Benefits of employees under the Employees State Insurance Act,1948

Introduction

Employees State Insurance Act,1948 applies to all factories. The government can also make this Act applicable to any other industrial, agricultural, commercial or any other establishment by issuing a notification.

Only those employees who are drawing wages up to Rs 15000 per month are covered under this Act.

Benefits available to the employees under this Act

Sickness benefit

Under this benefit cash payment made to an insured person periodically during the period of certified sickness occurring in a definite period when the insured person undergoes medical treatment and attendance with abstention from work on valid medical grounds.

The maximum duration of this benefit is 91 days in two consecutive benefit periods. There is also a waiting period of 2 days. Its is waived if the insured person is certified sick within 15 days of span for which sickness benefit was last paid. 

Sickness benefit amount= 50% × average daily wages of the insured person.

Medical benefit

Wide range of medical benefit is available to the insured and their dependents including their family members under this Act. 

Extended sickness benefit

If the insured person is suffered from Cancer, Leprosy, Tuberculosis, or other Malignant diseases or any other specified long term health issues, then such an employee can avail extended sickness benefit at a higher cash benefit rate provided, the sickness benefit payable up to 91 days has exhausted.

Extended sickness benefit amount = 70% × average daily wage for a period of two years.

Enhanced sickness benefit

Where the insured employee wants to go for sterilization operations for family planning, he is eligible to Enhanced Sickness Benefit. 

Enhanced sickness benefit amount= 2 × the rate of sickness benefit.

Maternity benefit

This benefit can be availed by woman employees. In the case of confinement or sickness or miscarriage occurring due to pregnancy, confinement, premature birth of child or miscarriage, the insured woman will get periodical cash payments by a duly appointed medical officer.

Dependent benefit

This benefit can be availed by the family members or dependents of an insured employee who dies due to an employment injury sustained as an employee under this very Act. Such family members or dependents will get periodical payments.

There is no such specific contributory conditions or criteria to qualify for such benefits. Therefore, if any unforeseen or unfortunate incident occurs for example, if an employee dies of employment injury even if it is on the first day of his employment, his family members or dependents are entitled to a dependent benefit. Provided death of such employee must occur in the course of employment while working.

Disablement benefits

An employee can avail disablement benefit only if such disablement benefit is caused by employment injury. In the case of temporary disablement, a benefit can be availed as long as the disability lasts. However, in the case of permanent disablement, benefits can be availed till the death of the insured employee. No such other conditions have been mentioned for this benefit.

Funeral benefit

The funeral benefit amount is paid either to the eldest surviving member of the family or in his or her absence to that particular individual who incurs the funeral expenses. This benefit can be availed only after the death of the insured employee to meet the funeral expenditure of the deceased employee.

Conclusion 

This Act applies to all non- seasonal factories as which employs ten or more individuals.

Funds of these benefits come from the contributions of insured employees and their employers. 

Employees whose average daily wage is Rs 40 or less are exempted from contributing to the fund.