ESIC benefits for insured person under ESIC act

by varun · Published December 5, 2020 · Updated December 24, 2021

ESIC benefits

ESI stands for Employees’ State Insurance Corporation. It is a self financing social security and health insurance scheme for Indian workers. ESIC is managed by employee state insurance corporation. It functions according to according to rules and regulations stipulated in ESI act, 1948. ESIC is a autonomous body and comes under Ministry of Labor and Employment. ESIC can be accessed at ESIC portal. In this article, we would discuss various benefits associated with ESIC registration. ESIC registration acan be done online on ESIC portal. To find out more about various aspect related to ESIC registration such as ESIC registration eligibility, ESIC respiration steps on ESIC portal and ESIC registration documents required. You can read our article on ESIC registration.

ESIC benefits

Medical benefit – Employee and his family registered under employee state insurance act is known as insured person. Benefits provided to insured person includes reasonable medical care, comprehensive medical care & clinical investigation for insured person and his family members.
Medical care to retired insured person – Under ESIC rules, these benefits are provided to a insured person who ceases to be in an insurable employment on account of permanent disablement caused due to an
employment injury. Benefits like Medical facility for primary and secondary care are provide to a registered employee.
Sickness benefit – Under employee state insurance act, 70% of the daily wages is provided as a sickness benefit. This benefit is provided for a period Up to 91 days in any two consecutive Benefit Period in the event of sickness.
Enhanced sickness benefit – ESIC rules states that 100% of daily wages to be provided under enhanced sickness benefits.
Extended sickness benefit – 80% of average daily wages is provided under this benefit. This benefit is provided for 124 to 309 days which may be extended up to two years (73 days) on medical advise specified for long term diseases till the age of 60 years.

Other ESIC benefits

Temporary disablement benefit – 90% of average daily wages payable during the contribution period/month/day of accident, as the case may be.
Permanent disablement benefit – Under ESIC act, permanent disablement benefit is paid for permanent disablement caused by an accident or an occupational disease arising during employment. Benefits includes- 1. Percentage of the total rate of disablement benefit which is equal to the full rate of TDB. 2. This can be
commuted into lumpsum in case the daily rate benefit is upto Rs.10 or the total commuted value does not exceed Rs. 60,000/-
Dependent benefit – Paid to the dependents of the Insured person who dies as a result of employment injury as defined in ESIC act. Benefits include 90% of average daily wages among dependents in fixed proportion.
Medical care to the Widow in receipt of Dependent Benefit – It is provided to widow of insured person. Benefits include Medical facility for primary and secondary care (excluding SST) within ESI Medical institutions on yearly payment of Rs. 120/ to the widow of deceased IP who is in receipt of dependent benefit
Maternity Benefit – 100% of the average daily wages.
Confinement expenses – The insured woman and insured person in respect of his wife shall be paid medical bonus paid on account of confinement expenses at a place where necessary medical facility under the scheme is not available. Benefit includes Rs.5,000/-per case up to two confinements.
Funeral Expenses – One time payment defraying expenses on funeral of an Insured person. Benefits includes maximum of Rs.10000 only.
Unemployment allowance – benefit includes Unemployment allowance at the rates of (a) 50% of last avg.
daily wages for 0- 12 months (b) 25% of last avg. daily wages for 13-24 months 2. Medical care for self and family during receipt of unemployment allowance.

In this article, we have discussed various benefits designed for a ESIC registered employee by ESIC. These benefits are paid by central pool or funds collected by ESIC from ESIC employee contribution and ESIC employer contribution. For further reading on different types of trade licenses required in India, you can visit our website’s other section.