4. MAJOR BENEFITS
1.Provident Fund Benefits (member or family)
2.Pension Benefits (member and/or family)
3.Death Benefits (family)
5. Employees’ Provident
Fund Scheme, 1952
Employees' Pension
Scheme, 1995
Employees’ Deposit Linked
Insurance Scheme, 1976
Benefits:
On retirement,
resignation , or
death, the the
member can settle
the account. i.e., the
member gets his PF
contribution,
Employer
Contribution and
Interest.
Partial withdrawals
allowed for specific
expenses such as
house construction,
higher education,
marriage, illness etc.
Monthly benefits for
superannuation/
retirement, disability,
survivor, widow (er),
children.
Amount of pension
based on average
salary during the
preceding 12 months
from the date of exit
and total years of
employment.
Employee Deposit Link
Insurance Scheme was
started in the year 1976. The
main objective of starting the
scheme was to provide
financial assistance to the
family of the employee after
his death.
Example, if the basic salary
+ dearness allowance of an
employee for the last 12
months, the amount is ₹
15000, then the amount of
insurance will be calculated
as follows. 15000 * 35 =
5,25000 5,25000 + 1,75000 =
7,00000 Total sum insured =
700000
6. Employees’ Provident
Fund Scheme, 1952
Employees' Pension
Scheme, 1995
Employees’ Deposit
Linked Insurance
Scheme, 1976
Claim Forms:
For final settlement
by member: Form 19
For Transfer of old
account to the new
one: Form 13
For Withdrawal in
certain cases: Form 31
For financing LIC
Policy: Form 14
For final settlement in
favour of nominee/
beneficiary of a
deceased member:
Form 20
For Monthly Pension:
Form 10D
For Withdrawal Benefit
and Scheme Certificate:
Form 10C
For claiming
Insurance Benefit by
a nominee/
beneficiary in case of
member’s death
while in service:
Form 5IF
7. SCHEME CERTIFICATE
This Certificate shows the service & family details of a member
This is issued if the member has not attained the age of 58 while leaving an establishment
and he applies for this certificate
Member can surrender this certificate while joining another establishment and the service
stated in the certificate is added with the service he is gaining from the new establishment.
After attaining the age of 58, the member can apply for Pension by surrendering this
scheme certificate (if total service is atleast 10 years)
This is a better choice than Withdrawal Benefit, as a member dies holding a valid scheme
certificate, his family will get pension (Death when NOT in service)
8. 1. Marriage / Education
2. Treatment
3. Purchase or construction of Dwelling house
4. Repayment of Housing Loan
5. Purchase of Plot
6. Addition/Alteration of House
7. Repair of House
8. Lockout
9. Withdrawal Prior to Retirement
10. Other Advances
9. Reason of Withdrawal Limit of Withdrawal
Minimum
number of
years in
service
Other terms and conditions
Education
Up to 50% of employee’s share
of contribution to EPF.
7 years
For either his education or
his children’s after
10th class.
Marriage
Up to 50% of employee’s share
of contribution to EPF.
7 years
For his own marriage or the
marriage of daughter/ son/
brother/ sister.
Purchase of home or plot
For home: up to 36 times of
monthly wage plus dearness
allowance (component of the
salary). 5 years
The land must be in the
name of the employee or
spouse or jointly owned.
For land: up to 24 times of
monthly wages plus dearness
allowance.
10. Reason of Withdrawal Limit of Withdrawal
Minimum
number of
years in service
Other terms and conditions
Medical treatment
6 times of wages plus
dearness allowance
N/A
For his own treatment or for spouse,
daughter, son, father or mother’s
treatment. The patient should be
hospitalized for more than a month.
In case of cancer, paralysis, TB,
leprosy, mental derangement or heart
ailment, advance can be availed without
hospitalisation.
Home loan payment
Up to a maximum of
90 % from both
employee’s
contribution and
employer contribution
in EPF
10 years
The land must be in the name of the
employee or spouse or jointly owned.
Related documents to the housing loan
should be presented.
The accumulation in the employee’s PF
account (or with the spouse), including
the interest, should be more than Rs.
20,000.
11. Reason of Withdrawal Limit of Withdrawal
Minimum
number of
years in
service
Other terms and conditions
Calamity
Up to 50% of the employee
share.
N/A
Employer will have to
provide the certificates of
damage.
Addition/alternation of
house
12 times of your wages 5 years
The land must be in the
name of the
employee/spouse or jointly
owned.
The house should be
constructed at least 5 years
ago.
Lockout Equal to your unpaid wages N/A
Employer must not be
getting wage for last two
months or company must be
closed for at least 15 days.
Withdrawal before the
retirement
Up to 90% of accumulated
balance with interest
57 years For self only.
23. The Act encompasses certain health related eventualities that the
workers are generally exposed to, such as sickness, maternity,
temporary or permanent disablement, occupational disease
resulting in loss of wages or earning capacity
24. Any person having monthly gross salary of Rs.21000/- or less`
Employee 0.75% of Gross Salary
Employer 3.25% of Gross Salary
Contribution period Benefit period
1st April to 30th September 1st Jan to 30th June
1st October to 31st March 1st July to 31st December
25. Upon joining employer submits a declaration form to ESI for the eligible employees within 10
days through esic portal and further directs the insured person to get his/her and dependents’
biometric features (photograph and finger prints) registered at specified branch.
After the biometric registration, the insured person can collect his/her card (Two numbers –one
for self and one for family) within 7 days.
27. Outpatient Treatment
Domiciliary treatment
Specialist consultation and diagnostic facilities
In-patient treatment
Free supply of drugs and dressings
X-ray and laboratory investigations
Vaccination and preventive inoculations
Anti natal care, confinement and post natal care
Free diet during admission in hospital
Free supply of artificial limbs, aids and appliances for physical rehabilitation
Medical certification
Special provisions including super speciality treatment
28. To qualify one should be the member for nine months and minimum 78 days of contribution is must
Insured employees is entitled to receive for the period of his sickness as the daily “standard benefit
rate”.
Benefit is not available for the first 2 days of sickness.
Maximum period for benefit is 91 days in one year.
70% Standard benefit rate is paid during the period of sickness
*Standard benefit rate: Average daily wages in the contribution period
29. The Maternity Benefit Provision has been enacted to provide maternity benefits to women
employees. As per the Act, provisions have been made to provide maternity benefit to women
employees at the time of maternity
Under the Maternity Benefit, women employees are required to work in that company or
establishment for at least 80 days within 1 year to get maternity benefit
According to the provisions made under the Maternity Benefit Act, a pregnant woman can take
leave 8 weeks before the expected date of delivery and the remaining leave can be taken after
delivery, under this type of Maternity Benefit Act, the pregnant woman can take a total of 26
weeks. Maternity leave can be taken. For this it is necessary that the woman should not have
two children before. According to the provisions made under the Maternity Benefit Act,
women who already have 2 children can take maternity leave for 12 weeks
30. Temporary Disablement Benefit: 90% of daily average
wages and not payable if incapacity lasts for less than 3
days.
Permanent disablement, whether total or partial, as a
result of an employment injury ( personal injury caused
by an accident arising out of and in the course of
employment) and depending on percentage of loss of
earning capacity
31. When an insured employee dies as a result of an employment
injury, his widow and children and in case the employee does not
leave behind him a widow or children, his other dependants, are
entitled to receive periodical payments.
32. In case of death of an insured employee, the eldest surviving member of his
family, and if the employee had no family or was not living with his family
at the time of his death, then the person who actually incurs expenditure on
the funeral of the employee, is entitled to receive the a payment called
“funeral expenses”.
Maximum permissible amount of such payment is Rs. 15000/-
33. Vocational Rehabilitation In case of Physical disablement
due to employment injury
As long as vocational training
lasts.
Actual fee charged or Rs.123/- a
day whichever is higher
Physical rehabilitation In case of Physical disablement
due to employment injury
As long as a person is admitted
in an artificial limb centre –
Rate: 100% of wages
Unemployment Allowance In case of loss of employment due to
closure of factory, retrenchment or
permanent invalidity (above 40%)due
to non employment injury and has min
3 yrs contribution
Maximum one year during life
time: Rate 50% wages
34. An employee is not entitled to receive two benefits at the same time. That means he cannot receive for
the same period.
(a) Both sickness benefit and maternity benefit; or
(b) Both sickness benefit and disablement benefit for temporary disablement; or
(c) Both maternity benefit and disablement benefit for temporary disablement.
35. Follow the Medical officer’s instruction
Don’t pressurize the Doctors for illegitimate demands
Carry ID card while going to ESI Hospitals always
Don’t provide false information at any time to ESI
Keep ID card safe and if it is lost, inform ESI to get the duplicate card. Don’t tamper the ID card
or misuse it.
When you happened to travel outside on duty or leave, he may be issued a certificate so as to
enable him to avail medical treatment in ESI dispensaries.
Inform whenever birth or death to ESI/employer to amend it and get medical benefits
Forms are issued at free of cost; no need to pay for it
