 To provide for certain benefits to employees

in case of sickness, maternity and

employment injury.

 To provide medical facilities to legal

dependents of the employees who are
insured person.

 This medical facility is also extended to

retired persons also
 This Act extends to whole of India

 Applicable to all factories, including factories

belonging to the Government, other than
season factories

 Any other establishment notified by central

government. (after giving one month
notification).
 Once the Act has become applicable to a
factory or an establishment, its application
will be continuous even if the number of
employees fall below the required standard.
1) A widow

2) A legitimate or adopted son who has not attained

the age of 25 years

3) An unmarried legitimate or adopted daughter

4) A widowed mother

5) If wholly dependent on the earnings of the insured

person at the time of his death, a legitimate or
adopted son or daughter who has attained the age
of 25 years and is infirm
6) If wholly or in part dependant on the earnings
of the insured person at the time of his death:-

i. a parent other than a widowed mother

ii. a minor illegitimate son

iii. an unmarried illegitimate daughter

iv. a daughter legitimate or adopted or illegitimate

v. if married and a minor if widowed and a minor
7) A minor brother

8) An unmarried sister

9) A widowed sister if a minor

10) A widowed daughter-in-law

11) A minor child of a pre-deceased son

12) A minor child of a pre-deceased daughter
where no parent of the child is alive

13) A paternal grand-parent if no parent of the

insured person is alive
 A personal injury to an employee caused by
accident or an occupational disease arising
out of and in the course of employment with
in or outside India.
1. a spouse

2. a minor legitimate or adopted child dependent

upon the insured person

3. a child who is wholly dependent on the

earnings of the insured person and who is:-

a) receiving
education, till he or she attains the
age of 25 years

b) an unmarried daughter
4) a child who is infirm by reason of any physical
or mental abnormality or injury and is wholly
dependent on the earnings of the insured
person, so long as the infirmity continues

5) dependent parents whose income from all

sources does not exceed such income as may
be prescribed by the Central Government

6) in case the insured person is unmarried and his

or her parents are not alive, a minor brother or
sister wholly dependent upon the earnings of
the insured person.
a) Any premises including the precincts
thereof whereon ten or more persons
are/were employed on any day of the
preceding 12 months ,and

b) in any part of which a manufacturing

process is being carried.
 Factory does not include:

a) Mine

b) Railway running shed

 Disablement of a permanent nature which
reduces the earning capacity of an employee
 Disablement of a permanent nature which
incapacitates an employee for all work.
 A condition resulting from an employment
which requires medical treatment and renders
an employee temporarily incapable of doing
the work.
 In the case of a factory:-

a) owner or occupier of the factory

b) managing agent of such owner or occupier

c) legal representative of a deceased owner or

occupier

d) manager of the factory

 In any Government establishment:-

a) The authority appointed by Government

b) Head of the Department [if no authority is so

appointed]

 In any other establishment:-

Any person responsible for the supervision and

control of the establishment.
 Factory which is exclusively engaged in one or more of the following
manufacturing processes:

a) Cotton ginning

b) Cotton or jute pressing

c) Decortications of groundnuts

d) Manufacture of coffee, indigo, lac, rubber, sugar, tea

e) Any manufacturing process which is incidental to or connected with

any of the aforesaid processes:-

i. A factory which is engaged for a period not exceeding seven months

in a year in any process of blending, packing or repacking of tea or
coffee

ii. Any other manufacturing process notified by Central Government

 The Corporation is a body corporate having
perpetual succession and a common seal and
shall by the said name sue and be sued.
a) Chairman

b) Vice Chairman

c) Other members representing the interests

of: Employers & Employees

d) State governments
f) Union territories

g) Medical practioners

h) Three members of the Parliament

i) Director General of the Corporation ,ex-officio.

 All orders and decisions of the Corporation shall

be authenticated by the signature of the Director
General.
 Corporation may appoint Regional Boards,
Local Committees and Regional and Local
Medical Benefit Councils in such areas and in
such manner and delegate to them such
powers and functions.
1. Chairman

2. Three members of the Corporation

3. Three members of the Corporation representing such three State Governments

4. Eight members elected by Corporation:-

a) three members from among the members of the Corporation representing

employers

b) three members from among the members of the Corporation representing

employees

c) one member from among the members of the Corporation representing

medical profession

d) one member from among the members of the Corporation elected by

Parliament

e) Director General of the Corporation, ex-officio.

 Term of office of a member of the Standing
Committee shall be two years.

 A member of the Standing Committee shall

cease to hold office when he ceases to be a
member of the Corporation.
 Standing Committee shall administer the
affairs of the Corporation and may exercise
any of the powers and perform any of the
functions of the Corporation.
a) Director General of ESI, ex-officio – Chairman

b) Director General, Health Services, ex-officio – Co-Chairman

c) Medical Commissioner of the Corporation – ex-officio

d) one member each representing each state other than Union

territories

e) three members representing employers

f) three members representing employees

g) three members representing the medical profession; among

them one shall be a woman.
 The term of the office of the members of
Medical Benefit Council- 4 years.

 A member of the Corporation, the Standing

Committee or the Medical Benefit Council
shall cease to be a member if he fails to
attend three consecutive meeting.
a) Advise the Corporation and the Standing Committee
on matters relating to the administration of medical
benefit

b) The certification for purposes of the grant of

benefits and other connected matters

c) Investigation complaints against medical

practitioners in connection with the medical
treatment

d) Perform such other duties in connection with the

medical profession
 Registration is the process of obtaining and recording
information about the entry of an employee into ‘insurable
employment’.

 At the time of joining the insurable employment, an

employee is required to provide his and his family details
to the employer along with a family photo.

 Registering an employee is a onetime exercise in life time

of an employee.

 The insurance number generated on the first occasion of

registration is to be used throughout his life time
irrespective of change of employment including change of
place.
 A person shall be disqualified as a member of the
Corporation, the Standing Committee or the Medical
Benefit Council:-

a) if he is declared to be of unsound mind by a

competent court

b) if he is an undischarged insolvent

c) if he has directly or indirectly by himself or by his

partner any interest in a subsisting contract with
the Corporation except as a medical practitioner

d) he has been convicted of an offence involving moral

turpitude.
 An Employees’ State Insurance Fund should be
created by the Corporation.

 All contributions paid under this Act and all other

moneys received on behalf of the corporation
shall be paid into this fund.

 The grants, donations and gifts received from the

Central Government or any State Government,
local authority or any individual or body are also
paid into this Fund.
a) Payment of benefits and provision of
medical treatment to insured persons and
their families.

b) Payment of fees and allowances to members

of the Corporation, the Standing Committee
and the Medical Benefit Council, the
Regional Boards, Local Committees and
Regional and Local Medical Benefit Councils.
c) payment of salaries, leave and joining time
allowances, travelling and compensatory
allowances, gratuities and compassionate
allowances, pensions, contributions to
provident or other benefit fund of officers and
servants of the Corporation.

d) establishment and maintenance of hospitals,

dispensaries and other institutions
e. payment of contributions to any State
Government, local authority or any private
body or individual, towards the cost of
medical treatment of insured persons and
their families.

f. such other purposes as may be authorized

by the Corporation with the previous
approval of the Central Government.
 Employer’s Contribution - 4.75% of wages

 Employee’s Contribution – 1.75% of wages

 The contribution shall be paid in a bank duly

authorized by the corporation within 21 days of the
last day of the each calendar month.

 The employer is required to file monthly

contributions online through ESIC portal.

 The principal employer shall bear the expenses of

remitting the contributions to the corporation.
 Immediate employer shall maintain a register
of employees employed by or through him
and submit the same to the principal
employer.

 Principal employer can recover contribution

paid by him from immediate employer.
 Any contribution payable under this Act may be recovered
as an arrear of land revenue [Section 45B].

 Authorized officer should issue a certificate to Recovery

Officer, who in turn proceed to recover the amount :-

a) attachment and sale of moveable or immovable property

of the factory

b) arrest of the employer and his detention in prison

c) approving a receiver for the management of the movable

or immovable properties of the factory or establishment
 The attachment shall first be effected against
the properties of the factory or the
establishment.

 If such attachment and sale is insufficient for

recovering the amount of arrears, the
Recovery Officer may take such proceedings
against the property of the employer.
 The insured persons , their dependents shall be entitled to the
following benefits:-

a) Periodical payments to any insured person in case of his

sickness

b) Periodical payments to an insured woman in case mis-carriage

or sickness arising out of the pregnancy

c) Periodical payments to an insured person suffering from a

disablement as a result of an employment injury

d) Periodical payments to such dependants of an insured person

who dies as a result of an employment injury
e) Medical treatment of insured persons

f) Payment to the eldest surviving member of the

family towards the expenditure on the funeral of
the deceased insured person

g) If the injured person at the time of his death does

not have a family, the funeral payment will be paid
to the person who actually incurs the expenditure.

 The claim for such payments shall be made within 3

months of the death of the insured person or within
such extended period.
 An insured person or his dependants shall
not be entitled to receive or recover any
compensation or damages under the
Workmen Compensation Act, 1923 or any
other law [Section 53].
 An insured person shall not be entitled to receive for the
same period:-

a) Both sickness benefit and maternity benefit

b) Both sickness benefit and disablement benefit for

temporary disablement

c) Both maternity benefit and disablement benefit for

temporary disablement

 Where a person is entitled to more than one of the

benefits he shall be entitled to choose which benefit he
shall receive.
 If any person has received any benefit or payment under
this Act when he is not lawfully entitled to receive the
same, he should return the amount to the Corporation.

 In the case of his death his representative shall be liable to

repay the same from the assets of the deceased.

 The amount recoverable may be recovered as if it were an

arrear of land revenue by the Recovery Officer.

 Employer not to dismiss or punish the employee during

sickness/maternity/temporary disablement etc. [Section
73]
 State Government should constitute an ESI Court [Section 74].

 ESI Court may decide any question or dispute arises as to:

i. whether any person is an employee within the meaning of this

Act

ii. whether he is liable to pay the employee’s contribution

iii. rate of wages

iv. rate of contribution payable by a principal employer

v. person who is or was the principal employer

vi. the right of any person to any benefit and as to the amount
and duration
 The following claims shall be decided by ESI Court:-

a) claim for the recovery of contributions from the principal

employer

b) claim by a principal employer to recover contributions

from any immediate employer

c) claim against a principal employer

d) claim for the recovery of the value improperly received

e) any claim for the recovery of any benefit admissible

under the Act
f) any direction issued by the Corporation on a review
of any payment of dependants’ benefit

g) any other matter which is in dispute between-

i. a principal employer and the Corporation

ii. a principal employer and an immediate employer

iii. a person and the Corporation

iv. an employee and a principal or immediate

employer
 An appeal can be made to the High Court from an
order of ESI Court if it involves a substantial
question of law. The appeal shall be filed within 60
days from the date of the order of ESI Court.

 No Civil Court have jurisdiction ESI matters.