EMPLOYEES STATE EMPLOYEES STATE INSURANCE ACT 1948INSURANCE ACT 1948

ANJANE SREEANJANE SREEPRE FINAL YEARPRE FINAL YEARXORTICANZ ' 11XORTICANZ ' 11

21.10.14 21.10.14 @$

Important measure of social security & health insurance.

Provide cash & medical benefits to industrial employees in case of sickness , maternity & employment injury.

INTRODUCTION

ESI AMENDMENT 1975

Small factory employees Shops Hotels & restaurants Cinema theatres Road motor transport establishment Newspaper establishment Private medical & Educational institutions.

ESI corporationESI corporation

Chairman : union minister for labourVice-chairman : secretary to gov. ministry of labourMembers : representing state & central gov. Employers organisation Medical profession & parliament.Head office : Delhi Director general-insurance commissioner Medical commissioner Financial commissioner

ADMINISTRATIONADMINISTRATION

23 regional office 26 sub regional office611 branch office

FINANCE

Employees & employers & grants from state & central govt. Employer : 4.75% total wage bill.Employee : 1.75% total wage billDaily wage employees below rs 70 : exempted

I. Medical benefitII. Sickness benefitIII.Maternity benefit

IV.Disablement benefitV.Dependants benefit

VI.Funeral expensesVII.Rehabilitation allowance

MEDICAL BENIFITS

Full medical careHospitalisation : insured persons Sickness Employment injury maternity

1.Out patient care

2.Supply of drugs & dressings

3.Special services in all branch of medicine

4.Pathological & radiological investigations

5.Domiciliary services

6.Antenatal,natal & postnatal services

7.Immunisation services

8.Family planning services

9.Emergency services

10.Ambulance services

TYPESTYPES

*DirectlyESI hospitals & dispensaries

*Indirectlypanel systempanel of private medical practioners ( insurance medical practioner )

OTHER BENEFITSOTHER BENEFITS

DenturesSpectaclesHearing aidsArtificial limbsHernia beltsSurgical boots

SICKENESS BENEFITSICKENESS BENEFIT

Periodical cash payment to an insured person.Maximum of 91 days in any continuous period of 365 days.Daily rate : 50% of avg daily wagesPerson should remain under medical treatment provided under act.

EXTENDED SICKNESS BENEFITEXTENDED SICKNESS BENEFIT

In addition 91 days of sickness benefit.For long term sickness : benefits upto 2 yrs34 diseases included in extended sickness benefit

Infectious diseases : 1.TB 2.leprosy 3.AIDS

4.chronic empyema

Neoplasm : 4.malignant diseases

Metabolic : DM

Nervous system :monoplegia hemiplegia paraplegia hemeparesis intracranial space occupying leison spinal cord compression parkinsons diseases Myasthenia gravis immature cataract with 6/60 vision glaucoma Retinal detachment

Cardio- vascular : CAD CHF valvular diseases cardiomyopathy heart diseases with surgical intervention

Chest diseases : brochiectasis interstitial lung diseases COPD Corpulmonale

Digestive system : cirrhosis with ascitis /active hepatitis

Orthopedic : dislocation of vertebra , non union of fracture , post traumatic surgical amputation , chronic OM

Psychosis> 20% burnsChronic renal failure Reynauds diseases

Sterilisation operation : cash benefit payable to insured person in the reproductive age grp.

7 days for vasectomy 14 days for tubectomyAmount payable is double the std sickness benefit

MATERNITY BENEFITMATERNITY BENEFIT

Confinement : duration of benefit is 12 weeksMiscarriage : 6 weeks

Sickness arising out of confinement : 30 days

Benefit is allowed at about full wages

DISABLEMENT BENEFITDISABLEMENT BENEFIT

Cash payment with free medical treatment.Temporary disablement : 70% of wages as long as it lasts.

Total permanent disablement : life pension based on loss of earing capacity

Partial permanent disablement : portion of it is granted as life pension

DEPENDENTS BENEFITDEPENDENTS BENEFIT

Death as a result of employment injury.Pension 70% of wages is shared by dependent in a fixed ratio.Son/daughter is entitled to benefits up to 18yrs.

FUNERAL BENEFITS

Not >rs. 5000

REHABILITATIONREHABILITATION

On monthly payment of rs.10 : insured person & his family members continue to get medical treatment after permanent disablement or retirement.

RAJIV GANDHI SHRAMIK KALYAN RAJIV GANDHI SHRAMIK KALYAN YOJANA 2005YOJANA 2005

l Unemployment allowance for employeesl Involuntry unemployment >6 months.l Due to retrenchment / closure of factory.l Benefits for 5 or more years.l Availed in one spell or different spells of not less than 1

month.