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Under ESI Scheme, the comprehensive and need based package of
Social Security Benefits in Cash and kind include the following:
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Medical Benefits |
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The Scheme provides full range of medical care to Insured person and family, through a network of ESI Dispensaries & Panel clinics, diagnostic
centres and ESI Hospitals etc. Super speciality facilities are provided to the beneficiaries
through recognised advanced medical institutions empanelled for the purpose on referral
basis. The Corporation has set up a revolving fund in most of the States to ensure
smooth flow of funds for super-speciality treatment of ESI beneficiaries.
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Sickness Benefits |
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Sickness Benefit represents periodical
cash payments made to an IP during the period of certified sickness occurring in
a benefit period when IP requires medical treatment and attendance with abstention
from work on medical grounds.
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Maternity Benefits |
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Maternity benefit consists of periodical
cash payments in case of confinement or miscarriage or sickness arising out of pregnancy,
confinement, premature birth of child or miscarriage, to an insured woman as certified
by a duly appointed medical officer or mid wife.
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Disablement Benefits |
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Disablement benefit is admissible for disablement caused
by employment injury. At the first instance, temporary disablement benefit is payable
as long as the temporary disability lasts. If the employment injury results in partial
or total/permanent disability, permanent disablement benefit is payable till the
death of the insured person.
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Dependant Benefits |
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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.
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Funeral Expenses |
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Funeral expenses are in the nature of a lumpsum payment upto a maximum
of Rs. 5000/- made to defray the expenditure on the funeral of deceased
insured person. The amount is paid either to the eldest surviving member
of the family or, in his absence, to the person who actually incurs the expenditure on the funeral.
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Rehabilitation |
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Physical rehabilitation
Insured Persons who suffer physical disablement due to employment injury are provided artificial appliances
or other physical aids such as wheel chairs, crutches, dentures and spectacles etc.
vocational rehabilitation
The Corporation at its cost arranges for the vocational rehabilitation of disabled insured
persons provided the disability has been assessed at above 40 percent and the beneficiary is
not over 45 years of age. The training is provided at vocational rehabilitation centres run by
the Govt. of India etc. The fee charged or Rs.123/- a day whichever is more, traveling expenses
etc are borne by the Corporation
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Old Age Medi Care |
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Insured Persons who cease to be in insurable employment on account of
permanent physical disablement due to employment injury or those who leave
the insurable employment on attaining the age of superannuation are eligible
to receive medical benefit for themselves and their spouses. The benefit
is provided on payment of contribution in lump sum for one year at the rate
of Rs. 10 per month in advance.
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Medical Bonus |
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An insured woman and an Insured person in respect of his
wife shall be paid a sum of Rs.1000/-(Rupees one thousand
only) per case as medical bonus on account of confinement
expenses provided that the confinement occurs at a place
where necessary medical facilities under the ESI Scheme
are not available.
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