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Unit 5: The Employees’ State Insurance Act, 1948: Adjudication, Benefits, and Penalties under the Act

Notes

Notes The Director General may enhance the duration of extended sickness benefit beyond
the existing limit of 400 days to a maximum, period of 2 years in deserving cases duly
certified by a medical board. The facility of extension would be available up to the date on
which the insured person attains the age of 60 years. The rate of this benefit is 40 per cent
more than the standard benefit rates for 7 days for vasectomy and 14 days for tubectomy.
This is paid in addition to the usual sickness benefits.

5.1.2 Maternity Benefit

An insured woman is entitled to maternity benefit at double the standard benefit rate. This is
practically equal to full wages for a period of 12 weeks, of which not more than 6 weeks shall
precede the expected date of confinement. Additional maternity benefit is given in case of
miscarriage. In case of sickness arising out of pregnancy, confinement, premature birth of a
child or miscarriage, an additional benefit is given for a period not exceeding one month. The
eligibility condition for maternity benefit is 80 days in one or two preceding contribution
periods of one year.

5.1.3 Disablement Benefit

If a member suffers an injury in the course of his employment, he will receive free medical
treatment and temporary disablement benefit in cash, which is about 70 per cent of the wages, as
long as the temporary disablement lasts, provided that the temporary disablement has lasted
for not less than 3 days, excluding the day of the accident. In case of permanent total disablement,
the insured person will be given a life pension at full rate i.e., about 70 per cent of his wages,
while in case of partial permanent disablement, a portion of it will be granted as life pension.
The benefit is paid for-Sundays as well. At the option of the beneficiary, the permanent
disablement pension may be commuted to a lump sum payment, if the rate of benefit is less than
one rupee and fifty paise per day.

5.1.4 Dependents’ Benefit

The dependents’ benefit consists of timely help to the eligible dependents of an insured person
who dies as a result of an accident, or an occupational disease arising out of the course of
employment. Pension at the rate of 40 per cent more than the standard benefit rate (70 per cent
of wages) will be paid periodically to the widow and children. It will be available to the widow
as long as she lives or until she marries; to sons’ and unmarried daughters up to the age of 18
without any proof of education; and to infirm or wholly dependent offsprings long as the
infirmity lasts. Where neither a widow nor a child is left, the dependents’ benefit is payable to
a dependent parent or grandparent for life, but equivalent to 3/1Ms. of the full rate; and if there
are two or more parents or grandparents, the amount payable to them shall ‘be equally divided
between them.

Did u know? ESI Corporation has decided to provide primary and secondary medical care
services in the areas directly where the concentration is more than 5000 and there is no
dispensary within 8 kms (5 kms in hilly areas) and where concentration is 25000 ( 15000 in
hilly areas) and there is no hospital within 25 kms. This facility will be available till the
ESI establishes its own hospital and dispensary.

LOVELY PROFESSIONAL UNIVERSITY 83