ESI scheme – benefits of ESI scheme

ESI is a health and social security scheme that requires 3.25% of gross salary as employers’ contribution and 0.75% as employee contribution which aggregates to 4% of the monthly contribution. The benefits of the ESI scheme include

  • Medical Benefits

The insured persons and dependants get full medical and surgical care without any limit at the ESI dispensaries and hospitals including other services like medicine supplies, ambulance services and super speciality services.

  • Sickness Benefits

Sickness benefit as cash compensation is given to the insured person at the rate of 70% of the wages during a period of certified illness for a maximum of 91 days in a year. In order to be eligible for the sickness benefit, the insured person needs to contribute for 78 days during a period of 6 months. Workers suffering from long-term diseases can claim sickness benefits for a period of 2 years at an enhanced rate of 80% of the wage.

  • Disablement Benefits

From the day the worker is registered to the scheme, irrespective of having made any contributions, 90% of the wage is payable as long as the temporary disablement persists.

Permanent disablement is payable at the rate of 90% of wage in the form of monthly payment if there is a permanent disablement based on the  loss of earning capacity certified by a Medical Board.

  • Death and Dependant Benefit

This benefit is paid at the rate of 90% of wage in the form of monthly payments to the dependants of the deceased insured person, if the death was caused due to occupational hazards or employment injury. Parents and spouses are entitled to this benefit and the dependants’ children enjoy this benefit until the age of 25.

  • Maternity Benefit

Maternity benefit is provided for six months subject to ESI contribution for 70 days in the preceding year. The Maternity Benefit Act, 1961 does not apply to any factory or establishment to which the ESI Act applies.

  • Unemployment Allowance

Under the Rajiv Gandhi ShramikKalyan Yojana, unemployment benefit is given to an insured person who is unemployed after three or more years because of the closure of the factory or establishment, retrenchment or permanent invalidity for a period of 24 months. The unemployment allowance provided include

  1. Unemployment allowance includes 50% of wage for a maximum period of one year.
  2. Vocational training that is provided for the purpose of upgrading skills – Expenditure on fee and traveling allowance will be borne by ESIC.
  3. Medical care for self and family from ESI hospitals and dispensaries.
  • Funeral Expenses

The funeral expenses are made to meet the expenditure during the funeral of the deceased insured person. This amount is usually paid to the eldest living member of the family or to the person who incurs the funeral expenses during the absence of the eldest member.

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