Knowledge Centre

All you need to know about ESIC

As a working professional we face many challenges day in and day out but what can bog anyone down is the need for financial help in the face of an emergency. Wondering who can be a messiah in this sticky situation then your answer is ESIC. ESIC stands for Employees State Insurance Corporation. It is a multidimensional social security system tailored to provide socio-economic protection to employees and their dependants covered under the scheme. It was the first major legislation that was meant to garner social security for workers and the Employees’ State Insurance Act,1948 (ESI Act) was implemented to acts as a financial safety net for workers. The ESI Act encompasses health related eventualities which workers are exposed to on a daily basis. This could include any type of sickness,temporary or permanent disability,maternity,diseases contracted from a workplace,death due to employment,and any type of injury that results in the loss of wages or earning capacity.

  • How it works: It’s pretty simple actually,you can call it a worker health insurance of sorts. The Employee State Insurance Corporation (ESIC) is deducted on gross salary consisting of 1% from the employee contribution &4% from the employer contribution.

  • Eligibility criteria: Now that you know what ESIC stands for and why it was implemented,the next question on your mind would be who is eligible or qualifies for the benefits doled out by the ESIC. So here it goes:

    • Employees who fall under the ceiling of ₹ 21,0 per month are applicable to come under the vast umbrella of benefits offered.

    • An individual who is employed in a work setup with more than 10 employees qualifies for the said scheme.

  • Coverage: Besides full medical care for self and dependants,that is admissible from day one of insurable employment,the insured persons are also entitled to a variety of cash benefits in times of physical distress due to sickness,temporary or permanent disablement etc. resulting in loss of earning capacity,the confinement in respect of insured women,dependants of insured persons who die in industrial accidents or because of employment injury or occupational hazard are entitled to a monthly pension called the dependants benefit. The ESI Act 1948,encompasses certain health related eventualities 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 or earning capacity-total or partial.

The Scheme has now been extended to shops,hotels,restaurants,cinemas including preview theatre,road motor transport undertakings and newspaper establishment employing 20 or more persons.

Benefits of the ESI scheme:

  • Medical Benefits to the employees and dependent family members

  • Sickness benefits of 70% of daily wages in cash for any illness which is certified and lasts for a maximum period of 91 days in a year

  • Maternity Benefit for the pregnancy is payable for the period of 26 weeks and can be extended further to one month on the advice of medical officer

  • In case of death of the employee while on work – 90% of the total salary is provided to the dependents of the employee every month after the death

  • Same benefits in case of disability of the employee

  • Funeral expenses

  • Old age care medical expenses

It is a provision for social security provision made to counterbalance or negate the resulting physical or financial distress of an emergency. It is aimed at upholding human dignity in times of crisis through protection from financial losses while helping with the retention and continuity of a socially useful and productive manpower.

This blog has been written by Diwaker Asthana Health Insurance industry experience of 20 years

Diwaker Asthana recommends buying my:health Suraksha Insurance to get the benefit of a wide range of coverage that the plan offers.For some unique benefits like cashless home health care and in-patient treatment for mental illness,he believes this plan will benefit customers in the long run

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