ESI Benefits List

Employees State Insurance (ESI) is a compulsory insurance for a specified class of wage earners for various contingencies like death, disease or physical disability. Employers are required to obtain ESI registration and provide ESI benefits for employees earning less than Rs.21,000 per month. In this article, we look at the list of ESI benefits that would be enjoyed by an employee covered under the Employees' State Insurance Act, 1948.

Medical Benefit

Full medical facilities for self and dependents are admissible from day one of entering insurance employment. The primary, out-patient, in-patient and specialist medical care and services are provided through a network of panel Clinics, ESI Dispensaries and Hospitals. Super speciality services are provided through in-house facilities in some of the ESI Hospitals and large number of advanced empanelled medical institutions on a referral basis.

Old Age Medical Care

Full medical care is provided under ESI for self and spouse on superannuation subject to having completed five years in insurable employment immediately before superannuation or in case of having suffered permanent physical disablement during the course of insurable employment.

Sickness Benefit

Sickness benefit is payable to an insured person in cash, in the event of sickness resulting in absence from work and duly certified by an authorized Insurance Medical Officer/Practitioner. The benefit becomes admissible only after an insured employee has paid the contribution for at least 78 days in a contribution period of six months.

Maternity Benefit

Maternity benefit is payable to insured women in case of confinement or miscarriage or related sickness from pregnancy. For claiming the benefit an insured women should have paid the contribution for at least 80 days in two consecutive contribution periods i.e. one year. Know more about maternity benefits in India.

Disablement Benefit

Disablement benefit is payable to insured employees suffering from physical disablement due to employment injury or occupational disease. An insured person should be an employee on the date of the accident.

Dependent Benefit

Dependent Benefit (Family pension) becomes payable to dependents of a deceased insured person where death occurs due to employment injury or an occupational disease. A widow can receive this benefit on a monthly basis for life or till her re-marriage. A son or daughter can receive this benefit on a monthly basis till eighteen years of age. Other dependents like parents can also receive this benefit under certain conditions, for life.

Funeral Expenses

In the event of a death of an insured person, maximum of Rs 5,000 is payable.

Vocational Rehabilitation

Vocational rehabilitation benefits can be availed in case of disablement in insured persons under 45 years of age with 40% or more disablement. Vocational training is now also being made available to those insured persons who are rendered unemployed unwillingly, for ensuring re-employability of those who are rendered unemployed unwillingly. These vocational training will be provided through AVTIs.

Medical Bonus

The rate of confinement expenses is Rs. 3,500 per confinement.

Physical Aids

Free supply of physical aids and appliances such as crutches, wheelchairs, dentures, spectacles and other physical aids.

Unemployment Allowance ( Rajiv Gandhi Shramik Kalyan Yogana)

Unemployment Allowance is payable to those workers facing involuntary unemployment due to closure of factory/establishment, retrenchment or permanent invalidity arising due to non-employment injury. The daily rate of unemployment allowance is at par with the standard sickness benefit rate which is just above 50% of the daily wages. This allowance is payable for a maximum period of 12 months either in one spell or in different spells of not less than one month’s duration. The insured person’s eligibility condition has now been relaxed to three years from earlier five years, for being able to avail the unemployment allowance.