CHAPTER 1.

INTRODUCTION OF THE EMPLOYEES' STATE INSURANCE

SCHEME

The social security program Employees State Insurance Scheme under the Employees' State
Insurance Act, 1948, was launched by the then Prime Minister Pundit Jawaharlal Nehru on 24th
February1952 from Kanpur city. This scheme is applicable to workers of those power and non-
power run establishments having at least 10 workers in their factories and to the employees
whose monthly salary is maximum Rs 15,000 /-, under this scheme an employee state insurance
contribution of 1.75 per cent from the salary of workers covered by the scheme and 4.75 per cent
of salary of workers covered by employer per month is deposited in the account of Employees
State Insurance Corporation Government of India. Currently 1357146 insured persons are
associated with this scheme, and their families are being provided with medical facilities
through15 Employees State Insurance Hospitals and 94 Allopathic hospitals, 11 Ayurvedic and
11 Homeopathic clinics set up across various regions of the state.
It provides benefits in case of sickness, maternity and employment injury and to make provisions
for related matters. As the name suggests, it is basically an insurance ‘scheme i.e. employee gets
benefits if he is sick or disabled.
The Employees' State Insurance Act has been enacted to provide certain benefits to employees of
selected employments in cases sickness, maternity and employment injury and to make provision
for certain other incidental matters related to these benefits.

Contribution period is
(a) 1st September to 31stMarch
(b) 1st April to 30th September. The corresponding benefit period is
(c) following 1stJuly to 31st December
(d) Following 1st January to 30th June. Thus, benefit period ‘starts three months after the
contribution periods over. The relevance of this definition is that sickness benefit and

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 maternity benefit is available only during benefit period‘. Thus, an employee gets these
benefits only after 9 months after joining employment and paying contribution.

APPLICABILITY OF THE ESI ACT:

The ESI Act, (1948) applies to the following categories of factories and
establishments in the implemented areas: -
 Non-seasonal factories using power and employing ten (10) or more persons
 Non-seasonal and non-power using factories and establishments employing twenty (20) or
more persons.

The “appropriate Government” State or Central is empowered to extend the provisions of the ESI
Act to various classes of establishments, industrial, commercial, agricultural or
otherwise in nature.

Under these enabling provisions most of the State Governments have extended the
ESI Act to certain specific classes of establishments, such as, shop, hotels,
restaurants, cinemas, preview theatres, motor transport undertakings, newspaper and
advertising establishment etc., employing 20 or more persons.

Organisation:

As provided under ESI Act, the Scheme is administered by a duly constituted

corporate body called the Employees State Insurance Corporation (ESIC). It
comprises members representing Central and State Governments, Employers, Employees,
Parliament and the medical profession, Union Minister of Labour functions as Chairman of
Corporation where as the Director General, as its chief executive, discharges the duty of running
the day-to-day administration. A Standing Committee representing all stake holders is
elected from the body corporate for  managing the affairs of the scheme and
monitoring the progress of implementation of various corporate decisions and policies

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etc. from time to time. The Medical Benefit Council, a statutory body advises the
corporation on matters related to administration of medical benefit under the ESI scheme.
Infrastructure

The central headquarters of the Corporation is located at New Delhi. For purpose of
coverage, revenue collection, extension of the scheme to new classes of establishments,
implementation of the scheme in new areas, coordination’s the Corporation has established
Regional and Divisional Offices across the country mostly located in the state capitals. Given the
huge number of beneficiaries- about 354 laths now the Corporation has set up a widespread
network of service outlet for prompt delivery of benefits in cash kind that includes
full medical care.

Medical facilities are provided through a network of 1422 ESI Dispensaries, over
2000 Panel Clinics, 307 diagnostic centers besides 144 ESI hospitals and 42
hospital annexes with over 28000 beds. For providing super-specialty medical care the
Corporation has tie up arrangement w i t h a d v a n c e d m e d i c a l i n s t i t u t i o n i n t h e
c o u n t r y , b o t h i n t h e p u b l i c a n d p r i v a t e s e c t o r . T h e medical benefit is
administered with the active cooperation of the State Governments. The payment of cash
benefit is made at the grass roots level through as many as 825 Branch Offices and
Pay Offices that function under the direct control of the corporation.

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 CHAPTER 2
AMBIT AND THE SCOPE OF THE ACT

The Employees’ State Insurance Act, 1948 has been made application; -to various parts of India
gradually and in phases. In the first instance the Act was made applicable to the city of Delhi and
Kanpur in 1952. Subsequently it was extended to the various states and finally in the year 1970 it
was extended in India including the state of Jammu and Kashmir. At the same time power under
section 1(3) has been vested in the Central Government to enforce different provisions of the Act
in different states or in different parts of the same state by issuing notification from time to time'.
Although there has been lot of contentions from the employers and the other parties as regards to
this discretionary power of the Central Government to issue notification, yet in several leading
judgments the judiciary had upheld this power of Central Government as justified. Thus, the
contention of the parties that it is the violation of Article 14 of Indian Constitution is held to be
not tenable by courts especially for the administration of the scheme. Therefore, the discretionary
power granted to the Central Government under section 1(3) of the Act is held to the not at
example of excessive delegation rather it is a delegation which operates in the Act improper
perspective in order to ensure protection of interest of workers.

Coverage under the Act:

In the beginning, the Employees' State Insurance Act was made applicable only to perennial
factories using power and in which at least twenty or more persons were employed, subsequent it
was made applicable to all types of factories irrespective of the fact that power used in those
establishments or not. At present, the act applies to non-seasonal factories including those of
government using power and employing 20 or more persons. The Central Government proposes
to extend the Act gradually to various non-implemented areas. In any state where the scheme is
in progress it can be extended by it to such areas of the state where either the scheme is not being
implemented or the schemas in progress but administered from the adjoining areas.

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The Act empowered the appropriate Government to extend its provisions or any of them to any
other establishment or class of establishments, industrial or commercial, agriculture otherwise.
However, in that case the appropriate governments waste consult the corporation and, where the
appropriate governments the State Government to take an approval from the Central Government
and it has to give six months notice of its intention to do so through a notification in the official
Gazette, The appropriate Government means the Central Government in the establishments
under the control of Central Government and it a .in the remaining cases it means the State
Government.

The employees working in the factories establishments’ as mentioned above and in receipt of
wages not exceeding Rs. 1600 Cost per month are covered under the Act. While all those
employees whose salary exceed 1,600/- per month, or is a member of Indian Army. Navy or Air
Force are exempted from the provisions of the Act,
The term 'employee' includes all employees directly employed byte principal employer or his
agent on any work which is preliminary to the work carried on in or incidental to the work of the
factory or establishment.

Extension of E.S.I. Scheme to the Unorganized Sectors of Employment:

It is true that in India, there has been a lack of sufficient on measures to protects the interest of
welfare of the un organized laborer’s. Although legislative measures confer a good deal of social
security upon the organized workers in the country or they constitute only 10% of the total work
force. In reorganized sector, because of the employer employee nexus, it is possible to organize
and oversee the implementation of loose measures. However, in the rural and the unorganized
sector It is difficult to implement such schemes. Moreover, there is also the big problem of
finding adequate resources to finance schemes on a massive scale in a country like India. In the
advanced countries in Europe and America, the expenditure on social security as a percentage of
Gross Domestic Product varies from 20% to 30%, whereas in India, the percentage is just 2.5%as
has been observed by the working group on social security (1984).

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"It is clear that any large-scale enlargement of social security in India would entail a significant
allocation of financial resources for the purpose. On the one hand, it is unavoidable; on the other,
the cost of social security should as sustainable. Comprehensive social insurance on the line
those available in the industrialized or centrally planning economies will clearly not be feasible
on account of financial and administrative factors. As at present, all possible approaches viz.
amelioration, promotion of insurance and legislated employers' liability will have to supplement
social assistance from the exchequer. Given our population size, the law of large number enables
insurance schemes, provided that they are sufficiently comprehensive, to be based on low per
capita costs. This advantage of our situation needs to be made fully exploited.

In India, the Life Insurance Corporation of India has been offering the schemes of group
insurance to the unorganized and the rural sector since 1970. It has been able to bring many in
groups into its fold. They include milk producers, handlooms, weavers, rickshaw pullers,
assistants, safai Karma chari, school teachers, beady workers, fish farmers and the like mainly
through their co-operative societies and in some cases through the help of some state
governments. However, the largest achievement in this regard is perhaps the announcement of
the Government of India, in 1987 to implement a measure of social security through group life
insurance even to unorganized workers in the country. The scheme was brought into force in
August 15, 1987 with an object to cover nearly 3 cores of landless agricultural laborer’s.

In the absence of a comprehensive social security scheme in the country, the E.S.I. scheme
comes through various prepossessions put forward by planners and labour economists that it
should be extended to more areas of the uncovered sectors. The two committees viz. the E.S.I.
Review Committee, and the committee on perspective planning, 1972 of the E.S.I. Corporation,
made certain recommendations towards which direction the future policies of the scheme should
be directed.

The following were the text of the comments offered by the E.S.I. Review Committee, 1966, for
extending the scheme, the important consideration which we feel out to be borne in minds that
since the resources of the Corporation, Financial Administrative and Technical are limited, any
over ambitious planning for expansion may be self defeating. Hence priority must be given to

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extending the scheme to those groups of workers, who have no protection at all at present rather
than trying to cover those sectors which have some measure protection even if it is not quite
adequate.

The recommendations of the committee have almost been given effect to except a few. The
committee of 1966 further observed that the scheme should be extended to new fields
immediately in gradually. Since the recommendations concerning for immediate implementation
have almost been executed, the prior recommendations relating to gradual implementation are as
given: -

(i) The minimum number of persons required for coverage should be brought down to 5 or more
persons.
(ii) Mines and plantations, employing ten or more persons, whether or not power is used should
be brought under the scheme.

The committee on perspective planning, 1972, which was required inter alia to work out a viable
programmed for the phased extension of the scheme supported by the perspective planning in
respect of wages and means, also considered the question of extension of the provision of the Act
in the light of changing developments.

The committee formulated the following criteria for deciding the strategy of extension of the
scheme to heterogeneous mass of wages earners:
(a) Needs for health protection,
(b) Feasibility of building up; or expanding viable medical facilities and
(c) Amenability of the establishments to enforcement by the corporation.

Consideration the above criteria the committee was of the view that the extension of the scheme
should follow the following new direction:
(a) In the first phase the factories running with power and employing 10 to 19 workers, factories
run without power employing more than twenty workers, and shops, theatre(including

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cinema),road motor transport establishments, newspaper establishments, hotels and restaurants
employing twenty or more workers are to be covered.

(b) The organized mines and plantations might be covered in the second phase. In matters of
mines and plantations, the committee opened that only cash benefit arrangements should be
provided since the medical benefit is already available to them free of cost.

(c) The committee suggested for extending it to unorganized sector in the third place, since no
accurate statistics were available about this sector. The first two recommendations of the
committee were already given effect to whereas the third them is yet to be implemented.
However, the ESI scheme is already applicable upon agricultural laborers provided they are
employed in a farm and the E.S.I. benefit provisions also exist. Besides, the contract and casual
labor employee in E.S.I. establishments have also been covered where suitable benefit provisions
are there and the establishment is covered under the scheme.

However, the Life Insurance Corporation of India has come to accept a new challenge of
insuring agricultural laborers of the unorganized sector. The scheme inaugurated by the prime
Minister of India in 1987, whereby the agricultural labourersmayin groups apply for insurance to
the extent of Rs. 1,000/- perlabour. The laborers should be in the age group of 18-60 years. The
premier for the first three years of Rs.10/- per laborer year has also been borne by the Central
Government. Besides this, various State Governments in co-operation with the life Insurance
Corporation of India succeeded in introducing social security insurance to the unorganized
workers. In addition tithe above, the L.I.C. also provides group insurance to beneficiaries under
Intensive Rural Development Projects up to assume of rs. 3,000/- to the age group of 18-60 year
with effect from1st April, 1988.

The E.S.I. Scheme has also been extended to cover building construction workers who belong to
the semi-organized/un-organized sectors in the Metropolitan Cities and Towns where the scheme
is already in force. So farther Delhi has obtained approval to extend the scheme to building
construction workers.

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 CHAPTER 3
ADMINISTRATIVE PROBLEMS IN PROVIDING E.S.I.
BENEFITS IN NEW AREAS TO THE BENEFICIARIES:

There is no difficulty for the E.S.I. Corporation to provide E.S.I. Benefits in the areas having
compact network of many industrial establishments. But in case of extension of the scheme in
rural areas where in Industrial establishment are generally scattered over wide areas, it is quite
difficult to provide E.S.I. benefits to employees working in such establishments. It will not be
feasible financially as well as in other respects for the corporation to set up local offices for such
establishments and if one local office is established for the service of a number of establishments
then, in that case also it cannot function effectively owing to the fact than will administer
benefits to the employers of the establishments scattered over wide areas. So, there can be two
proposals administration of benefits in such areas. One is that the E.S 0benefits may be
administered by the employer but in that case, there is likelihood that this arrangement may not
be approved the employees. The other proposals are that the joint committees of the workers and
the management may be created for the purpose of providing benefits to the employees. If
anyone or more proposed systems of administering benefits is accepted then in such a case
necessary amendment will be required to be made in section 94A of the Act.

Administrative structure: The E.S.I. Corporation

The Employees’ State Insurance Corporation, established on 15th October, 1948 is entrusted with
the administration of Employees’ State Insurance Scheme. The Corporation is autonomous one
and has all the features of a corporate existence. The corporation has a fund of its own and the
same may be expended for 'health, welfare, rehabilitation, re-employment of employees covered.

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The Constitution of the Corporation:

The corporation shall be comprised of the following persons the Board, namely

(a) The Minister of Labour in the Central Government, Ex-officio Chairman;

(b) The Minister for Health, Government of India, Ex-Officio Vice-Chairman;
(c) Not more than five members to be nominated by the Central Government of who at least
three shall be the officials of the Central Government;
(d) One person each representing each of the states in whinchat the Act is in force to be
nominated by the state Governments concerned;
(e) One person to be nominated by the Central Government to represent the Union Territories;
(f) Five persons representing employers to be nominated by the Central Government in
consultation with such organizations of employers as may be recognized for the purpose by the
Central Government.
(g) Five persons representing employees to be nominated by the Central Government with
consultation of employees' organization.
(h) Three persons selected by the parliament, and
(i) Two persons representing the Medical Profession after consultation with the Medical
Organization.

The term of the above members shall be for four years except the term of the Ex-Officio member
and members appointed under clause (a) to (e). However, a member shall hold the charge till the
Time of his successor's appointment. Any retiring member is also eligible for re-nomination or
re-election.

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Harmonization of Group Interest:

The total number of membership in the corporation is subject to changes in the number of states
newly brought under the operation of the scheme. At present the schemes has been operation in
15 states. However, there shall be only one nominee by the Central Government to represent the
Union Territories.
All these together may result in poor representation of the employers' and employees'
association. For following a standard, in the preparation of representation of the corporation, the
E.S.I. Scheme Review Committee observed "We feel that is necessary to remove the feeling of
representatives of me beneficiaries that they are not adequately represented of the corporation.
Taking note of all the factors we recommend that the employers, the employees and the
Government, including other interests should be represented in the ratio of respectively”.
Therefore, it is felt that a structural re-organization of the administrative set-up of the corporation
is an imperative need to be undertaken in the future.

The important duties which any State Government has to discharge under the scheme are
enumerated as below:
(a) Extension of the scheme under section 1(5);
(b) Nominating State representative for corporation;
(c) Nominating a representative on the Medical Benefit Counsel under section 10(1)(d);
(d) Providing Medical Treatment to the insured persons their family members;
(e) Constitution of Employees' Insurance Court under section 75;
(f) Exemption of the factories and establishments from provision of the Act;
(g) Constitution of Medical Board;
(h) Nominating representatives of the State Governments to the Regional Boards etc.

From the above, it is evident that the State Governance entrusted with many administrative as
well as executive action for the implementation of the scheme. The Health and the Labour
Departments are concerned in different degree with the execute affairs of the scheme.

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Besides the above two groups of social force and the participation of State Government, the
Central Government authorised to nominate five persons to the corporation of whom at least
three shall be officials of the Central Government. However, no specific qualification has been
prescribed forepersons to be appointed as Central Government nominees.

Scope of Corporation's Function:

The corporation has an executive officer, viz. the Director General, who will discharge all
executive functions except the functions which require endorsement by the corporation proper.
The following are some of the functions which along the corporation is empowered to decide.

1. Formulation of regulation and rules under section 97 of the E.S.I. Act and any amendments
thereto;
2. Any measures proposed for health and welfare of insured persons and for rehabilitation of
disabled insured persons.
3. Any dispute with the State Government proposed in referred to administration;
4. Any proposal to confer Medical Benefit to families;
5. Any proposal to set up hospital in the corporation;
6. Any proposal to grant exemption;
7. Any proposal to enhance benefits;
8. Any other matter which the corporation or its Chairman may direct to the standing committee
or the Director General to place before the corporation.

Apart from the matters mentioned above, the corporation which is the highest body for execution
of the scheme is empowered to take many other decisions on subjects not inconsistent with the
E.S.I. Act.
However, the Central Government at any time may dissolve the corporation if it appears to the
Government that the corporation has failed to carry on the works assigned to it.

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The Standing Committee:

The Standing Committee is constituted from among the members of the corporation. In the
standing committee, representation in given to members of all fields or interests in a manner
similar to that of a corporation. In fact, it acts as an executive body for the administration of the
E.S.I. Scheme subject to overall control of the corporation. Meetings of the standing committee
are held regularly to implement the decisions taken by the corporation with the help of the
subordinate staff. The committee supervises and controls the day to day workings of the E.S.I.
Scheme. The standing committee is constituted from, among the members of the corporation in
the manner discussed were under. The Chairman of the committee is nominated by the Central
Government. Three other members are also nominated by the Central Government. At the same
time the Central Government nominates three members representing such three states as may be
notified by it. Eight members of the standing committee are elected from the members of the
corporation, three out of which represent the employees, three that of employers, one is
representative of the medical profession and one is that of the parliament. The Chairman as well
as the representative or ore Central Government and the State Governments hold the office at the
pleasure of the Central Government. The elected members of the corporation hold the office for a
period of three years from the date of the notification of their election in the official Gazette. As
soon as a person ceases to be a member of corporation, he automatically ceases to be a member
of standing committee as well.

Medical Benefit Council:

For advising the corporation in the matters of Medical beneficiary the E.S.I. Act provides for the
constitution of a Medical Benefit Council. The Council shall consist of the following the
members: -
(a) The Director General, Health Service, Ex-Officio as Chairman;
(b) A Deputy Director General, Health Services, to be nominated by the Central Government;
(c) The Medical Commissioner of the corporation as Ex-Officio.

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(d) One member each representing each of the state other than Union Territories in which this
Act is in force to be nominated by the State Government concerned;
(e) Three members representing employers to be nominated by the Central Government in
consultation with such organizations. Of employers as may be recognized for the purpose by the
Central Government;
(f) Three members representing employees to be nominated by one Central Government in
consultation with such organizations the employees as may be recognized for the purpose by
the Central Government; and
(g) Three members of whom not less than one shall be a woman. Representing the medical
profession, to be nominated by the Central Government in consultation with such organization of
medical practitioners as-may be recognized for the purposely the Central Government.

According to E.S.I. Corporation Annual Report of 1987-83, there were in all 32 members in
Medical Benefit Council.

Functions:

The Medical Benefit Council is a specialized set-up to advise the Government on health matters
relating to the administration of medical benefit, the clarification for the purpose of the grantor
benefits and other concerned matters. It also looks into the complaints against medical
practitioners in connection with the medical treatment and attendance.

It also advises the corporation in regard to the scale and nature of medical benefit to be provided,
the nature and extent of medicines, staff and equipment required, the medical formulated medical
statistics, returns, registers and other medical records, measures for improvement of health and
welfare insured persons and the rehabilitation and re-employment of disabled or injured persons.

The Medical Benefit Council performs advisory functions in matters of health care and
maintenance of standards of medical care. The nature of the Medical Benefit Council, however,
necessitates the association of more medical personnel in its membership. Commenting on it the

P a g e | 14
Review Committee, 1966, made the following observation, "We think that the Central
Government
Should in addition have powers to nominate on the council for medical experts who may be
specialists in medicine, chest, surgery, orthopedics and indigenous system of medicine.

Composition of the corporation's standing committee and the medical benefit

council
Representative Corporation Standing Committee Medical Benefit
Organ Council
Central Government 7 4 3
State Government 20 3 20
Union Territories 1 - -
Employers 5 3 3
Employees 4 3 3
Medical Profession 2 1 3
Parliament 3 1 -
Total 42 15 32

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 CHAPTER 4
REGIONAL BOARD

The Employees' State Insurance Act, 1948 does not itself prescribe for the constitution of
Regional Board, Local Committees and Regional and Local Medical Benefit Councils.
However, the Act has suitably empowered the corporation to associate the opinion of such
private bodies whenever there inane such need. The E.S.I. Regulation, 1950, provides for
constitution of such delegated forums with limited power and authority.

According to the Employees' State Insurance (General) Regulation. 1950 which empowers the
Chairman of the corporation to set of Regional Boards for any areas considered appropriate by
him. Regional Board shall consist of the following.

a) A Chairman to be nominated by the Chairman of the corporation in consultation with the state
government or the administration of the Union Territory;
b) one representative of each of the other states; if any, included in the area to be maintained by
the state government concerned;
c) The Director of the Health Services of the States concerned;
d) such number being not less than two and not more than five of the employee’s representatives
as may be considered appropriately the Director General;
e) an equal number of employee’s representatives to be nominated by him in consultation with
their representative organizations recommended by the state concerned for the purposes;
f) the Regional Director or Officer In-Charge of the Regional Office Ex-officio who shall act as
Secretary to the Board.
With regard to the Constitution of the Regional Boards, the Regulation provides for the
nomination of one representative each of the employers and the employees from each of the
states in the area covered under the jurisdiction of the Regional. Board. The Regulation also
provides that the Chairman of eve corporation, if considered to be expedient, may nominate such
representatives of the employers and employees, not exceeding three from each side, with a view
to providing for adequate representation of important organizations not included in the

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nominations of the State Government concerned and are maintaining the parity between the
number of representatives of employers and employees.

Function of the Regional Boards:

The function of the Regional Boards is to maintain liaison among the various groups viz. the
corporation, its officers, one office of the employers, employees and the insured persons. It
performs advisory functions and may also recommend to one Director General, any changes
which may in its opinion be advisable in the regulation, the forms and the proceedings.

The regulations specify that the Regional Boards shall perform the following functions in respect
of the region for which it is set up.

(a) Such administrative and/or executive functions as May, from time to time be entrusted or
delegated to by a resolution, by the corporation or the standing committee;
(b) Making recommendation from time to time in regard to changes, which may in its opinion be
advisable in the Act, Rules and Regulations and forms and procedures to do followed in the
functioning of the scheme.
(c) Referring such complaints as it may consider necessary, note Director General with its
recommendations;
(d) Advising the corporation on such matter as may be offered to it by the standing committee or
the Director General.

However, if the Regional Board fails to perform its duties, the same may be superseded by the
corporation. It is significant to notice that the Regional Boards are required to obtain prior
approval from the Director General before taking up any matter for discussion. The prior
approval of the Director General very much limits the sphere of the functions of a Regional
Board.

According to the Annual Report of the E.S.I. Corporation1987-88, at the close of the year 1987-
88, 19 Regional Boards have been constituted. The number of meetings of such Regional Boards

P a g e | 17
Have also increased considerably in contrast to many previous years.

Local Committees:

The amendment to the E.S.I. Regulation in 1955 brought about a change by providing for
constitution of Local Committees consisting of representatives of the State Government, the
corporation, the employers and the employees with powers to co-opt a representative of the
Insurance Medical practitioner] in areas where the panel system is followed.

Constitution of Local Committees:

Regulation 10-A of the E.S.I. (Central) Regulation provides that a local committee may be set up
by the Regional Board and shall consist of the following members:
(a) A Chairman to be nominated by the Chairman, Regional Board
(b) An official of the state to be nominated by the State Government;
(c) The Administrative Medical Officer In-Charge of the scheme in the area concerned, Ex-
Officio, or any other Medical Officer nominated by him;
(d) Such number not being less than two and not more than four, or representative of employer in
the area as may be considered appropriate by the Chairman, Regional Board, to be nominated by
him, in consultation with such employers' organizations as may be recommended for the purpose
by testate Government ;

(e) An equal number of representatives of employees in the area to be nominated by the

Chairman, Regional Board, in consultation with the organization’s employees as may be
recommended for the purpose by the State Government;
(f) An official of the corporation to be nominated by the Director General who shall also act as
the Secretary to committee.

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Sub-section (9) to section 10-A lays down the functions of local committees as follows.
(a) To discuss local problem in regard to the scheme, to secure its efficient working with the full
co-operation of all the parties concerned and make recommendations;
(b) To refer such complaints as it may consider necessary the Regional Director concerned or in
the case complaints concerning Medical Benefit, to the State Government or such authority, as
the Government may nominate for the purpose; and
(c) To advise the corporation or the Regional Board on such matters as may be referred to it for
advice.

As per the E.S.I. Annual Report of 1987-88, at the close of year, 265 local committees were in
position throughout is country under Regulation 10-A of the E.S.I. (General) Regulation1950.

P a g e | 19
 CHAPTER 5
ORGANIZATIONAL SET UP

The organizational set-up of the corporation is composed of various functionaries both at the
Apex and the field level, the first of its being the Headquarters which is headed by the supreme
executive called the Director General of the corporation.
The Director General along with other four officers namely, one Insurance Commissioner, the
Medical Commissioner, the Chief Accounts Officer and the Actuary are called the Principal
Officers of the corporation. Thus, the whole of the E.S.I. staff is divided into two types (a) the
Principal Officers and the (b) Staff.

(a) The Principal Officers and their Functions:

The Chief Executive Officer of the scheme known as the Director General is the head of the
Headquarters Office. The Director-General is required to supervise, co-ordinate and control the
work of all other Principal Officers. He has to call meetings of the corporation, standing
committee and the Medical Benefit Council under the direction of the Chairman and in
accordance with the Act and he has to implement the decisions taken in the meetings. He is
required to enter into contracts on behalf of the corporation in the manner prescribed under the
Act or in accordance with general or special instructions of the corporation or the standing
committee, as the case may be. He has to furnish all returns and documents as required under the
Act, Rules and Regulations. He has to correspond with the Central Government and the various
State Governments on behalf of the corporation

(b) Insurance Commissioner:

The Insurance division is headed by the Insurance Commissioner. The Insurance Commissioner
is sub-ordinate to and works under the control and supervisions of the Director General. He haste
establishes insurance and regional offices for the administration of the scheme provided under
the Act. He is required to inspect, supervise and to investigate all complaints referred to him byte

P a g e | 20
Regional Boards or the Local Committees and to exercise such powers and to discharge duties
delegated to him from, time to time.

(c) Medical Commissioner:

The Medical Division is headed by a Medical Commissioner. The Medical Commissioner is a
professional and one of the principal officers of the corporation. The Medical Commissioner is
also sub-ordinate to the Director General and works under his control and supervision. He has to
supervise control and co-ordinate the working of the medical organizations of the corporation.
He hastes advice the corporation in regard to construction of the hospitals, and the dispensaries.
He has to suggest measures for improving health conditions in the areas where the Act is enforce
and to inspect hospitals, dispensaries, clinics, and other institutions where medical treatment and
the benefits under the Act are provided to the insured members and their dependents either by the
State Government or the corporation as the case may be. He has to give expert opinion regarding
the adequacy of medical treatment provided by the factories or establishments applying for
exemption. He has to investigate complaints made byte insured persons with regard to medical
benefits. He is required to conduct medical research in accordance with one directions of the
Medical Benefit Council. It is the lookout of the medical commissioner to ensure adequate
arrangement for providing medical benefits to the insured persons and their family members.

(d ) Chief Accounts Officer :

The next division is the Accounts and Finance Division which is headed by Financial Adviser
and Chief Accounts Officer, who is one of the Principal Officers of the corporation. The Chief
Accounts Officer is sub-ordinate to the Director General and works under his control and
supervision. He has to maintain Accounts of the corporation and is required to comply with
accounts by collecting the returns from the Central as well as regional areas. He has to prepare
the budget of the corporation and to arrange for the internal audit of the Accounts of the Central
as well as the Regional Offices. He has to make recommendations for the investment of the
funds of the corporation. He has to exercise all such powers and to discharge such duties as are
delegated by the corporation from time to time

P a g e | 21
(e ) Actuary :

The fourth division under the corporation is known as the actuarial division. The division is
headed by another Principal Officer known as actuary. The actuary also works under the control
and supervision of the Director General. He has to collect, compile and analyze statistics with
regard to working of the corporation and has to advise the Director General of all actuarial and
statistical problems relating to the working of the corporation. He has to detect and to prevent
successive claims made by the insured persons and their dependents. He has to exercise
discipline in financial matters thereby protecting interests of both the corporation and the
claimant.

P a g e | 22
 CHAPTER 6
NATURE AND EXTENT OF BENEFITS

As a comprehensive Social Security Scheme, E.S.I. Act, extend various kinds of benefits to the
insured person. The statue benefits provided under the scheme are namely, medical benefit
sickness benefit, disablement benefit, maternity benefit dependent benefit and the funeral benefit.
Apart from the benefits, the E.S.I. has scheme for some other miscellaneous benefits, like the
payment of coverage allowances, remittance cash benefits by money order at the cost of
corporation or so on. Out of the benefits, the maternity and the sickness benefits require
fulfillment of qualifying conditions and necessary contribution must have been paid during
appropriate contribution period. However, the medical benefit, available to an employee from the
first day of his joining service.

The Medical Benefit:

The Medical Benefit under the corporation is payable in the form of medical treatment and
attendance on insured persons and their dependents, and includes consultation, dispersion,
diagnostic investigational construction, hospitalization and domiciliary visit. Medical care
benefit may be provided to the beneficiaries either in the form of outpatient treatment in the E.
S.I. dispensary, hospital or any other institution or as an indoor patient in a hospital or an
institution of either the E.S.I. Corporation or the concerned State Government. Outpatient
medical treatment may be provided to the beneficiaries under the E.S.I. Scheme either through
the E.S.I. dispensaries established under the scheme for the exclusive treatment of the insured
persons and their families or through a panel of private medical practitioners approved under the
panel system to Act as panel doctors. Panel doctors are required to have their own consultation
rooms and dispensaries and they are required to maintain minimum prescribed standard with
regard to medicine and the other instruments. Each panel doctor is permitted to have with him
750 family units or less than that on his patients ‘list. A panel doctor is expected to give ordinary
medicines to the insured persons and their dependents from his clinic and special medicines are
prescribed by him and these are to be obtained by the beneficiaries from approved chemists who

P a g e | 23
are directly paid by E.S.I. Corporation or the concerned authorities. Presently panel system is
operating in West Bengal., Gujarat, and Maharashtra etc. Since December 1977, the condition
with regard to entitlement of family members of the insured persons for medical care has been
relaxed and the families of the insured persons, who were previously entitled to medical care
benefit after a period of thirteen weeks from the time when insured person become entitled to it,
are now entitled to medical care benefit without waiting period. "Medical care benefit of only
one kind and on such scale as is provided by testate Government or the corporation may be
claimed by the insured person or his family members”.

An insured person or his family shall not have a right to claim any medical treatment except such
as is provided by ere dispensary, hospital, clinic or any other institution to which he or his family
is allotted. An insured person or his family members shall be entitled to claim reimbursement
from one corporation of any expenses incurred in respect of any medical treatment in accordance
with the prescribed regulations. Infect the Act does not prescribe any scale of medical benefits of
the extent of reimbursement of claims for medical treatment and those the State Government or
the corporation, as the case may be, the empowered to decide about the scale of medical care
benefits admissible to the beneficiaries. At the same time a liability is imposed on the State
Government to provide reasonable standard of medical, surgical, obstetric treatment facilities to
the beneficiaries. The State Government in consultation with the corporation make proper
alternative arrangement for medical treatment of the beneficiaries at the clinics of panel doctors
in areas where there is no E.S.I. dispensary. The corporation incompetent to enter into agreement
with any local authority, private body, or individual for the purpose of providing medical
treatment and attendance to the insured person and their family members. The corporation in
consultation with the Scare Government may undertake the responsibility of providing medical
care benefit to the insured persons and beneficiaries and in that situation, it will be the
responsibility of the concerned State Government to provide facilities of medical care to those
Since 1980, after necessary modifications, medical care benefit provided to the families of the
insured persons have often conveniently divided into three categories as discussed below:

P a g e | 24
a ) Restricted Medical Care :
It consists of outpatient medical care which is provided to the beneficiaries either at E.S.I.
dispensaries or by the panel doctors. In addition to these, pre-natal and post-natal care,
consultation and immunization services are also available to the beneficiaries as outdoor patients.
In serious cases the doctors are required to visit the place of residence of the insured
person in order to provide medical treatment to one beneficiaries.

b) Extended Medical Care :

Under the extended medical care facility, in addition to outdoor patient, the beneficiaries are
entitled to consult specialist -and they can get special medicines prescribed by the specialists.
Beneficiaries are also entitled to available facilities of X-ray examinations and pathological
laboratory. Therefore, it can be said that under the category of extended medical care facilities,
outdoor patient treatment overspecialized nature is provided to the beneficiaries in case of
prolonged or chronic disease.

c ) Full Medical Care or Indoor Patient Treatment :

Under this category hospitalization facilities are provided to the beneficiaries who include indoor
treatment along which specialists' services, drug and diet as required by the patient. Under this
facility, an insured person or his family members can remain in the hospital for getting medical
treatment for period which the doctors deem proper, and until he recovered from the disease
from which he is suffering.

Cash Benefits:
The E.S.I. scheme in its essence is a small measure fulfilling minimum requirement of the
working community who are faced with myriad of insecurities during work life. However, this
ensures minimum safety to the workers especially in view of the fact that labour welfare, in its
diverse form, is not compulsory with the exception of a few organized employments. The
following are the statutory cash benefits available under the scheme of E.S.I.

P a g e | 25
a ) Sickness Benefit :
Sickness has been defined as a condition which requires medical treatment and attendance and at
the same time necessitates abstention from work of an insured employee on medical ground. In
case, sickness is certified by any approved authorized doctor any medical practitioner authorized
by the corporation, person becomes entitled to get sickness benefit for a period fifty six days as
provided in the Act but the E.S.I. Corporation by exercising its power under section 99 of the Act
has enhance the duration of sickness benefit to ninety one days in a year. Sickness benefit is not
payable for the first two days unless the spell of sickness follows the last spell within a period
Fifteen days. Therefore, a person shall not be qualified claim sickness benefit in two consecutive
periods after a period of more than fortnight from the earlier sickness for which sickness benefit
was paid and the maximum duration of payment sickness benefit is ninety one days in any two
consecutive periods. Benefit rate is roughly equivalent to fifty percent of the average daily wage
of an insured person.

An insured person suffering from any long term disease specified in schedule III of the Act is
entitled to extended sickness benefit after exhausting the sickness benefit of ninety one days .for
a further period of one hundred and twenty four days or three hundred and nine days as the case
may be depending upon the nature of the disease and its duration provided that the insured
person has been in continuous service for a period of at least two years or more in the same
factory or establishment. The extended sickness benefit is payable at a higher rate of sixty two
and half percent of average daily wage. An insured person is entitled to get extended sickness
benefit from the E.S.I. Corporation on the recommendation of the Medical Benefit Council
which examines the case of an insured employee claiming extended sickness benefit from time to
time. Enhanced sickness benefit at the rate of hundred percent average daily wage is also
provided to the insured employees who are otherwise eligible to get ordinary sickness benefit, in
case they undergosterilisation operation for family planning. The sickness benefit in such cases is
ordinarily payable for a period of seven days if they undergo vasectomy and up to a period of
fourteen days for tubectomy. The benefit is extended in case post operative complications
continue for a period more than the period mentioned above and in that case the sickness benefit
period is also extended accordingly. Therefore, it may be said that the sickness benefit can be

P a g e | 26
claimed for ordinary diseases as well as in the form of extended sickness benefit in case of
chronic diseases as specified in the third schedule. Another interesting aspect of this benefit is
that the concerned employee may seek sick leave from his/her employer and the same is not
barred by the Act.

(b ) Maternity Benefit :
Maternity benefit is payable to an insured woman employee for a period of 12 weeks, of which
not more than 6 weeks shall precede the expected date of confinement, and six weeks after the
actual day of delivery. Though the qualifying condition for the entitlement to maternity benefit is
the same as in the case of sickness benefit but it has been subjected to an additional provision,
that at least one contribution has been paid between thirty five and forty weeks before the week
in which confinement takes place or in which the notice of pregnancy is given before the
confinement. Of course, the pregnancy should last at least for a period of 26 weeks and not less.
The miscarriage after 16 weeks or the delivery of a dead child will be considered a condition of
maternity. A woman employee to be eligible to claim the benefit should produce a certificate
from her insurance medical officer indicating the confinement or expected confinement. The
benefit is payable from the date from which to is claimed provided that such a date does not
precede the expected date of confinement by more than 42 days. A women employee shall not
undertake any work for remuneration anywhere or she shall render herself ineligible for benefit.
The rate of benefit is double the rate of the standard benefit.

(c) Disablement Benefit:

Disablement means disability or incompetency of a person to do work or to discharge his duties
at the place of employment. Disablement may be of temporary or permanent nature. A person
who sustains temporary disablement arising out of employment shall be entitled to get
disablement benefit in the form of periodical payments provided that such disablement continues
for not less than three days excluding the day of occurrence of the accident. Payment for
disablement in the form of benefit, is to be made in accordance with the rates prescribed in first
schedule A person who sustains permanent disablement either total, or partial will get the benefit

P a g e | 27
if it has been assessed either provisionally or finally either for a limited period or for life the
case may be. If an insured person suffers from temporary disablement arising out of employment
injury, he would be entitled to get disablement benefit at the rate of about seventy percent of the
daily average wages for the whole period during which the injured person suffers from
temporary disablement and provided that it is certified by the insurance medical officer or panel
doctor that the insured person has not worked during that period for wages. This benefit is
payable to the insured person irrespective of any condition of number of contributions paid by
him. Rate of periodical payment is determined only when the permanent disablement is certified
as final. If a person is insured under the Employees' State Insurance Act, 1948, then neither he
nor his dependents shall be entitled to recover any compensation or damages under the
Workmen's Compensation Act, 1923. In case of occupational diseases, the person concerned is
also eligible for compensation provided he was employed for a period of six months preceding
the date of discovery of such disease.

The duration for which disablement benefit is paid is co-terminus with the disability caused by
the accident. Thus, so long as the worker is not fit to work, he may go on drawing disablement
benefit. However, in case of temporary disablement, no payment is payable if the injury lasts for
less than three days excluding the day of injury. In case of permanent disablement, the payment
is for life time, unless it is reviewed. Further, in case of permanent disablement the rate of benefit
will be in proportion to the degree of such disability as determined by the medical board.

d) Dependents Benefit:
An unemployment injury resulting in the death of an employee makes the scheme liable to pay
dependents' benefit to the dependents of that employee. The dependents include wife children,
father, and mother of the deceased. The percentage of dependents' benefit and its continuation
varies with the dependents’ drawing the benefits. The widow for life or until her re-marriage -
equivalent to three/fifth (3/5) of the full rate.

The total amount of the dependents’ benefit payable to all the dependents is limited to the full
rate and if it exceeds the full rate, the share of dependents are proportionately reduced so that the

P a g e | 28
total amount payable to them does not exceed the amount of disablement benefit at the full rate.
The full rate is 25% more than the daily standard benefit rate.

In case the deceased is left with children at the time of his death, the benefit rate becomes, to all
legitimate or adopted children an amount equivalent to two/fifth (2/5) of full rate until they attain
18 years of age or until the marriage of girls, if it is earlier.

If a person does not leave behind a widow or legitimate children, dependents' benefit shall be
payable to a parent or grandparent or any other dependents at such rate as may be decided by the
commissioner appointed under the workmen’s compensation act.

(e ) Funeral Benefit:
The benefit comprises the payment towards the expenditure on the funeral of an insured person.
The sum of benefit payable to the eldest surviving member of the deceased person's family. In
case the insured person did not have a family or was not living with his family, then the benefit is
payable to the person who actually pays the expenditure of the funeral.

A claim for the payment of benefit must be made within three months of the death of the insured
person or within such period as allowed by the corporation or an officer or an authority of the
corporation authorized to do so. The amount currently available under the scheme is its. 1,000/-.

(f) Rehabilitation Benefit:

The Rehabilitation Benefit has been introduced since 1st January, 1980. The Rehabilitation
Benefit is intended to grant Rehabilitation Allowances to the insured persons for each day on
which they remain admitted in the Artificial Limb Centre for fixation or repair or replacement of
the "Artificial Limbs" on the rates which generally confirm the sickness benefit rate as specified
in the resolution of E.S.I. Corporation. The rate of Rehabilitation Allowance is same with the
sickness benefit rate

P a g e | 29
 CHAPTER 7
FINANCIAL RESOURCES OF THE CORPORATION

Contribution:

The Employees' State Insurance Scheme is of contributory nature so employers as well as their
employees are required to the contributions under this scheme. Those employees whose detail
wages are rupees six or less than that are exempted from paying contribution but at the same
time they are entitled to such benefits admissible under the scheme. Contribution is the sum of
money payable to the corporation by the principal employer in respect of an employee and
comprises the amount payable by the employee and the employer (employees contribution will
be 2.253 of the wages while the employer’s contribution will be 53 of the wages paid/payable in
respect of every wage period).

The definition of wage is given under the Act as all remuneration paid or payable in cash to any
employee if the terms of his contract of employment express or implied were fulfilled and it
includes any payment to an employee in respect of any period of authorized leave, strike which
is not illegal, lock out or lay off and other additional remuneration, if any paid at intervals not
exceeding two months.

Wage Period:
Every contribution is payable in respect of a wage period. And a wage period may be of daily,
weekly, fortnightly or monetarily determination. However, no wage period shall exceed more
than a month which is the statutory maximum fixed under payment of wages Act

Calculation of Contribution Payable:

The employees' contribution and the employers' contribution have been delinked from each other
and contribution is now to be paid as a fixed percentage of wages, i.e. each employee's

P a g e | 30
contribution for every wage period will be calculated @ 2.258 of his wage rounded to the next
higher multiple of 5 paisa and the employer's contribution will be calculated @ 5% of the total
Wage bill of all the employees in respect of every wage period, rounded to the next multiple of 5
paisa. No employee's contribution shall be payable in respect of a person whose average daily
wages are below Rs.6/- in any wage period. The detailed rates of contribution together with the
corresponding standard benefit rates have been mentioned in Table No. 4.2. Average daily
wages’ for this purpose would be the wages payable for a wage period divided by 26, 13, 6 or 1
accordingly as the wage period of a person is a month, a fortnight, a week or a day respectively.

Governmental Contribution:
The Central Government as well as the various State Governments exercise extensive control
over the day to day functioning of the corporation but the financial contribution made by them is
Quite meager in comparison to the population of working force to which the corporation extends
benefits. The Central Government used to contribute only at the initial stage of the creation of
the E.S.I. Corporation and now they are not contributing anything for the working of the scheme
and at the same time the concerned State Governments are contributing only the eighth share in
the cost of medical expenses under the scheme.
A provision has been made in the Act for the institution of special machinery in the form of the
Employees’ State Insurance Scheme.

P a g e | 31
 CHAPTER 8
RATE OF CONTRIBUTION AND DAILY STANDARD BENEFIT
RATE UNDER E.S.I. SCHEME
Group of Employees weekly Employer’s Total weekly Corresponding
employees whose contribution(Recov weekly contribution(Employers daily standard
daily wages are erable from contributio and Employees benefit rate
employees) n contribution)
1.Below Rs 6/- Nil 5% 5% Rs. 2.00
2.Rs.6/- & above 2.25 5% 7.25% Rs. 3.00
but below Rs/.8
3.Rs.8/- and Do 5% - Rs. 5.00
above but below
Rs.12/-
4.Rs.12/- and Do 5% - Rs. 7.00
above but below
Rs.16/-
5.Rs.16/- and Do 5% - Rs. 10.00
above but below
Rs.24/-
6.Rs.24/- and Do 5% - Rs. 15.00
above but below
Rs.36/-
7.Rs.36/- and Do 5% - Rs. 20.00
above but below
Rs.48/-
48.5%Rs.48/- and Do 5% - Rs. 25.00
above

Court, for adjudication of claims and disputes. The purpose of constitution of the E.S.I. Court is
to ensure speedy justice in case of dispute relating to matters covered by the scheme. Thus the
jurisdiction of Civil Court has been barred.

P a g e | 32
The State Government is empowered, to constitute the E.S.I Court with declaration of its
operational area. There may however, be more than one Court in one State. The E.S.I. Court
decides questions of disputes arising in connection with insurability of the right and the amount
and the duration of benefit, etc. Other matters which also fall in the purr-view of the E.S.I.
Courts are:

(i) Claim for the recovery of contribution ;

(ii) Claim for compensation against the employer or other persons liable thereto; or
(iii) Claim for recovery of benefit or for refund of benefit unlawfully drawn.

The E.S.I. Court may decide the following questions:

(1)If any question of dispute arises as to –

(a) Whether any person is employed within the meaning of this act or whether he is liable to pay
the employees contribution; or
(b) The right of any person to any benefit and as to the amount and duration thereof; or
(c) The person who is or was the principal employer in respect of any employee; or
(d) Any direction issued by the corporation under section 55 in a review of any payment of
disablement or dependents benefit, etc.

2. The following claims -

(a) For the recovery of contribution from the principal employers;
(b) By a principal employer to recover contribution from any immediate employer;
(c) Any claim for recovery of any benefit admissible under this Act;

All such matters shall be decided by the E.S.I. Court. The E.S.I. Court shall have all the powers
of a Civil Court for the purpose of summoning witness, production and discovery of documents
and administering oath and recording evidence. No appeal shall be made against the decision of
the Court on the question of fact. However, if substantial question of law is involved an appeal
shall lie in the High Court.

P a g e | 33
Thus, it can be seen that the Employees ‘State Insurance Scheme’ is the minimum programmed
of fulfilling all the basic needs of the underprivileged employees who are exposed to various
hazards in industrial life. In spite of its several limitations, it must, however, be admitted that the
scheme is unique in its object and no other arrangement can be regarded as its substitute under
the existing set of arrangements. Except for the contract labour in certain selected areas, the
scheme has not, however, been extended to the unorganized labour in general. The
implementation of the scheme is the joint responsibility of the E.S.I. Corporation and the
respective State Government. However, the Central Government is also endowed with control
over the scheme to some extent. The corporation has its own hierarchy of administrative set up
aided by State Medical Personnel whose services are usually drawn on. Deputation. Apart from
the Board of Directors of the Corporation, the Standing Committee and the Medical Benefit
Council are the two powerful bodies which constantly guide and monitor the implementation of
the scheme. Besides these, the Regional Boards and the Local Committees are the other aiding
organization at the local level of the corporation. The various benefit available under the scheme
have been spelt out or the Act and the Regulation with a little variation in respect of
Medical Benefit only. The fund of the corporation is raised and recurring contribution of the
employees, employers and the State Government (i.e. l/8th share towards the cost of Medical
Benefit).

CHAPTER 9.
DATA ANALYSIS AND DATA INTERPRETATION

P a g e | 34
Q.1) Do you have any type of Insurance Policies?

42%

58%

Yes No

Data analysis:
Yes 42 %
No 58 %

Data interpretation:

For this above given data we can interpret that 42% of people from the 50-sample people have
Insurance policies because it is compulsory and 58% of people do not have policies for risk
exemption and not because it is compulsory.

Q.2) Have you heard about Employees State Insurance Scheme?

P a g e | 35
 33%

67%

Yes No

Data analysis:
Yes 67 %
No 33 %

Data interpretation:

For this above given data we can interpret that 67% of people from the 50-sample people have
Insurance policies because for their future benefits and 33% of people do not have policies for
risk exemption.

Q.3) How much percentage of people in India have their Insurance?

P a g e | 36
 1-25 % 26-50 % 51-75% 76-100%

8% 8%

33%

51%

Data analysis:
1-25% 8%
26-50% 51 %
51-75% 33%
76-100% 8%

Data interpretation:

For this above given data we can interpret that 51% of people in the category of 26-50% from the
50-sample people have Insurance policies 33% of people have policies for risk exemption in the
category of 51-75% and in the category of 1-25%& 76-100% have less insurance policies 8%.

Q.4) Awareness of ESI benefits Provide by the ESI?

P a g e | 37
 17%

33%

50%

Fully Aware Partially Aware Not Aware

Data analysis:
Fully aware 17 %
Partially aware 50 %
Not aware 33%

Data interpretation:

For this above given data we can interpret that 17% of people are fully aware of benefits
provided to employees in the company from the 50-sample people and 50% people are partially
aware of the benefits and 33% people are not only aware of the benefits given to the employees
in the company.

Q.5) From where did you came to know about the source of awareness of the
ESI benefits?

P a g e | 38
 Brochures Employees Newspaper Advertisement

8%

34%

50%

8%

Data analysis:
Brochures 8%
Employees 50%
Newspaper 8%
Advertisement 34%

Data interpretation:

For this above given data we can interpret that 50% of people from the 50-sample people came
to know about this ESI scheme through Employees working with them and 34% people came to
know through Advertisement and remaining % of people came to know through Brochures and
Newspaper ,Etc.

Q.6) Are you satisfied with the measures taken by the corporation for
providing information on the ESI Scheme?

P a g e | 39
 8%

24%

59%

8%

Extremely Satisfied Partially Satisfied Not Satisfied Cannot Say

Data analysis:
Extremely satisfied 8%

Partially satisfied 25 %
Not satisfied 8%
Cannot say 59%

Data interpretation:

For this above given data we can interpret that 50% of people from the 50-sample people are not
aware about this scheme and 25% people are partially satisfied with the measures taken by the
corporation that the company provides the information of the ESI scheme but 8% people are
fully satisfied with this measures and the same remaining 8% are not satisfied.

Q.7) Is it mandatory for the employer/ employees to register under the

scheme?

P a g e | 40
 Yes No

25%

75%

Data analysis:
Yes 75 %
No 25 %

Data interpretation:

For this above given data we can interpret that 75% of people from the 50-sample people believe
to get register under this scheme and remaining 25% do not believe to be registered under the
ESI scheme.

Q.8) Will you Continue after retirement in medical benefits scheme of the
corporation?

P a g e | 41
 Yes No

8%

92%

Data analysis:
Yes 92 %
No 8%

Data interpretation:

For this above given data we can interpret that 92% of people from the 50-sample people agrees
to continue after their retirement to take the benefit from the corporation and 8% don’t agree to
take benefit from the corporation.

Q.9) Are you Satisfied with the services of the administrative staff for
claiming the benefits?

P a g e | 42
 25%

42%

25%

8%

Extremely Satisfied Partially Satisfied Not Satisfied Cannot Say

Data analysis:
Extremely satisfied 25 %
Partially satisfied 25 %
Not satisfied 8%
Cannot say 42%

Data interpretation:

For this above given data we can interpret that the ratio of extremely and partially satisfied
people is 25% and 8% people are not satisfied with the services and remaining 42% cannot say
from the 50-sample people.

Q.10) Is there any provision for exemption of a factory or establishment from

ESI coverage?

P a g e | 43
 Yes No

7%

93%

Data analysis:
Yes 93 %
No 7%

Data interpretation:

For this above given data we can interpret that 93% of people say yes there is provision of
exemption of factory or establishment from the ESI coverage and 7% people say no from the 50-
sample people.

Q.11) Is there any provision for exemption from payment of employers

contribution?

P a g e | 44
 Yes No

25%

75%

Data analysis:
Yes 75 %
No 25 %

Data interpretation:

For this above given data we can interpret that 75% of people say yes that there is exemption
from payment of employers contribution and 25% people say no from the 50-sample people.

Q.12) Will the delayed payment attract any interest?

P a g e | 45
 25%

75%

Yes No

Data analysis:
Yes 25 %
No 75 %

Data interpretation:

For this above given data we can interpret that 25% of people say yes that delayed payment
attract the interest of the employees and 75% people say no from the 50-sample people.

Q. 13) Are you aware about any other benefit / services provided under ESI?

P a g e | 46
 Yes No

33%

67%

Data analysis:
Yes 33 %
No 67 %

Data interpretation:

For this above given data we can interpret that 33% of people are aware of the another benefits&
services and 67% people are not aware about another benefits& services from the 50-sample
people.

CHAPTER 10.
CONCLUSION

P a g e | 47
Employees’ State Insurance Scheme is an integrated social security scheme tailored to provide
protection to workers and their dependents, in the organized sector, in contingencies, such as,
sickness, maternity and death or disablement due to employment injury or occupational hazard.
The ESI Act, (1948) applies to following categories of factories and establishments in the
implemented areas: -Non-seasonal factories using power and employing ten (10) or more persons
on-seasonal and non-power using factories and establishments employing twenty (20) or more
persons.

The ESI Scheme is mainly financed by contributions raised from employees covered under the
scheme and their employers, as a fixed percentage of wages. Employees of covered units and
establishments drawing wages upto Rs.7500/- per month come under the purview of the scheme
for social security benefits. However, employees’ earning upto Rs.50/- a day as wages are
exempted from payment of their part of contribution. However, they shall remain entitled to all
benefits as usual as per their wage group.

The State Govts. bear one-eighth share of expenditure on Medical Benefit within the per capita
ceiling of Rs.900/- per annum additional expenditure beyond the ceiling. Employees covered
under the scheme are entitled to medical facilities for self and dependents. They are also entitled
to cash benefits in the event of specified contingencies resulting in loss of wages or earning
capacity. The insured women are entitled to maternity benefit for confinement. Where death of
an insured employee occurs due to employment injury, the dependents are entitled to family
pension.

A Standing Committee constituted from among the members of the Corporation acts as the
Executive Body for the administration of the Scheme. There is also a Medical Benefit Council to
advise the Corporation on matters connected with the provision of Medical Benefit.

The Director General who is the Chief Executive of the Corporation is also ex-officio member of
the Corporation and of its Standing Committee.

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Besides the Hqrs. Office in New Delhi, the Corporation has 23 Regional Offices and 8 Sub-
Regional Offices at Pune, Nagpur, Coimbatore, Madurai, Hubli, Noida, Surat, Baroda,
Vijayawada, Varanasi (U.P.), Salem and Divisional Offices at Ambala, Gurgaon in Haryana,
Rohini, Nand Nagari & Okhla in Delhi, Barrackpur in West Bengal and 628 Branch Offices and
Pay Offices (116) all over the country for the administration of the Scheme. The Medical care
under the Scheme is administered by State Governments, who have the statutory responsibility in
this regard, except in Delhi State and Noida area of U.P. Besides, the ESI Hospital, K.K. Nagar
at Chennai, ESI Hospital, Thakurpukur at Calcutta and ESI Hospital at Nagda are also being run
directly by the Corporation and eleven hospitals in various regions as ESI Model Hospital.

CHAPTER 11.

ANNEXURE

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 SAMPLE QUESTIONNAIRE

I Harsh Radia of TYBBI (Banking and Insurance) am doing project on

Employees State Insurance Scheme. I ensure you that all the information that you provide
shall remain confidential.

1] Do you have any type of insurance policies?

a) Yes b) No

2] Have you heard about Employees State Insurance Scheme?

a) Yes b) No

3] How much percentage of people in India have their Insurance?

a) 1-25% b) 26-50% c) 51-75% d) 76-100%

4] Awareness of ESI benefits Provide by the ESI?

a) Fully aware b) Partially aware c) Not aware

5] From where did you came to know about the source of awareness of the ESI benefits?

a) Brochures b) Employees c) Newspaper d) Advertisement

6] Are you satisfied with the measures taken by the corporation for providing information on the
ESI Scheme?

a) Extremely satisfied b) Partially satisfied c) Not satisfied d) Cannot

say

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7] Is it mandatory for the employer/ employees to register under the scheme?

a) Yes b) No

8] Will you Continue after retirement in medical benefits scheme of the corporation?

a) Yes b) No

9] Are you Satisfied with the services of the administrative staff for claiming the benefits?

a) Extremely satisfied b) Partially satisfied c) Not satisfied d) Cannot say

10] Is there any provision for exemption of a factory or establishment from ESI coverage?

a ) Yes b) No

11] Is there any provision for exemption from payment of employer’s contribution?

a ) Yes b) No

12] Will the delayed payment attract any interest?

a) Yes b) No

13] Are you aware about any other benefit / services provided under ESI?
a) Yes b) No

References/ Bibliography

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Employee State Insurance
http://www.esic.nic.in/benefits

Global Jurix Advocate and Solicitors

http://www.globaljurix.com/esi-registration-what-is-esi-scheme.php

Economics Times
https://economictimes.indiatimes.com/wealth/personal-finance-news/esic-reduction-in-
insurance-contribution-of-employers-employees-takes-effect/articleshow/56083677.cms

Times of India
https://timesofindia.indiatimes.com/topic/ESI-Scheme

HR Magazine
https://www.businessmanager.in/benefits-under-esi-scheme.php

Arthapedia
http://www.arthapedia.in/index.php?title=Employee_State_Insurance_(ESI)

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