By- Anjanee Goel[1]

The persons who are provided benefits under the Employees’ State Insurance act, 1948 are called the insured persons. There are various benefits provided to such insured persons such as sickness benefit, cash advantage, benefits on disability and dependency, and maternity benefits. These benefits are funded by the continuous contributions made by both the employers and the employees. The Employee State Insurance scheme provides all kinds of care to the employees who get themselves registered under the act when he is incapable to restore his health and working ability. The act also accommodates financial aid to such employees who are unable to visit the industry premises due to sickness or injury whether maternity or employment. The scheme provides benefits to the employee as well as the employee’s family during hospitalization.

According to rule 2 (7A) of The Employees’ State Insurance (Central) Rules, 1950, the advantages accessible under the Employee State Insurance Scheme are connected to the standard benefit rate which is thusly connected to the ‘average daily wages’ of the workers. Section 46 of the act describes the various Social Security benefits provided under the Act.

Sickness benefit:

After carrying out 9 months in insurable service, each and every protected employee is qualified for the cash advantage for the time period of bad health happening during the benefit phase and licensed by a suitably selected practicing medical specialist. It is provided as cash reimbursement at 70 percent of the standard benefit rate.

Insured people experiencing TB, cancer, etc. long-term diseases are at liberty to extended advantages at somewhat higher rates, although, he ought to be consistently employed for as a minimum two years.

Extended Sickness Benefit (ESB):

Sickness Benefit can be further extended as long as two years on account of long-term diseases at an improved higher rate of 80 percent of wages. Insured persons undergoing sterilization for 7 days for male workers and 14 days female employees are entitled to the payment of an equivalent to full wage.

Maternity benefit:

Maternity Benefit in case of pregnancy confinement, delivery or miscarriage or clinical termination of pregnancy, etc. is to be paid to the guaranteed female worker under the act for a time period of 26 weeks which is further extendable by one month on the remedial recommendation for post-confinement illness at full wage rate, provided that, a contribution for 70 days in the 2 straight away preceding Contribution Periods is made.        

On the other hand, if the female employee is previously having at least two or more existing children, the benefit is allocated for a maximum time period of 12 weeks of which not exceeding 6 weeks will precede the probable day of delivery.

Disablement benefit:

Section 51 & 52A of the Act discuss the disablement Benefit which is due to be paid to a worker who is wounded throughout his job period and is eternally or for the time being disabled or associates any work-related disease.

Temporary disablement benefit

It is payable from the very first day of entering insurable service & regardless of having rewarded any payment in case of employment injury at 90% payable in so far as the disability continues.

Permanent disablement benefit

The benefit is paid at 90% of Standard Benefit Rate as scheduled monthly payment relying on the degree of loss of earning competence as certified by a Medical Board

Dependents' benefit:

If as a consequence of employment injury that happened in the course of his employment or an occupational ailment, a worker dies, the dependants will have a right to the benefit as a pension at 90% of Standard Benefit Rate as a regularly scheduled monthly payment to the dependants of an expired insured individual.

Medical benefit – for self & family:

Protected people under the act and their families have the right to get free, full, and extensive medical care in an Employee State Insurance Hospital, up to two years for unceasing and long-term diseases.

The package covers all parts of medical services from basic/essential to super-specialist facilities, like Out-patient treatment, Diagnostic facilities, Specialist consultation, Ambulance service or conveyance charges, and In-patient treatment, etc.

Funeral expenses:

If an insured worker of an establishment dies, the oldest living member from his family or to the individual who performs last customs is qualified for compensation of such cost subject to a maximum sum of Rs.15,000/-.

Payment of benefit in case of death:

The benefit payable up to and including date of death if an individual dies during any period for which he is qualified for a cash advantage under this Act, the sum of such advantage up to and including the day of his passing will be paid to any individual assigned by the deceased individual as recorded in hard copy, if there is no such selection, to the beneficiary or lawful representative of the deceased individual.

The scheme likewise provides a number of other need-based advantages to insured workers such as Atal Bimit Vyakti Kalyan Yojana, Rajiv Gandhi Shramik Kalyan Yojana and it also provides an incentive to managers in the Private Sector for furnishing regular employment to the people with disability. 

The Atal Bimit Vyakti Kalyan Yojana was made effective from 1st July 2018. This scheme is enforced and is applicable for two years period initially on a test basis. The relief of up to 25% of the average per day earning all through the previous four contribution periods (total earning during 4 contribution periods/730) is paid to the insured person under this Act up to a maximum of 90 days in which he is unemployed once in a lifetime. It is given to the insured person when he submits the claim in the form of an affidavit.

The Rajiv Gandhi Shramik Kalyan Yojana was made effective from 1st April 2005. Under this scheme, if any person who is employed under any organization after 1st April 2005, he/she shall be entitled to claim all the benefits which are accessible to them under the unemployment allowance benefit, shutting down of organization or in case the organization winds up. This scheme is subjected to more changes and amendments to increase its ambit resulting in more benefits to more people.

[1] 5th Year, BBA LLB (H.) in Corporate Laws, UPES, Dehradun.


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