The Employees' State Insurance Act, 1948 is a pioneer social insurance scheme providing medical care and cash benefits in cases of sickness, maternity, and employment injury.
1. ESI Administration
- ESI Corporation (ESIC): A high-power body comprising representatives of employers, employees, central/state governments, and the medical profession to administer the scheme.
- ESI Fund: All contributions from employers and employees are deposited into this fund, which is used to pay benefits and administrative expenses.
2. Six Core ESI Benefits
- Sickness Benefit: Periodical cash payments to an insured person in case of certified sickness (payable up to 91 days in a year).
- Maternity Benefit: Paid cash benefit during maternity leave (comparable to the Maternity Benefit Act).
- Disablement Benefit: Cash payment for employment injury (temporary or permanent).
- Dependents' Benefit: Periodical cash payment to dependents of an insured person who dies as a result of employment injury.
- Medical Benefit: Full medical care (outpatient, inpatient, specialist care) to the insured person and their family members.
- Funeral Expenses: Payment towards the cost of the funeral of a deceased insured person (currently up to Rs. 15,000).