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Employee state insurance act, 1948

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Employee state insurance act, 1948

  1. 1. Employee State Insurance Act, 1948 Presented By : Namrata Jadhav 58
  2. 2. Employee State Insurance Act, 1948 • ESI Scheme of India, is a multidimensional social security system tailored to provide socio-economic protection to worker population and their dependants covered under the scheme. • Pioneering measure in social insurance in India. • Originally called “workmen’s state insurance bill” 1946. • Came into force on 19th April 1948.
  3. 3. Applicability • ACT APPLIES TO FACTORIES USING: • Smaller power-using factories with 10-19 persons • Non-power factories with 20 or more persons • Shops • Hotels and restaurants • Cinemas including preview theatres • Newspaper establishments • Road motor transport undertakings employing 20 or more persons. • The Existing Wage Limit for coverage under the ACT is 15,000/- pm, w.e.f May 01, 2010
  4. 4. ESI Contribution Share Employee’s ESI Contribution (1.75% of the Gross Salary) Employer’s ESI Contribution (4.75% of the Gross Salary ) Total ESI Contribution (6.5% of the Gross Salary)
  5. 5. Contribution & Benefit Period • Employers covered under the ACT, are required to pay the Contribution towards the scheme on a monthly basis. (every 21st of the month. • There are 2 Contribution periods each of SIX months and two corresponding benefit periods also of SIX months like : Contribution Benefit Period 1st April to 30th Sep 1st Jan to 30th June 1st Oct to 31st March 1st July to 31st Dec
  6. 6. Social Security Benefits (Sec46) 1. Sickness and extended sickness benefit 2. Maternity benefit 3. Disablement benefit 4. Dependants’ benefit 5. Medical benefit 6. Funeral benefit
  7. 7. SICKNESS AND EXTENDED SICKNESS BENEFIT • Represents periodical payments made to an insured person for the period of certified sickness after completing 9 months in insurable employment. • To qualify, contributions should be for minimum 78 days in the relevant period. • Maximum duration for benefit is 91 days. • Rates of payment vary from rs.14-125 per day, i.E. Average of 50% of daily wages.
  8. 8. MATERNITY BENEFIT • Implies cash payment to an insured woman in case of confinement or miscarriage or sickness arising out of pregnancy or premature birth. • Woman should have contributed for minimum 70 days in the preceding two consecutive contribution periods. • Daily rate of benefits double the standard sickness benefit rate, i.E. Full wages. • Normally payable for max 12 weeks for confinement and 6 weeks for miscarriage or medical termination of pregnancy.
  9. 9. DISABLEMENT BENEFIT • In case of temporary disability arising out of employment injury, this benefit is admissible for the entire period certified by an insurance medical officer/practitioner for which the insured person does not work for wages. • Rate payable not less than 70% of daily wages; minimum 3 days of incapacity required. • In case injury results in permanent, partial or total loss of earning capacity, periodical payments to be made for life. One-time lump sum is permissible in certain cases.
  10. 10. DEPENDANTS’ BENEFIT Periodical pension paid to dependants of deceased where death occurs out of employment injury or disease. • Widows: 3/5th of benefit rate for life or until remarriage • Children: 2/5th of benefit rate until 18 • Total amount distributed not to exceed ceiling of disablement benefit. • Benefit not paid to married daughters.
  11. 11. MEDICAL BENEFIT • Treatment continues even if person goes out of coverage, till sickness ends. • Package covers all aspects of health care from primary to super- specialist facilities, such as : 1) Out-patient treatment 2) Domiciliary treatment 3) Specialist consultation and diagnostic facilities 4) X Ray and Lab Investigations 5) Ambulance services etc
  12. 12. FUNERAL BENEFIT • Funeral Expenses : An amount of Rs.10,000/- is payable to the dependents or to the person who performs last rites from day one of entering insurable employment. ALL BENEFITS UNDER THE ESI SCHEME ARE PAID IN CASH EXCEPT MEDICAL BENEFIT, WHICH IS GIVEN IN KIND.
  13. 13. The ESI scheme today • No.of implemented Centres 677 • No.of Employers covered . 2.38 lacs • No.of Insured persons 85 lacs • No.of Beneficiaries 330 lacs • No.of Regional offices/SRO’s 26 • No.of ESI Hospitals / Annexes 1453 • No.of Penal Clinics 2950
  14. 14. PROTECTION An employer cannot dismiss or punish an employee under treatment for sickness of in receipt of any benefit or absent from work due to illness. Any notice of dismissal, discharge or reduction is invalid. However, the employer can discharge or punish the employee if: – He has received temporary disablement benefit and remained absent for 6 months or more – Is under treatment for sickness other than TB or arising out of pregnancy and remained absent for 6 months or more – Is under medical treatment for TB or a malignant disease and has remained absent continuously for 18 months or more.
  15. 15. PENALTIES • Different punishments have been prescribed for different types of offences in terms of Sec.85 (i) (six months imprisonment and fine Rs. 5000/-), (ii) (one year imprisonment and fine), and 85-A: (five years imprisonment and not less to 2 years) and 85-C (2) of the ESI Act, which are self explanatory. Besides these provisions, action also can be taken under section 406 of the IPC in cases where an employer deducts contributions from the wages of his employees but does not pay the same to the corporation which amounts to criminal breach of trust.
  16. 16. THANK YOU

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