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It is quite possible that an
IW may qualify for maternity benefit with reference to contributions paid by her in two consecutive contribution periods immediately preceding the date of her
confinement/expected confinement but the average daily wages may work out differently in each contribution period. In such a case, she will be entitled to higher of the benefit rates with reference to contributions paid by her in the two above-said contribution periods.
Criteria for determination of rate
Maternity benefit for confinement: -
(a) Where claim partly or wholly covers pre-confinement period and payments commence before actual confinement eligibility as well as the rate will be determined with reference to the benefit period in which the date of expected confinement falls.
(b) Where the claim partly or wholly covers a pre-confinement period but payment of maternity benefit for this period has to be postponed till after actual confinement, the eligibility as well
as rate of maternity benefit is to be determined with reference to the benefit period in which
confinement was expected to occur (provided certificate of expected confinement was submitted in accordance with Regulations) or with reference to the benefit period in which confinement actually
occurs whichever is beneficial to the
IW.
(c) Where the claim covers only the period after confinement, the eligibility as well as rate of maternity benefit will be determined with reference to:
(i) the benefit period in which confinement actually occurs, if no certificate of expected confinement was submitted; or
(ii) the benefit period in which the confinement occurs or the benefit period in which the confinement was expected to occur, whichever is more advantageous to the insured woman, provided that certificate of expected confinement was duly submitted strictly in the manner laid down in the Regulations and not otherwise.
(d) where the claim covers a pre-confinement period and -
(i) no certificate of expected confinement was issued, the eligibility and the rate of benefit admissible is to be determined with reference to the benefit period in which confinement actually occurs.
(ii) a certificate of expected confinement was issued before confinement but is submitted after confinement. In such a case, submission of certificate of expected confinement becomes infructuous and such a certificate has lost its validity. Hence, eligibility to maternity benefit as well as the rate of benefit admissible will be that determined with reference to the benefit period in which date of actual confinement falls.
(e) Where claim is for sickness arising out of confinement, premature birth of child or miscarriage and where maternity benefit terminates on the last day of a benefit period or continues into the next benefit period and the sickness arising out confinement, etc., commences thereafter the rate of maternity benefit payable during the spell of sickness arising out of confinement will continue to be the same at which maternity benefit was paid, irrespective of the conditions obtaining in the subsequent benefit period.
Eligibility as well as rate of maternity benefit for miscarriage shall be determined with
reference to the benefit period in which the date of miscarriage falls.
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