Professional Documents
Culture Documents
A PRESENTATION BY
NARAYAN CHANDRA SARANGI, Ph.D.
ASSOCIATE PROFESSOR, XaHR
1
THE ESI ACT
The ESI Act passed in 1948
(amended in 1970, 1984 and 1989) is
an important measure of social
security and health insurance in this
country. It provides for certain cash
and medical benefits to industrial
employees in case of sickness,
maternity and employment injury.
2
COVERAGE …
•The Act extends to the whole of India,
except Manipur, Sikkim, Arunachal
Pradesh and Mizoram.
•The Act of 1948 covered all power using
factories other than seasonal factories
wherein 20 or more persons were
employed (excluding mines, railways and
defense establishments).
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CONTINUED……
• The provisions of the ESI (Amendment ) Act
of 1975 were extended to the following new
classes of establishments:
– Small power-using factories employing 10 to 19
persons, and non-power-using factories employing
20 or more persons.
– Shops, Hotels and Restaurants.
– Cinemas and Theatres.
– Road-motor transport establishments
– Private Medical & Educational Establishments and
– Newspaper establishments.
4
COVERAGE
•With effect from 01.01.1997 the Act
covers all employees – manual, clerical,
supervisory and technical drawing upto
Rs.21000/- per month. [w.e.f.01/01/2017]
•The provisions of the Act can be extended
to any other agricultural or commercial
establishment by issuing a 30 days prior
notice by appropriate government in the
official gazette
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ADMINISTRATION OF THE ACT
The Act is a central Act having two wings:
I. Enforcement and providing non-medical
services of the Act – Central Government –
Department of Labour – Employees State
Insurance Corporation
II. Extending the Medical Services to insured
Persons and family members-
State Government – Department of Labour –
Employees State Insurance Scheme (Medical.)
Services. 6
ADMINISTRATION
• The comprehensive and multi-pronged social security
programme is administered by an apex corporate body
called the Employees' State Insurance Corporation.
• It comprises members representing vital interest
groups, including, employees, employers, the Central
and State Government, representatives of Parliament
and medical profession.
• The Corporation is headed by the Union Minister of
Labour, as its Chairman, whereas the Director
General, appointed by the Central Government
functions as its Chief Executive Officer.
ADMN…CONTD
• The broad based corporate body is, primarily,
responsible for coordinated policy planning and
decision making for growth, development and efficacy
of the scheme. A Standing Committee, constituted
from among the members of the Corporation, acts as
an Executive Body. The Medical Benefit Council,
constituted by the Central Government, is yet another
Statutory Body that advises the Corporation on
matters related to effective delivery of medical services
to the Beneficiary Population.
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ADMN…CONTINUED
• The Corporation, with its Central Headquarters at
New Delhi, operates through a network of 52
Regional, Sub- Regional and Divisional Offices located
in various States. The administration of Medical
Benefit is taken care of by the respective State
Government except in case of Delhi and
Noida/Greater Noida area in Uttar Pradesh where the
Corporation administers medical facilities directly.
The Corporation has taken over the administration of
23 ESI Hospitals in various States for developing them
as ESIC Model Hospitals.
9
WAGES Defined …
• Wages means all remuneration paid or payable in cash
to an employee, if the terms of the contract of
employment, express or implied, were fulfilled and
includes any payment to an employee in respect of any
period of authorized leave, lock out, strike which is not
illegal or layoff and other additional remuneration, if
any, paid at intervals not exceeding two months, but
does not include :-
a). Any contribution paid by the employer to any
pension fund or Provident fund, or under this act;
b). Any traveling allowance or the value of any
traveling concession;
c). Any sum paid to the person employed to defray
special expenses entailed on him by the nature of his
employment ; or
d). Any gratuity payable on discharge. 10
WAGES Defined …
The above definition has three parts
1. All remuneration paid or payable in cash to an
employee following from the term of employment
(including agreement) express or implied. The
periodicity of payment is not relevant in this case.
2. Any additional remuneration even if not flowing
from any agreement or settlement but paid at
intervals not exceeding two months.
3. The exceptions as provided in Clause (a) to (d) above. Any
remuneration paid or payable under Para 1 and 2 is wages
and chargeable to contribution whereas any amount paid
towards items mentioned in clause (a) to (d) are not wages
and therefore no contribution is chargeable on the amount.
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WAGES NOT WAGES
b) Overtime allowance is wages for payment of b) Annual Bonus is not wages if the
contribution only but not for determination of periodicity of the payments is more than 2
employee’ u/s 2(9) of the Act. months.
c) Inam is wages when it is paid for special skill or c) Incentive Bonus: Incentive Bonus is not
higher responsibilities or where the employer has no wages if the periodicity of the payments is
right to withdraw or revise it more than 2 months.
e) House Rent Allowance is wages. e) Inam is not wages where the employer has
right to withdraw at his discretion and where
there is scheme of ‘Inam’ in writing but still
employer might be making payment under the
head ‘Inam’ on the basis of some
understanding between the parties and the
periodicity of payment is beyond 2 months.12
f) Night Shift/Heat/Gas/Dust Allowance is f) ‘Annual Commission’ is not wages.
wages.
15
IMPORTANT DEFINITIONS
16
(6A) "dependant" means any of the following relatives of a
deceased insured person, namely,-
17
iii) if wholly or in part dependent on the earnings of the insured
person at the time of his death,-
(a) a parent other than a widowed mother,
(b) a minor illegitimate son, an unmarried illegitimate daughter
or a daughter legitimate or adopted or illegitimate if married
and a minor or if widowed and a minor,
(c) a minor brother or an unmarried sister or a widowed sister
if a minor,
(d) a widowed daughter-in-law,
(e) a minor child of a pre-deceased son,
(f) a minor child of a pre-deceased daughter where no parent of
the child is alive, or
(g) a paternal grand-parent if no parent of the insured person is
alive,
18
DEFINITIONS CONTINUED
8) "employment injury" means a personal injury to an employee
caused by accident or an occupational disease arising out of and in
the course of his employment, being an insurable employment,
whether the accident occurs or the occupational disease is
contracted within or outside the territorial limits of India;
19
CONTRIBUTION
E.S.I. Scheme being contributory in nature, all the employees in
the factories or establishments to which the Act applies shall be
insured in a manner provided by the Act. The contribution
payable to the Corporation in respect of an employee shall
comprise of employer's contribution and employee's contribution
at a specified rate. The rates are revised from time to time.
Currently, the employee's contribution rate (w.e.f. 1.1.97) is
1.75% of the wages and that of employer's is 4.75% of the wages
paid/payable in respect of the employees in every wage period.
Employees in receipt of a daily average wage upto Rs.100/- are
exempted from payment of contribution. Employers will however
contribute their own share in respect of these employees.
20
CONTRIBUTION
Collection of Contribution:
An employer is liable to pay his contribution in
respect of every employee and deduct employees
contribution from wages bill and shall pay these
contributions at the above specified rates to the
Corporation within 21 days of the last day of the
Calendar month in which the contributions fall
due. The Corporation has authorized designated
branches of the State Bank of India and some
other banks to receive the payments on its behalf.
21
Contribution & Benefit Period …
• Employees covered under the ESI Act, are
required to pay contribution towards the scheme
on a monthly basis. A contribution period means a
six month time span from 1st April to 30th
September and 1st October to 31st March.
• Cash benefits under the scheme are generally
liked with contributions paid. The benefit period
starts three months after the closure of a
contribution period. The two type of periods are
elucidated below.
Contribution Period Benefit Period
1st April to 30th September 1st January to 30th June
of the following year
1st October to 31st March 1st July to 31st Dec. 22
CALCULATION OF ESI
• Once contribution in respect of an employee begins, the
contribution should continue until the end of the contribution
period (Apr to Sep or Oct to Mar) even if the salary (for the
purpose of ESI calculation) increases beyond Rs 21,000 per
month during the contribution period.
• An employee whose wages crosses the prescribed ceiling limit
in any month at anytime after commencement of the
contribution period, continue to be an employee till the end of
that contribution period. Though there is a wage ceiling limit
for coverage of an employee, there is no ceiling limit in the
definition of wages for payment of contribution. Hence
contribution is payable on the total wages without any ceiling
limit.
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ADVANTAGES OF EMPLOYERS …
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SCALE OF MEDICAL BENEFIT
• To Family Members of Insured Persons:-
While in all implemented areas, IPs are entitled
to medical care as detailed above, members of a
family of an IP are entitled to one or other of
the following scales of Medical Benefits:-
"FULL" Medical Care i.e., all facilities as for IPs
including hospitalisation.
• "EXPANDED" Medical Care i.e., all facilities as for
IPs except hospitalisation. A small number of IPs in
the States of Gujarat and Bihar fall under this category.
32
SICKNESS BENEFITS
• Sickness Benefit in the form of cash
compensation at the rate of 70 per cent of
wages is payable to insured workers during the
periods of certified sickness for a maximum of
91 days in a year. In order to qualify for
sickness benefit the insured worker is required
to contribute for 78 days in a contribution
period of 6 months.
33
SICKNESS BENEFIT
• Extended Sickness Benefit(ESB) : SB
extendable upto two years in the case of
34 malignant and long-term diseases at an
enhanced rate of 80 per cent of wages.
• Enhanced Sickness Benefit : Enhanced
Sickness Benefit equal to full wage is
payable to insured persons undergoing
sterilization for 7 days/14 days for male
and female workers respectively.
34
Maternity Benefit
35
Maternity Benefit…
36
Maternity Benefit…
37
Maternity Benefit…
• Medical Bonus
Medical Bonus is lump sum payment
made to an insured woman or the wife of
an insures person in case she does not
avail medical facility from an ESI hospital
at the time of delivery of a child. This
bonus of Rs. 250/- has been increased to
Rs. 1000/- from 1st April 2003
39
Disablement Benefit …
a). Temporary disablement benefit :
44
Other Benefit …
(i). Funeral Expenses
45
Other Benefit …
Rehabilitation Allowance
The corporation, vide its Resolution dated
22.12.1979, resolved to grant rehabilitation
Allowance to the IPs, for each day, on
which they remain admitted in an Artificial
Limb Centre. On the rates, which generally
confirm to double the Standard Sickness
Benefit rate. The above benefit was
introduced with effect from 1.1.1980
46
Levy of Interest & Damages …
• Under Section 39(5)(a) of the ESI act, read with Regulation 31(A) of
the ESI (General) Regulations 1950, the employer is liable to pay
simple interest at the rate of 15 percent per annum in respect of each
day of default or delay in payment contributions. In addition, under
the Provision of Regulation 31-C of ESI (General) Regulations, 1950,
read with sec.85(B)(i) of the ESI Act, the Corporation is empowered
to recover damage as under:
Period of delay in Rate of Damages
payment of Contribution on the amount due
i). Up to less than 2 months 5%
ii). 2 months and above but less than 4 months 10%
iii).4 months and above but less than 6 months 15%
iv). 6 months and above 25%
Interest and damages can also recovered as arrears of land
revenue Section 45(c) to Section 45(I) by the Recovery
Officer of ESI Corporation.
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Safeguard for Insured Employees:
• Right to receive payment of any benefit under the Act are not
transferable.
• Employer shall not dismiss, discharge or reduce the wages
or otherwise punish a covered employee during the period
he/she is in receipt of Sickness Benefit or Maternity Benefit etc.
• By reason of his liability to pay his share of contribution under
the ESI Act, no employer shall directly or indirectly reduce the
wages of a covered employee.
• Right to register their grievances / complaints at any level for
immediate redressal. Right to approach ESI Court against any
action/decision of the Medical Board etc
• Cash Benefits payable under the Act are not liable to
attachment or sale in execution of any decree or order of any
court
48
EMPLOYERS’ DUTIES UNDER THE ACT………………
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Obligation of the Employers …
Maintain the following records/ registers properly for the
purpose of inspection
1. Attendance Registers / Muster Rolls (in respect of all
employees including those employed through
contractors)
2. Wage Register
3. Cash Book / Bank Book
4. Account Books including Ledgers and Vouchers,
Balance Sheet.
5. Employees’ Register
6. Accident Book
7. Returns of Contribution
8. Return of Declaration Forms
9. Copies of Challans
10. Inspection Book
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Thank You
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