ESI (Employee State Insurance) Benifits
Full medical care is provided to an Insured person and his family members from the day he enters insurable employment. There is no ceiling on expenditure on the treatment of an Insured Person or his family member.
- System of Treatment
- Scale of Medical Benefit
- Benefits to Retired IPs
- Administration of Medical Benefit in a State
- Domiciliary treatment
- Specialist consultation
- In-Patient treatment
- Imaging Services
- Artificial Limbs & Aids
- Special Provisions
- Sickness Benefit (SB):
Sickness Benefit in the form of cash compensation at the rate of 70 per cent of wages is payable to insured workers during the periods of certified sickness for a maximum of 91 days in a year. In order to qualify for sickness benefit the insured worker is required to contribute for 78 days in a contribution period of 6 months.
Extended Sickness Benefit (ESB) : SB extendable up to two years in the case of 34 malignant and long-term diseases at an enhanced rate of 80 per cent of wages.
Enhanced Sickness Benefit: Enhanced Sickness Benefit equal to full wage is payable to insured persons undergoing sterilization for 7 days/14 days for male and female workers respectively.
- Maternity Benefit (MB):
Maternity Benefit for confinement/pregnancy is payable for three months, which is extendable by further one month on medical advice at the rate of full wage subject to contribution for 70 days in the preceding year.
- Disablement Benefit
Temporary disablement benefit (TDB) : From day one of entering insurable employment & irrespective of having paid any contribution in case of employment injury. Temporary Disablement Benefit at the rate of 90% of wage is payable so long as disability continues.
Permanent disablement benefit (PDB) : The benefit is paid at the rate of 90% of wage in the form of monthly payment depending upon the extent of loss of earning capacity as certified by a Medical Board
- Dependents’ Benefit (DB):
DB paid at the rate of 90% of wage in the form of monthly payment to the dependents of a deceased Insured person in cases where death occurs due to employment injury or occupational hazards.
- Other Benefits:
Funeral Expenses: An amount of Rs.10, 000/- is payable to the dependents or to the person who performs last rites from day one of entering insurable employment.
Confinement Expenses: An Insured Women or an I.P.in respect of his wife in case confinement occurs at a place where necessary medical facilities under ESI Scheme are not available.
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