons who cease to be in insurable employment on account of permanent physical disablement due to employment injury or those who leave the insurable employment on attaining the age of superannuation are eligible to receive medical benefits for themselves and their spouses (or dependants). The benefit is provided on payment of contribution in lump sum for one year at the rate of Rs. 10/- monthly in advance.

Scale of Medical Benefits

Superannuated or disabled insured workers are entitled to the same scale of Medical Benefits and to the same package of medical/healthcare facilities that are admissible to an insured person and spouse.
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NiyasPandallur Thursday, July 14, 2016

Dear Sir,

Kindly inform me the details of ESI schemes for dental treatments and also the available dental hospitals in Kerala.

akm8591 Tuesday, June 23, 2015

How do we report use of ESIC insurance by people who are enrolled in organisations for the sake of use of ESI previlages hand in glove.

taxmann Friday, April 10, 2015

My father was working in ESI as Lab assistance he Expired on may 1, 2012 during job period . so kind u send policy from which i can get that Job in place of my father or is there in rule from which we can get job please suggest and reply coz my family background is very bad situation and i need this job very urgently ......please suggest . thanx

aprchristumas Thursday, August 14, 2014

Dear Sir, I joined ESI scheme on 1st Aug'14, I have paid one month contribution only. Now my father needs to undergo eye surgery. Is it possible to have such facility from ESI scheme. Please give me details in this regard.

reachankitbansal Tuesday, July 1, 2014

Hi, I joined company on 2nd May 2014, Please can you advise when can i and dependent can get full medical treatment or reimbursement from ESIC.

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