19th April, 1948. An Act to provide for certain benefits to employees in case of sickness, maternity and ' employment injury ' and to make provision for certain other matters in relation thereto.

1. PRESENTED BY
DR.ANJALATCHI MUTHUKUMARAN
VICE PRINCIPAL
ERA COLLEGE OF NURSING
ERA UNIVERSITY LUCKNOW
EMPLOYEE STATE INSURANCE
ACT
ESI ACT 1948

2. Learning objectives
 Introduction
 History of ESI act
 To discuss new amendment in ESI act
 To explain the ESI act like coverage , and administration , and finance, medical
facility provided through.
 To describe the benefits for employees.
1. Medical benefit
2. Sickness benefit
3. Maternity benefit
4. Disablement benefit
5. Dependent benefit
6. Funeral expenses
7. Rehabilitation allowance
 List out the dental and medical college under the ESI act
 Summary & conclusion .

3. INTRODUCTION
 Employees' State Insurance Corporation (abbreviated as ESIC)
is a statutory body under the ownership of Ministry of Labour
and Employment, Government of India. The fund is managed
by the Employees' State Insurance Corporation (ESIC)
according to rules and regulations stipulated in the ESI Act
1948.
 HISTORY
 In March 1943, Prof. B.P.Adarkar was appointed by the
Government of India to create a report on the health insurance
scheme for industrial workers.The report became the basis for
the Employment State Insurance (ESI) Act of 1948.

4. NEW AMENDENT
 The Employees’ State Insurance Corporation (ESIC)
raised the monthly wage limit to Rs. 21,000 from the
existing Rs. 15,000, for coverage with effect from 1
January 2017. The rate of contribution was reduced
from 6.5% to 4% ( employer's share 3.25% and
employee's share 0.75%) effective from 1 July 2019.

5. ESI act
 Important measure of social security & health insurance in
India Cash & medical benefits to industrial employees in
case of sickness, maternity & occupational injury
Coverage –
 From 6 September 2016 act covers all employees getting
up to 21000 per month.
 Covers all factories in India EXCLUDING - Mines,
Defense & Railways.
 Covers all state & UTS EXCEPT-Manipur, Sikkim,
Arunachal Pradesh, Mizoram, Delhi & Chandigarh

6. Cont..
Administration:-
 ESI Corporation
 Chairman- Union minister of labour (in central
government)
Chief executive officer - Director General
-Assisted by
Principal officers
 Insurance commissioner
 Medical commissioner
 Financial commissioner
Head Office- New Delhi

7. Cont...
Medical facilities provided through
Inspection officer - inspect factories
 Dispensaries
 Clinics
 Hospitals
Super specialty services - tie up with advanced
medical institutions

8. Con...
Finance:-
 Employer contributes -0.75% of total wage
 Employee contributes --3.25 % of total
wage
 ESI Corporation share 6:7 of total cost of
medical care
 State government-(1/8) & Central
government (7/8) share 1:7 of medical
expenditure

9. Cont ..
Benefits to EMPLOYEE'S:-
 1. Medical benefit
 2. Sickness benefit
 3. Maternity benefit
 4. Disablement benefit
 5. Dependent benefit
 6. Funeral expenses
 7. Rehabilitation allowance

10. 1. Medical benefit
 Full medical care NOT a cash benefit
Services:-
 Outpatient care
 In patient treatment
 Drugs
 Specialist services
 Pathological & radiological investigation
 ANC/PNC
 Immunization services
 Ambulance services

11. Cont...
Medical care is provided by:-
1. Direct pattern
1000/more employees
 Dispensaries/ Hospital Full time doctor
Less than 750
 Part time ESI Dispensaries
If employees are scattered over long distance
 Mobile dispensaries

12. Cont...
 2. Indirect pattern
 Panel system Registered Medical Practitioner (RMP)
designated as Insurance Medical Officers.
Other medical facilities
 Dentures, spectacles & hearing aids
 Artificial limbs, Walking calipers

13. 2. Sickness benefit
 Sickness is certified by Insurance Medical Officer
 91 days
 70% daily wage
Extended sickness benefit:-
 Benefit extended for 2 years
 80% wages
Person is eligible if:-
 employment is continuous for-2 years

14. Cont..
Suffering from enlisted - 34 diseases
 1. Infectious diseases- TB, AIDS
 2. Neoplasm's-malignant diseases
 3. Metabolic disorders- diabetic retinopathy/ nephropathy
 4. Nervous systems- Parkinson's disease
 5. Cardiovascular systems- CAD
 6. Respiratory system- COPD
 7. Digestive system-cirrhosis of liver
 8. Orthopedic diseases- prolapsed IVD
 9. Psychosis-Schizophrenia
 10. Others- Burger's disease.
Enhanced sickness benefit:- full average daily wage for duration
up to 7 days in case of vasectomy & upto 14 days in the case of
tubectomy

15. 3. Maternity benefit
 Full wages
 24 weeks (6 months)-confinement (5000/confinement)
 26 weeks- miscarriage or MTP
 4 weeks-sickness arising out of pregnancy, confinement or
premature death
 Maternity act 2017 amendments
Insured women now include
o A commencing mother who wishes to have a child with
surrogacy
o A woman who legally adopts a child upto 3 months of age

16. Cont..
 Adopting mother and commencing mother
o 12 weeks from date on which child is being handed
over to mother
 Insured women with 2 or more surviving children
o 12 weeks (of which not more than 6 weeks shall
precede the expected date of confinement)

17. 4. Disablement benefit
The act provides for cash payments , beside for free
medical treatment in the events of temporary and
permanent disabled as a results of employment injury
as well as occupational disease.
 Temporary disablement
90% wages till recovery
 Permanent disablement
90% wages
Lifetime pension

18. 5. Dependent benefit
 Death as a result of employment injury
 Dependents get pensions at rate of 90 % of wages
 Son or daughter is entitled to get benefit up to age of
18 years (benefits is withdrawn If daughter gets
married)

19. 6. Funeral expenses
 Funeral benefits is a cash payments payable on
the death of an insured person towards the
expansion of his funeral.
 Funeral expenses Cash not exceeding Rs.
15000

20. 7. Rehabilitation
 On monthly payment of Rs 10 to insured person
& his family members continue to get medical
treatment after permanent disablement all
retirements ,

21. ESIC 2.0-Health reform agenda of
ESIC
 Online availability of electronically stored health
records of the ESI beneficiaries
 Special OPD for senior citizens & differently abled
persons

22. MEDICAL AND DENTAL COLLEGE
 There are 8 Medical Colleges managed by the Ministry of Labour and
Employment (India) under the ESI Corporation. They are :
 ESIC Medical College and PGIMSR,[10] K. K. Nagar, Chennai, Tamil
Nadu
 ESIC Medical College and PGIMSR, Joka, Kolkata, West Bengal
 ESIC Medical College and PGIMSR, Sanath
Nagar, Hyderabad , Telangana
 ESIC Medical College and PGIMSR, Rajaji
nagar, Bengaluru, Karnataka
 ESIC Medical College and PGIMSR, Faridabad, Haryana
 ESIC Medical College and PGIMSR, Gulbarga, Karnataka
 ESIC Medical College and Hospital, Alwar, Rajasthan
 ESIC Medical College and Hospital, Bihta, Patna, Bihar

23. Bibliography
 K.PARKs. preventive and social medicine.23rd
addition. Banarsidas bhanot publishers. New
Delhi 2015. Page number 815, 914-915.
 R P Saxena textbook of community health
nursing. Second edition. Jaypee brother
publisher. 2017. Page number-539-544.
 "WHO South-East Asia Region: India statistics
summary (2002 - present)". World Health
Organization. Retrieved 13 January 2014
 WWW. Wikipedia .com .esiact.