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Benefit at a glance
BENEFITS UNDER THE SCHEME | ELIGIBILITY CONDITIONS | DURATION AND SCALE OF BENEFITS |
---|---|---|
1. SICKNESS BENEFIT | ||
Sickness Benefit | Payment of contribution for 78 days in corresponding contribution period of six months. | Upto 91 days in two consecutive benefit periods at 70% of the average daily wages |
Enhanced sickness Benefit | Same as above | 14 days for Tubectomy & 7 days for Vasectomy, extendable on medical advice. Rate of payment is 100% of the average daily wages. |
Extended Sickness Benefit | Continuous insurable employ -ment for two years with 156 days contribution in four consecutive contribution periods is required to avail this benefit,If suffering from 34 specified long term diseases | 309 days which may be extended up to two years on medical advice and can be availed during a period of three years.Rate: 80% of the average daily wages. |
2.DISABLEMENT BENEFIT | ||
Temporary Disablement Benefit (i) Employment injury (ii) Occupational diseases | From day one of entering insurable employment irrespective of having paid any Contribution and payable for employment injury cases only. The Occupational diseases as defined in the third schedule of ESI Act 1948 and as confirmed by Special Medical Board are treated as Employment injury. | As long as temporary disablement lasts. Rate: 90% of the average daily wages. Same as above. |
Permanent Disablement Benefit | Same as above | For whole life. Rate: 90% of the average daily wages if permanent disability is total. Incase of partial disablement proportionate to the loss of earning capacity. |
3.DEPENDANT’S BENEFIT | From day one of entering insurable employment in case of death due to employment injury. | To the widow for life or until her re-marriage. To children till the age of 25 years. To dependent parents for life. Rate:90% of the average daily wages shareable in fixed proportion. |
4.MATERNITY BENEFIT | Payment of contribution of 70 days in two preceding contribution period (one year) | Up to 26 weeks in case of normal delivery up to 8 weeks in case of miscarriage. Extendable by 4weeks on medical advice. For Insured Woman with two or more surviving children Maternity Benefit will be for 12 weeks. Rate: 100% of the average daily wages. |
5.MEDICAL BENEFIT | ||
Along with the allopathic system of medicines, ESIC also provides medical care through Indian System of Medicine (ISM) including Ayurveda, Yoga, Unani, Sidha and Homeopathy (AYUSH). This facility is available in 95 selected ESI Hospitals / Dispensaries throughout the Country | Full medical facilities for self and family from day one of entering insurable employment.Family includes spouse, dependant children up to 18 years, if continuing education up to 21 years, dependant unmarried daughter, dependant infirm child, dependant parents, As also if insured person is unmarried and his/her parents are not alive, minor brother or sister wholly dependant on the earning of Insured person. | Full Medical care till disease or disablement lasts to IP & family. . Retired insured persons who have been in insurable employment for at least five years before retirement on superannuation or retires under voluntary retirement scheme (VRS) of the employer or premature retirement (not resignation) or leaves employment in case of disability due to employment injury are also entitled to medical care available at ESI Institutions. Entitled for self and spouse on payment of Rs.120/- as yearly contribution. |
6. OTHER BENEFITS | ||
Confinement Expenses | An insured Woman or an IP in respect of his wife is eligible from day one in case the confinement occurs at a place where necessary medical facilities under ESI Scheme are not available. | Up to two confinements only. Rate: Rs.5000/- per case. |
Funeral Expenses | From day one of entering insurable employment and if eligible for any benefits as an Insured Person. | Rate: Actual expenses subject to a maximum of Rs.10000/- |
Unemployment Allowance(Rajiv Gandhi Shramik Kalyan Yojana) | In case of involuntarily loss of employment due to closure of factory, retrenchment or permanent invalidity due to non-employment injury and the contribution in respect of him have been paid/payable for a minimum of two years prior to loss of employment. | Maximum twenty four months during the life time.Rate: 50% of the Average daily wages for first 12 months and 25% of average daily wages from 13 to 24 Months. |
Vocational Training | In case of physical disablement due to employment injury. | As long as vocational training lasts. Rate : Actual charged of Rs.123/- a day whichever id higher. |
Physical Training | In case of physical disablement due to employment injury. | As long as a person is admitted in an artificial limb centre. Rate:100% on the average daily wages. |
Skill up-gradation Training | Same as above | For a short duration – maximum up to 12 months. |
Quota for MBBS / BDS admission | The Children of Insured Person / Insured Woman who satisfies the eligibility condition as per the guidelines issued by ESIC Hqrts. from time to time published in website “www.esic.nic.in” will be eligible for admission under IP quota in ESIC Medical Institutions. ADMISSION | MBBS/BDS seats are reserved for ward of Insured Persons( Children) in ESIC Medical/Dental Colleges The candidates should attend the NEET Examination and should find a place in the rank list. |