Employees’ State Insurance Scheme.

Administered by Employees’ State Insurance Corporation (ESIC).

ESI is the Social Insurance Scheme.

Mainly for Working Clause.

To all non-seasonal & seasonal Factories (manufacturing units) & establishments (non-manufacturing) employing 10 or more employees including Educational institutions and Private Medical institutions.For employees drawing wages up to Rs. 15,000/- per month (01/05/2010).

3.Benefits under the Act3.Benefits under the Act

Benefits under the ActBenefits under the Act

Benefits provided under the Act: Medical benefit Sickness benefit Maternity benefit Disablement benefit Dependents’ benefit

Benefits under the Act

1. Medical benefit :• Sickness of Insured employee or (where

medical benefits is extended to his family) a member of his family.

• Available to the employee right from the first day of employment,during any period for which contributions are paid in respect of him or in which he can claim sickness benefit.

Benefits under the Act 2. Sickness benefit :

• Sickness benefit is a Cash benefit.• Insured employees is entitled to receive for the period of

his sickness as the daily “standard benefit rate”.• Minimum 78 days of the corresponding contribution is

must.• Benefit is not available for the first 2 days of sickness.• Maximum period for benefit is 91 days in one year. Sickness benefit rate : The daily rate which sickness

benefit is payable to an insured employee during the period of his sickness is 70% of his earned gross wages.

Benefits under the Act 3. Maternity benefit : • Confinement, miscarriage or medical

termination of pregnancy,• Sickness arising out of pregnancy,

confinement, premature birth of child or miscarriage or medical termination of pregnancy.

• Minimum 70 days in the immediately preceding two consecutive contribution periods is must.

• Minimum period for benefit is 12 weeks and maybe extended up to 16 weeks on medical grounds.

Benefits under the Act 4. Disablement benefit :

• Permanent disablement, whether total or partial, as a result of an employment injury (personal injury caused by an accident arising out of and in the course of employment).

• Benefit for the whole of life.

Benefits under the Act 5. Dependants’ benefit :

• When an insured employee dies as a result of an employment injury, his widow, children and his widowed mother would get the dependents benefit. In case the employee does not leave behind him a widow or children, his other dependants, are entitled to receive periodical payments.

Benefits under the Act Funeral expenses :

• In case of death of an insured employee, the

eldest surviving member of his family, and if

the employee had no family or was not living

with his family at the time of his death, then

the person who actually incurs expenditure

on the funeral of the employee, is entitled to

receive a payment called “funeral expenses”.

• Maximum permissible amount of such payment is Rs. 10000/-

SUPER SPECIALITY TREATMENT

ESIC has Tied-Up with some private Hospitals to provide Super-Specialty treatment to the Insured persons and to their families

Both Cashless treatment as well as Reimbursement of Medical expenses is provided

ELIGIBILITY FOR SUPER SPECIALTY TREATMENT

For Self - Should have completed at least 3 months service and should have remitted contribution for 39 days.

For Family - Should have completed at least 6 months service and should have remitted contribution for 78 days.

Medical Benefits to Retired Insured Persons

The retired IPs (including voluntary and pre-mature retirement) who were insured for not less than five years are to receive medical benefits for the IP and spouse on payment of Rs.120 per year.

CHENNAIS.No Tie-up Hospital Name & Address

1Chettinad Super Speciality Hospital, Rajiv Gandhi Salai,

Kelambakkam, Kanchepuram-603103

2MIOT HOSPITALS,

4/112 MOUNT POONAMALEE ROAD, MANAPAKKAM, CHENNAI 600 089

3GLOBAL HOSPITALS & HEALTH CITY, No: 439,Cheran Nagar, Perumbakkam, Cennai 600 100

4Kauvery Hospital(A unit of Sri kavery Medical Care Ltd.,

Trichy), No.81, TTK Road, Alwarpet, Chennai-600018.

5SRM SPECIALITY HOSPITALS, SRM NAGAR, POTHERI,

KATTANKULATHUR, KANCHEEPURAM Dist-603 203

6Dr.Kamakshmi Memorial Hospital, Pallikarani, Chennai-

100

CHENNAI

S.No Tie-up Hospital Name & Address

7Dr.Kamakshmi Memorial Hospital, Pallikarani, Chennai-

100

8Dr.Kamakshmi Memorial Hospital, Pallikarani, Chennai-

100

9Frontier Lifeline Pvt. Ltd, R-30-C, Ambattur Industrial

Estate Road, Chennai-600101

10 Lakshmi Nursing Home, Pallavaram, Chennai-100

11Vasan Health Care Pvt.Ltd, Rk Salai, Mylopore, Chennai-

04

CHENNAIS.No Tie-up Hospital Name & Address

12Dr.Agarwal's Eye Hospital Ltd., Cathedral Road, Chennai

86

13MEDALL Health care Pvt. Ltd., Precision Diagnostics, No.

191, Poonamallee High Road, Kilpauk, Chennai-600010

14Aarthi Scans Pvt Ltd., 50, Paper mills Road, Perambur,

Chennai-11

15 Nephrolife Care (India) Pvt. Ltd. Kilpauk, Chennai-10

16PARVATHY ORTHO HOSPITAL,

NO.241,G.S.T.ROAD,CHROMEPET, CHENNAI –600044.

Employer should get factory/establishment registered online,

immediately on applicability of ESI Act to his unit.

Employer should get his employee including the employee

employed through the contractors registered online and T.I.C.

generated immediately after taking him in insurable

employment.

The employer should direct and pursue his employees to get photographed for Pehchan Card.

Employer has to maintain Accident book.

Maintain register of employees in form – 6 (reg.32)

Ensure maintenance of separate register of employees by

contractor and settle contractor’s bills only on production of

this register to esic. ( sec-41 (1-a)

Deposit both employee’s and employer’s contribution as per

specified rates within 21 days of the following month. {reg. 31}

Insure all employees by generating Ins no. through online

Facilitate proper inspection of records/registers and the

premises by visiting officers of ESIC as and when so required.

{ u/s 45}

Report promptly about the accident so as to enable ESIC to

provide benefit in time

FILL THE FORM-1.

GET THE INSURANCE NUMBER.

REGISTER THE INSURANCE NUMBER TO THE LOCAL DISPENSARY AND HAVE PHOTO SHOOT FOR PEHCHAN CARD. ARRANGE FOR FAMILY PHOTO.

IF EXPIRY DATE IS MENTIONED RENEW IT APPROPRIATE TIME.

INFORM THE ESI IN CASE IF THERE IS ANY ADDITION IN THE FAMILY MEMBERS.