Employees State Insurance act 1948

"An Act to provide for certain benefits to employees in case of sickness, maternity and

employment injury and to make provision for certain other matters in relation thereto."

Presented By:

(GROUP – 12)

Nandita Negi

Neha Baweja

Nidhi Rani

Seema

Ranjana Priya.

Presented To:

Mr. Vivek Narayan Sharma

ESIC ACT 1948

The promulgation of Employees’ State Insurance Act, 1948

envisaged an integrated need based social insurance scheme that

would protect the interest of workers in contingencies such as

sickness, maternity, temporary or permanent physical

disablement, death due to employment injury resulting in loss of

wages or earning capacity. the Act also guarantees reasonably

good medical care to workers and their immediate dependants.

Contd..

The Central Govt. set up the ESI Corporation to administer

the Scheme. The Scheme, thereafter was first implemented at

Kanpur and Delhi on 24th February 1952. The Act further

absolved the employers of their obligations under the

Maternity Benefit Act, 1961 and Workmen’s Compensation

Act 1923. The benefit provided to the employees under the

Act are also in conformity with ILO conventions. The

Corporation shall be a body corporate by the name of

Employees' State Insurance Corporation having perpetual

succession and a common seal and shall by the said name sue

and be sued.

Short title, extent, commencement and

application(1) This Act may be called the Employees' State Insurance Act, 1948.

(2) It extends to the whole of India.

(3) It shall come into force on such date or dates as the Central Government

may, by notification in the Official Gazette, appoint, and different dates

may be appointed for different provisions of this Act and for different

States or for different parts thereof .

(4) It shall apply, in the first instance, to all factories (including factories

belonging to the government) other than seasonal factories.

PROVIDED that nothing contained in this sub-section shall apply to

a factory or establishment belonging to or under the control of the

government whose employees are otherwise in receipt of benefits

substantially similar or superior to the benefits provided under this Act.

Contd..

(5) The appropriate government may, in consultation with the Corporation and where the appropriate government is a State Government, with the approval of the Central Government, after giving six months' notice of its intention of so doing by notification in the Official Gazette, extend the provisions of this Act or any of them, to any other establishment or class of establishments, industrial, commercial, agricultural or otherwise.

PROVIDED that where the provisions of this Act have been brought into force in any part of a State, the said provisions shall stand extended to any such establishment or class of establishments within that part if the provisions have already been extended to similar establishment or class of establishments in another part of that State.

Contd..

6) A factory or an establishment to which this Act applies shall continue

to be governed by this Act notwithstanding that the number of persons

employed therein at any time falls below the limit specified by or under

this Act or the manufacturing process therein ceases to be carried on

with the aid of power.

Coverage

The ESI Act 1948 in the first instance, applies to:

Factories using power in the manufacturing process and employing 10

or more persons ,Non-power using factories or establishments

employing 20 or more persons for wages.

The provision of the Act are being implemented area wise by stages. The

Act contains an enabling provision under which the Appropriate

Government is empowered to extend the provision of the Act to other

classes of establishments--

Industrial Commercial Agricultural or otherwise

Contd..

Under these provisions State Governments have extended the

provisions of the ESI Act to the following classes of establishments:

Shops

Hotels & Restaurants

Cinemas, including preview theaters

Road Motor Transport Undertakings

Newspaper establishments

The ESI Act is applicable to over two lakh industrial units, across the

length and breadth of the country.

Contribution

Contribution is the amount payable to the Corporation by the principal

employer in respect of an employee and comprises the amount payable

by the employee and the employer.

The scheme is primarily funded by contribution raised from insured

employees and their employers in the implemented areas as a small but

specified percentage of wages payable to such employees.

The rates of contribution as of now are:-

Employees’ contribution-1.75 percent of the wages

Employers’ contribution-4.75 percent of the wages

Total-6.50 percent of the wages

Contd..

It is obligatory on the part of the employer to calculate and remit ESI

Contribution comprising of employers' share 4.75% plus employees'

share of 1.75% which is payable on or before 21st of the following

month, to the month to which the salary relates. If the employee is

drawing up to Rs.50/- as daily average wage, he is exempt from the

payment of his share of contribution. The employer is however to pay

employer's share of 4.75% of the salary received/receivable by the

employee.

The State Govt. bears one-eight share of expenditure on medical

benefits with in the per capita ceiling of Rs.1000/- per I.P. family per

annum.

Recovery of contribution

In the first instance the Principal Employer is to pay

employers' share of contribution in respect of every employee

whether employed directly or through immediate employer.

The employees' share may thereafter, be recovered by making

deduction from their wages for the wage period for which

contribution is, however is payable. No such deduction may

be made from any wages other than those relating to the

period in respect in which contribution is payable.

Exemption

The “Appropriate Government”, may grant or renew exemption under

section 87 of the ESI Act in respect of a Factory/Establishment or

class of factories or establishments in any specified area from the

operation of the Act for a period not exceeding one year at a time.

Exemption Under section 88 of the Act is granted by the “ Appropriate

Government” to employees, or class of employees, who remain away

from their Hqrs. for more than 7 months in a year, and those employees

who are posted in non-implemented areas.

Exemption under Section 90 can be granted to a

Factory/Establishment belonging to any local authority such as

municipality/Corporation, etc. if employees in any such

factory/Establishment are otherwise in receipt of benefits substantially

similar or superior to the benefits provided under the Act.

Wage Ceiling

Employees of covered units and establishments drawing wages up to

Rs.10,000/- per month (excluding remuneration for overtime) come

under the purview of the ESI Act, 1948 for multi-dimensional social

security benefits.

Social Security Benefits

Under ESI Scheme, the comprehensive and need based package of Social Security Benefits in Cash and kind include the following:

MEDICAL-BENEFITS:

Insured persons and their dependants are entitled to full medical care from day one of taking up employment in any factory or establishment covered under the ESI Act 1948. The comprehensive package includes primary medical care, specialists and diagnostic services, in-patient care with provision for all super specialist facilities. The scheme provides full range of medical care, namely;

Out-Patient services Diagnostic services Specialists services Hospital service through a network of ESI dispensaries & Panel clinics, diagnostic centers and ESI Hospitals.etcThe package covers all aspects of health care from primary to super-specialist facilities as detailed :

Contd..

Out patient treatment

Domiciliary treatment

Super- specialty treatment

Specialist consultation and diagnostic facilities

In-Patient treatment

Free supply of drugs and dressings.

X-ray and laboratory investigations

Vaccination and preventive inoculations

SICKNESS-BENEFIT (Section 49 of the

ESI Act)

Sickness Benefit is paid in cash to the insured persons to compensate their loss of wages in the event of sickness certified by an authorized medical officer. It is admissible for 91 days in an year and the cash benefit is equal to 50% of the wages.

ELIGIBILITY CONDITIONS FOR SICKNESS BENEFIT & EXTENDED SICKNESS BENEFIT

Not less than 78 days contribution in the relevant contribution period for sickness benefit and not less than 156 days contribution in 4 relevant contribution periods and eligibility for sickness benefit at least in one of these contribution periods and two years of service are essential eligibility conditions for Extended Sickness Benefit.

MATERNITY-BENEFITS

Maternity Benefit is admissible to insured women in the event of confinement or miscarriage etc. for 12 weeks and the rate of about 100 percent of the wages

DISABLEMENT-BENEFITS

Temporary Disablement benefit is paid in cash till the incapacity due to employment injury lasts at the rate of 70% of the wages. In case of permanent physical disablement due to employment injury or occupational disease, disablement benefit is paid for life at a rate proportionate to loss of earning capacity as determined by the medical board.

DEPENDANTS-BENEFITS

Dependants benefit is paid as family pension to the dependants of a

deceased insured person in the event of death due to employment injury

or occupational disease and is equivalent to about 70% of the wages.

OTHER BENEFITS

Funeral Expenses Rehabilitation Allowance Free Supply Of Physical

Aids Old age medical care Rijiv Gandhi Shramik Kalyan Yojana

Confinement Expenses

(Compensation Insurance)

PERSONAL INJURIES ACT 1963

The Personal Injuries (Compensation

Insurance)Act, 1963

An Act to impose on employers a liability to pay

compensation to workmen sustaining personal injuries and

to provide for the insurance of employers against such

liability.

Some definitions

Employer: "employer" includes any body of persons whether incorporated or not and any managing agent of an employer and the legal representative of a deceased employer, and when the services of a workman are temporarily lent or let on hire to another person by the person with whom the workman has entered into a contract of service or apprenticeship, means the latter person while the workman is working for that other person;

Contd..

"notification" means a notification published in the Official

Gazette.

"partial disablement" means, where the disablement is of a

temporary nature, such disablement as reduces the earning

capacity of a workman in any employment in which he

was engaged at the time the injury was sustained

disablement is of a permanent nature, such disablement as

reduces his earning capacity in any employment which he

was capable of undertaking at that time

Contd..

"total disablement" means such disablement whether of a

temporary or permanent nature, as incapacitates a

workman for all work which he was capable of performing

at the time the injury was sustained

"workman" means any person (other than a person whose

employment is of a casual nature and who is employed

otherwise than for the purposes of the employers trade or

business) who is employed in any of the employments

specified in section 3

Compensation payable under the Act

The workmen to whom this act applies are:

workmen employed in any employment or class of employment which is, or has been declared to be, an essential service.

the workmen employed in any factory as defined in clause(m) of section 2 of the Factories Act, 1948

workmen employed in any mine within the meaning of theMines Act, 1952(35 of 1952)

workmen employed in any employment specified in this behalf by the Central Government by notification.

By whom and how payable

These are payable by the employer in respect of personal injury sustained by a gainfully occupied person who is a workman to whom thisAct applies subject to such conditions as may be specified in the Scheme.

Compensation, in addition to any relief provided under the Personal Injuries (Emergency Provisions) Act, 1962 (59 of 1962.) is given Provided that where an employer has taken out a policy of insurance, as required by sub-section (1) of section 9, and has made all payments.

Contd..

The compensation payable under this Act shall be payable

in accordance with the provisions made in

If any person has a right to receive compensation (whether

in the form of gratuity, pension, compassionate payment or

otherwise)apart from Personal Injuries act then the right

shall extend only to so much of such compensation or

damages as exceeds the amount of compensation payable

under this Act.

Exemption of compensation

If the premium is due from the employee side or where by

the provisions of sub-section (1) of section 9 or of sub-

section (2) of section 10 the employer is not required to

insure, the Central Government shall assume and discharge

on behalf of the employer the employers liability to pay

compensation under this sub-section.

Amount of compensation

where death results from the injury, the amount payable in

a like case under the Workmen Compensation Act,

reduced by the value in lump sum of the amount payable

under the Personal Injuries.

where permanent total disablement results from the injury,

the amount payable in a like case under the

Workmen Compensation Act reduced by the value in lump

sum of the amount payable under the Personal

Injuries (Emergency Provisions) Act, 1962

Contd..

where permanent partial disablement results from the injury-

in the case of an injury specified in theSchedule-- such percentage of the compensation which would have been payable in the case of permanent total disablement as is specified therein as being the percentage of disablement;

in the case of an injury not specified in theSchedule--the percentage of such compensation specified in the Schedule for disablement held by a competent medical authority acting under the Scheme made under the Personal Injuries (Emergency Provisions) Act,

Contd..

where more injuries than one are sustained--

the aggregate of the compensation payable in respect of

those injuries, so however as not to exceed in any case the

compensation which would have been payable if

permanent total disability had resulted from the injuries;

PERSONAL INJURIES (COMPENSATION

INSURANCE) SCHEME

where temporary disablement, whether total or partial, results from the injury, the half-monthly payments payable in a like case under the Workmen CompensationAct, 1923 (8 of 1923), reduced in each case, so long as he receives any payment under the Scheme made under thePersonal Injuries (Emergency Provisions) Act, 1962 (59.of 1962), by the amount payable under the said Scheme.

(2) Where the monthly wages of a workman are more than five hundred rupees, the compensation payable under this Act shall be the amount payable under the provisions of sub-section (1) in the case of a workman whose monthly wages are more than four hundred rupees.

Contd..

The Scheme shall secure that any liability of the Central

Government as insurer under the Scheme is determined by a

policy of insurance issued in the prescribed form by a

person acting on behalf of the Central Government.

Contd..

The Central Government shall, by notification, put into

operation a Scheme to be called the Personal Injuries

(Compensation Insurance) Scheme whereby provision is

made for all matters necessary to give effect to the

purposes of this Act and whereby the Central Government

under takes, in relation to employers of workmen to whom

this Act applies, the liabilities of insuring such employers

against liabilities incurred by them to workmen under this

Act and the Scheme

Contd..

The Scheme may be amended at any time by the Central Government.

the Scheme may--

(a) make provisions regulating the payment of the compensation payable under this Act and the Scheme, including provisions for punishment by fine not exceeding two thousand rupees for the contravention of any requirement of the Scheme;

(b) make provisions specifying the persons to whom and the proportions and manner in which payments under this Act shall be made;

(c) make provisions for determining the value in lump sum of the amount payable under the Personal Injuries(Emergency Provisions) Act, 1962 (59 of 1962)

provide for the final assessment of the total premium due on a policy of insurance under the Scheme.

Compulsory insurance.

Every employer of workmen to whom this Act applies

or is subsequently made applicable, except an employer

whose total wages bill for any quarter after the

commencement of this Act has never exceeded fifteen

hundred rupees, shall take out a policy of insurance.

Employment of agents by the Central

Government.

The Central Government may by notification employ or

authorize the employment of any person to act as its agent

for any of the purposes of this Act and to pay to the person

so employed such remuneration as it may think fit.

Prohibition of certain insurance business.

After the date on which the Scheme is put into operation,

no person shall, except as a person authorised by the

Central Government as its agent to issue policies in

pursuance of the Scheme, carry on the business of insuring

employers in India against the liabilities for insurance

against which the Scheme provides.

MISCELLANEOUS

any person authorized in this behalf by the Central Government may require any employer to submit to him such accounts, books or other documents or to furnish to him such information or to give such certificates as he may reasonably think necessary.

The Central Government shall exempt any employer from the provisions of this Act on the employers request, if satisfied that he has before the commencement of this Act entered into a contract with insurers substantially covering the liabilities imposed on him by this Act, for so long as that contract continues.

Contd..

The Central Government may by notification make rules to

carry into effect the provisions of this Act.

THANK YOU