ESIC: India’s Health Insurance and Social Security System to Protect Workers and Their Dependents

The Employees’ State Insurance Corporation of India (ESIC) is a multidimensional social security system tailored to provide socio-economic protection to worker populations and their dependents. It is a unique health insurance and social security plan, as it offers total health care without any ceiling on individual expenditure. Full medical care is admissible from the first day of insurable employment. Insured people are also entitled to a variety of cash benefits in times of physical distress, which may be due to sickness, temporary or permanent disablement, resulting in a loss of earning capacity.

This can also be in the case of dependents of insured persons who die in industrial accidents, or those who suffer injury from occupational hazards. Such workers are entitled to a monthly pension called ‘the dependents benefit’.

Medical benefit under the ESI scheme is discharged either in the form of out-patient treatment and attendance in a hospital or dispensary, clinic or other institutions, or by visits to the home of the insured person. The insured person, on completion of two years' service with 156 days' contribution, is entitled to receive medical benefits for a period of three years, even after he ceases to be in insurable employment.

On completion of 3 months' service and with 39 days of contribution to the scheme, the insured person is entitled to super specialty treatment. If his family members need to use the benefit, then he must be employed for at least six months with 78 days' contribution to the scheme.

ESIC also provides sickness benefit for 91 days, maternity benefit for 12 weeks, and disablement benefit - temporary disablement till it lasts and permanent disablement for life.

For more information on ESIC, go to http://esic.nic.in/

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Source-Medindia