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PRESENTATION OF ESIC
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PRESENTATION OF ESIC

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A detailed PPT on ESIC and its benefits.. …

A detailed PPT on ESIC and its benefits..


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  • 1. PRESENTATION ON EMPLOYEE STATE INSURANCE Act - 1948 A STATUTORY BODY UNDER MISTRY OF LABOUR & EMPLOYEMENT Web site: www.esic.nic.in THE AKSHAYA PATRA FOUNDATON HR ANNUAL CONEFERENCE 2011
  • 2. WHAT IS ESIC? "An Act to provide for certain benefits to employees in case of sickness, maternity and employment injury and to make provision for related matters.”
  • 3.
    • SICKNESS BENEFIT
    • MEDICAL BENEFIT
    • MATERNITY BENEFIT
    • DISABLEMENT BENEFIT
    • DEPENDANT BENEFIT
    • FUNERAL EXPENSES
    • PHYSICAL REHABILITATION
    • VOCATIONAL REHABILITATION
    BENEFITS TO IPs UNDER ESIC SCHEMES ESIC SCHEME PROVIDES THE FOLLOWING MAJOR SOCIAL SECURITY BENEFITS TO THE INSURED PERSONS
  • 4. SICKNESS BENEFIT
  • 5.
    • General Sickness
    • Extended Sickness
    • Enhanced Sickness
    There are three types under SICKNESS Benefit
  • 6.
    • GENERAL SICKNESS
    • General Sickness represents periodical cash payments made to an IP during the period of certified sickness
    • And when IP requires medical treatment and attendance with abstention from work on medical grounds.
    • Sickness benefit is roughly 60% of the average daily wages and is payable for 91 days during 2 consecutive benefit periods.
    • ELIGIBILITY CONDITIONS
    • An IP should have paid contribution for not less than 78 days during the corresponding contribution period.
    • A person who has entered into insurable employment for the first time has to wait for nearly 9 months for becoming eligible to sickness benefit.
  • 7.
    • EXTENDED SICKNESS BENEFIT (ESB)
    • An IP suffering from certain long term diseases is entitled to ESB
    • ESB includes 34 diseases which are grouped in 11 groups as per International Classification of diseases
    • To be entitled to the Extended Sickness Benefit an Insured Persons should have been in continuous employment for 2 years or more at the beginning of a spell of sickness.
    • ESB shall be payable for a period of 124 days initially and may be extended up to 309 days in chronic suitable cases.
  • 8.
    • ENHANCED SICKNESS BENEFIT (ESB)
    • IPs/IWs for undergoing sterilisation operations for family welfare are paid of enhanced Sickness Benefits.
    • Leave up to 7 days in the case of IPs (Male) and up to 14 days in the case of the IW’s (Female) from the date of operation or from the date of admission in the hospital.
    • Insured Persons eligible to ordinary sickness benefit are paid enhanced sickness benefit at double the rate of sickness benefit i.e., about full average daily wages.
  • 9. MEDICAL BENEFIT
  • 10.
    • MEDICAL BENEFIT
    • The Scheme provides full range of medical care to Insured person and family, through a network of ESI Dispensaries & Panel clinics, diagnostic centers and ESI Hospitals etc..
    • All Insured Persons and members of their family are entitled to free, full and comprehensive medical care such as.
    • Out patient treatment
    • Domiciliary treatment 
    • Super specialty treatment
    • Specialist consultation and diagnostic facilities
    • In-Patient treatment
    • Free supply of drugs and dressings.
    • X-ray and laboratory investigations
    • Vaccination and preventive inoculations
    • Ante-natal care, confinement and post natal care
    • Ambulance Service or conveyance charges for going to hospitals diagnostic centres, etc. wherever admissible
    • Free diet during admission in hospitals
    • Free supply of artificial limbs, aids and appliances for physical rehabilitation
    • Family welfare services and other national health programmed services
    • Medical certification
  • 11. METERNITY BENEFIT
  • 12.
    • MATERNITY BENEFIT
    • For entitlement to maternity benefit, the insured woman should have compulsorily work for 55days with in 9month from the date of employment.
    • Maternity Benefit is payable for a period of 12 weeks (84 days) to an Insured Woman.
    • Miscarriage or Medical Termination of Pregnancy (MTP)-payable for 6 weeks (42 days) from the date following miscarriage.
    • Sickness arising out of Pregnancy, Confinement, Premature birth-payable for a period not exceeding one month
    • In the event of the death of the Insured Woman during confinement leaving behind a child, Maternity Benefit is payable to her nominee
    • Maternity benefit rate is double the Standard Benefit Rate, or roughly equal to the average daily wage.
  • 13. DISABLEMENT BENEFIT
  • 14.
    • DISABLEMENT BENEFIT
    • Disablement benefit is the personal injury to an employee caused by an accident or by an occupational disease arising out of employment of the employee in a covered factory or establishment.
    • There are two types under disablement Benefit
    • Temporary Disablement Benefit (TDB)
    • Permanent Disablement Benefit (PDB)
  • 15.
    • TDB is payable to an employee who suffers employment injury (EI) or Occupational Disease and is certified to be temporarily incapable to work.
    • This benefit is not subject to any contributory conditions. An IP is eligible from the day he joins the insurable employment.
    • There is no prescribed limit for the duration of TDB. This is payable as long as temporary disablement lasts and significant improvement by treatment is possible.
    TEMPORARY DISABLEMENT BENEFIT (TDB)
  • 16.
    • Permanent Disablement Benefit is paid to an insured person who suffers from permanent disability as a result of an employment injury (including occupational disease), which results in loss of earning capacity.
    • If the employment injury results in partial or total/permanent disability, the PDB is payable till the death of the insured person.
    • No contributory conditions are prescribed for this benefit. While the rate of temporary disablement benefit is 70% or a little more of the wages and that of permanent disablement benefit is proportionate to the loss of earning capacity caused by the injury.
    PERMANENT DISABLEMENT BENEFIT (PDB)
  • 17. DEPENDANT BENEFIT
  • 18.
    • Dependants' benefit consists of periodical payments to dependants of an insured person who dies as a result of an employment injury sustained as an employee under the ESI Act.
    • There are no contributory conditions for qualifying to this benefit. Thus, if a person dies of employment injury even on the first day of his employment, his dependants are entitled to the benefit.
    • The minimum rate of DB is Rs.14/- per day and these rates of the DB are increased from time to time.
    DEPENDANT BENEFIT
  • 19. FUNERAL EXPENSES
  • 20.
    • Funeral expenses are in the nature of a lump sum payment up to a maximum of Rs. 5000/- made to defray the expenditure on the funeral of insured person. The amount is paid either to the eldest surviving member of the family or, in his absence, to the person who actually incurs the expenditure on the funeral.
    FUNERAL EXPENSES
  • 21. REHABILITATION
  • 22.
    • Disabled insured persons who remain admitted in an artificial limb centre for fixation or repair or replacement of the artificial limb are entitled to rehabilitation allowance for each day on which they remain admitted at Artificial limb centre at double the standard sickness benefit rate. This is not subject to any contributory condition.
    PHYSICAL REHABILITATION
    • This Scheme has been designed to provide financial assistance to the insured persons who are referred to vocational rehabilitation centre for training.
    • Insured person who satisfy following conditions are entitled to avail benefits of the vocational rehabilitation scheme. 
    VOCATIONAL REHABILITATION
    • whose permanent loss of earning capacity has been determined as 40% or more.
    • who is in receipt of permanent disablement benefit under the ESI Act, 1948.
    • who is not in any gainful employment, and
    • who is not more than 45 years of age on the date of his application.
  • 23. RAJIV GANDHI SHRAMIK KALYAN YOJANA
  • 24.
    • An Insured Person who become unemployed after being insured three or more years, due to closure of factory/establishment, retrenchment or permanent invalidity are entitled to :-
    RAJIV GANDHI SHRAMIK KALYAN YOJANA
    • Unemployment Allowance equal to 50% of wage for a maximum period of up to one year.
    • Medical care for self and family from ESI Hospitals/Dispensaries during the period IP receives unemployment allowance.
    • Vocational Training provided for upgrading skills - Expenditure on fee/traveling allowance borne by ESIC.
  • 25. THANK YOU Looking for your Feed back [email_address] K. SAI KISHORE Senior Executive HR The Akshaya Patra Foundation, Hyderabad

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