FAQ

The ESI scheme provides full medical care to workers registered under the ESI Act, 1948, when they are unable to work due to illness, work-related injury, or maternity, until they are fully fit to return to work. It also offers financial assistance to cover lost wages during this period. Medical care is extended to their family members as well.

The ESI Scheme is administered by a statutory corporate body called the Employees' State Insurance Corporation (ESIS). This group has members who represent workers, employers, the government, doctors, and some Hon’ble Members of Parliament. The Director General is the Chief Executive Officer/Head of the Corporation and is also an ex-officio member of the Corporation.

At the national level, the Standing Committee manages how the ESI Corporation runs, while the Medical Benefit Council helps with decisions about medical benefits. At the regional level, Regional Boards and Local Committees check how well the scheme is working and suggest improvements. Hospital Development Committees and State Executive Committees have also been created for monitoring purposes.

The ESI scheme is a self-financing scheme. The funds are primarily built out of contributions from employers and employees payable monthly at a fixed percentage of wages paid. The State Governments also bear 1/8th share of the cost of Medical Benefits.

The ESI Scheme is implemented in phases in different parts of the country through a Gazette notification after setting up the necessary facilities to provide medical and other benefits.

In areas notified by the Central Government under Section 1(3), all factories with 10 or more workers are covered under Section 2(12) of the ESI Act. Additionally, according to the government's notification under Section 1(5), the following places with 10 or more employees also come under ESI coverage:

1. Shops
2. Hotels or restaurants (only involved in sales, not manufacturing)
3. Cinemas, including preview theaters
4. Road transport businesses
5. Newspaper offices (not covered as factories under Section 2(12))
6. Private educational and medical institutions (such as hospitals, nursing homes, diagnostic centers, and labs, whether corporate, trust-based, or private)

Registration is the process by which every eligible factory/establishment gets itself registered online for compliance. If a factory/establishment is identified by ESIS, it is asked to register itself under the Act.

Yes, it is the employer's legal duty under Section 2A of the Act, along with Regulation 10-B, to register their factory or establishment under the ESI Act within 15 days of it becoming applicable to them.

The factory or establishment covered by the Act must register on the ESIS portal within 15 days of becoming eligible. The employer needs to provide information such as the factory/establishment name, address, employer's name, bank account, PAN, and details about power usage (for factories), along with other required details.

It is a 17-digit unique ID number given to each factory or establishment registered under the Act. This number is created through the ESIS portal after the employer submits the required information.

This is a unique identification number allotted to a sub-unit, branch office, sales office, or registered office of a covered factory or establishment located in the same state or a different state.

Once a factory or establishment is covered under the Act, it continues to be covered even if the number of employees goes below the required limit or there is a change in the manufacturing activity.

Yes, exemptions from the provisions of the Act are allowed if the employees of a factory or establishment are already receiving benefits that are similar to or better than those provided under the ESI Act.

If an employee's wages (excluding overtime) go above the limit set by the Central Government after the contribution period starts, they will remain covered as an employee until the end of that period. The contribution should still be deducted and paid based on the total wages earned.

In case the wages of an employee are increased from a retrospective date, resulting in crossing the wage limit prescribed, its effect on coverage will only be after the expiry of the contribution period during which the increase is announced or declared.

According to Rule 50 of the Employees' State Insurance (Central) Rules, 1950, if an employee’s wages go above the set limit after the contribution period begins, they will remain an employee until the end of that period, and contributions should be paid on their total wages.

Overtime is not a regular payment but happens occasionally. If overtime was counted towards the wage limit, an employee might keep losing and gaining coverage. However, overtime is included for calculating contributions to cover the employee during that time and to provide higher cash benefits.

Yes, with effect from 1st April 2008, the wage ceiling for employees with disabilities (PWDs) has been raised to ₹25,000 per month. The employer is exempted from payment of the Employer's share of contribution for employees with disabilities for up to 10 years.

The contribution must be paid within 15 days after the end of the month in which the wages are due.

The employer must file monthly contributions online through the ESIS portal for all employees. The amount is based on the days worked and wages paid. Payments can be made through a payment gateway of 58 banks, including SBI.

Non-payment or late payment of employees' contribution deducted from wages amounts to 'Breach of Trust' and is punishable under IPC 406, 409, and is also an offense under Section 85 of the ESI Act.

Yes, simple interest at the rate of 12% per annum is payable for each day of delay in payment of contributions.

The Corporation can charge and collect damages under Reg. 31C for late or missed payments, at rates that do not exceed the amount of the unpaid contribution. Period of delay Rate of damages in % p.a.

i) Less than 2 months 5 %
ii) 2 to 4 months 10 %
iii) 4 to 6 months 15 %
iv) 6 months and above 25 %

The Corporation may levy damages at a rate not exceeding the amount of contribution payable, depending on the period of delay, and the employer may face prosecution under Section 85(a) of the ESI Act.

For ESI compliance, the employer has to maintain the following records:

1. Muster roll, wage record, and books of accounts maintained under other laws.
2. Accident register in new Form-11.
3. An inspection book.
4. The immediate employer is also required to maintain the employees’ register for the employees deployed to the principal employer.

The employer has to submit the following records:

1. Accident Report: Notice of accident to the concerned branch office in Form-12 should be submitted online within 24 hours.
2. Abstention Verification Report: It is required to be submitted to the branch office as and when sought by the branch manager for any insured person.
3. Records including attendance, wages, and books of accounts in respect of the principal employer and the immediate employer as required by the labor laws.

Registration means recording information about an employee when they start a job covered by the ESI Act, to identify them under the scheme. The employer must register the employee online before they begin working

Registration of an employee is necessary for their identification, which is required to provide the benefits under the Act, which are related to the contributions paid by the employer on behalf of each insured person.

When an employee starts a job covered by ESI, they give their family details and a family photo to the employer for online registration. The insurance number they get during this process stays with them for life, even if they change jobs or move to a new place.

After the employee's online registration, the employer can print out a Temporary Identity Certificate (TIC). Once the employee's Aadhar is linked with the insurance number, the TIC is converted into a Permanent Identity Card (PIC), which allows the employee and their family to avail of ESI benefits.

Medical benefit means the medical attendance and treatment to the insured persons covered under the Act and their families as and when needed. This is the only benefit provided in kind through the State Governments, including Model Hospitals run by ESI Corporation (except in Delhi), and uniformly to all as per their requirement without linking it to their wages and contributions.

The scale of medical benefits includes a full range of medical, surgical, and obstetric treatments, consisting of outpatient and inpatient treatments, supply of drugs and dressings, pathological and radiological investigations, prenatal and postnatal care, super specialty consultations and treatments, ambulance services, and provision of artificial appliances.

The insured person and their family get medical benefits from the first day of starting a job covered by ESI. In the first three months, they can access primary and secondary medical care. If they stay employed for more than three months, the benefits continue for the related benefit period. For long-term illnesses, medical benefits can last up to 730 days within three years.

If the insured person's family resides in a different location, they can avail medical benefits at an ESI dispensary in their area by using a Family Identity Card. With the Pehchan card (Aadhar-linked), they can access medical benefits at any ESI dispensary/hospital in the country.

By linking the Aadhar card online for the insured person and family members, medical benefits can be availed at any ESIS/ESIS dispensary across the country. It is advisable to fill up Form-105, signed by their employer, to facilitate this process.

The dependents' benefit is 90% of the deceased insured person’s wages and is distributed among the eligible dependents. The widow receives 3/5th of the total amount, the widowed mother receives 2/5th, and each child gets 2/5th of the benefit until they turn 25 or marry, whichever happens first. Disabled children continue to receive the benefit after the age of 25.

Yes, there are no qualifying or contributory conditions attached for the payment of Temporary Disablement Benefit (TDB), Permanent Disablement Benefit (PDB), or Dependent Benefit (DB). Even if a casual or temporary employee suffers an employment injury on the first day, they are eligible for benefits.

(i) Family members are entitled to full medical care as and when needed.
(ii) They are also entitled to artificial limbs or appliances as part of medical treatment.
(iii) If the insured person dies during the receipt of unemployment allowance, the family continues to receive medical benefits.
(iv) In case of death due to employment injury, dependents are entitled to Dependents' Benefit.
(v) Funeral expenses up to ₹10,000 are paid to the family or the person who incurs the funeral expenditure.

An insured person who retires after at least five years of being covered is eligible for medical benefits for themselves and their spouse, as long as they provide proof of retirement and pay a small yearly fee of ₹120. If the insured person passes away, the spouse can still receive medical benefits by paying the required contribution under Rule 61.

An insured person who permanently stops working due to a work-related injury can get medical benefits for themselves and their spouse by paying ₹120 per year, until their normal retirement age. Those under 45 with 40% or more disability from the injury can also join vocational rehabilitation programs.

The Vocational Rehabilitation program under Rule 60 is available for insured persons under 45 years old with at least 40% disability from a work injury. They receive training at government or approved institutions. The insured person can get their training costs reimbursed, either based on the center's rate or ₹123 per day, whichever is higher, plus travel costs such as second-class train or bus fare to attend the program.

Yes, The Corporation in its 161st meeting held on 28.1.2014 & 14.2.2014 has passed the resolution to provide the medical care (excluding SST) to the widow for self, who is in receipt of dependent benefit on payment of contribution of rupees one hundred and twenty for one year.

Rajiv Gandhi Sharmik Kalyan Yojana (RGSKY) was introduced w.e.f. 01.04.2005 to provide unemployment allowance to the Insured Persons who have been rendered unemployed due to (a) Retrenchment as defined in the Industrial Dispute Act, 1947 (b) Closure of the factory/Establishment as defined in the Industrial Dispute Act, 1947 and (c) Permanent invalidity not less than 40% arising out of non employment injury. The invalidity should be duly certified by a Medical Board constituted by the Central or State Government.

Under this scheme, an insured person can get unemployment allowance if they have worked for at least two years with 78 days of contributions in each period. The allowance is paid for up to 24 months in total. For the first 12 months, they receive 50% of their last average daily wages, and for the next 12 months, they receive 25%.

The insured person (IP/IW) must get admitted to a government or approved institution following the entry rules of the Vocational Rehabilitation Center. The corporation will cover the full training fee and reimburse second-class train or bus fares for travel to and from the training at AVTI. The training can last up to one year. IPs and their family members are eligible for medical care, except for super-specialty treatments.