EMPLOYMENT INJURY UNDER THE EMPLOYEES’ STATE INSURANCE ACT, 1948

603 Labour Law II

SUBMITTED BY-

Saranga Koushik Phukon

UID: SM0121054

3rd Year & 6th Semester

Submitted to

Dr. Kasturi Gakul

Assistant Professor of Law

National Law University and Judicial Academy, Assam

 TABLE OF CONTENT
Table of Cases… ......................................................................................................................... i
List of Statutes… ......................................................................................................................... i
Table of Abbreviation………………………………………………………………………...i-ii

1. Introduction… ....................................................................................................................... 1-4

1.1 Aims and Objectives…......................................................................................................... 2

1.2 Scope and Limitations… ........................................................................................................ 2

1.3 Review of Literature…......................................................................................................... 2-4

1.4 Research Questions… ............................................................................................................4

1.5 Research Methodology… ........................................................................................................ 4

2. The Employees’ State Insurance Act of 1948 and Injury… ..................................................5-7

2.1 Analysis of the Provisions related to injuries and their scope of coverage… ....................... 5-7

3. Benefits available under the Employees’ State Insurance Act, 1948 ..................................... 8-11

3.1 Kinds of Disablement… ........................................................................................................ 8-10

3.2 Medical Benefits……………………………………………………………………
3.3 Sickness Benefits…………………………………………………………………….
3.4 Maternity Benefits…………………………………………………………………

4. Judicial Analysis… .............................................................................................................. 11-12

5. Conclusion… ............................................................................................................................ 13

Bibliography…............................................................................................................................... iii
 List of Cases

Mr. A. Tehan V/S M/S. Associated Electrical Agencies & Anr.

Western India Plywood Ltd V/S Shri. P. Ashokan
National Insurance Co. Ltd. v. Hamidia Khatoon and others
Regional Director, ESI Corporation v. Francis De Costa and others

List of Statutes

Employees’ State Insurance Act, 1948

Workmen Compensation Act, 1921

Table of Abbreviations

§ Section

Anr. Another

ed. Edition

HC High Court
L.J. Law Journal

Ltd. Limited

Ors. Others

SC Supreme Court

SCC Supreme Court Cases

UOI Union Of India

v. Versus

Vol. Volume
 CHAPTER 1
INTRODUCTION
The health component is crucial for an average worker, particularly one who is impoverished
and relies on employment for sustenance. If the person is not in good physical condition, their
earning potential is immediately impacted. Given these circumstances, it is crucial to prioritize
the establishment of adequate healthcare systems for workers in general, and specifically for
those in the unorganized sector, especially the urban informal sector. Social Security, in its
current understanding, is a powerful and influential idea in the modern era that impacts both
social and economic policies.1The security provided by the state protects individuals with
limited financial resources against current threats. Assert his independence either individually
or in confidential collaboration with his peers. The notion of social security is intrinsically
linked to the lofty principles of human dignity and social fairness. In a welfare state, extensive
social security programs provide support for individuals throughout their whole lives, from
birth to death. According to the International Labour Organization (ILO), social security refers
to the protection provided by society, through proper organization, against certain hazards that
individuals with limited financial resources are unable to adequately address on their own or
even through private collaboration with others.2 Social security aims to safeguard individuals
against a range of potential hazards, including illness, disability, childbirth, work-related
injuries, joblessness, aging, death, and unforeseen expenses. Typically, there are two
fundamental pillars or approaches to social security. Welfare programs that provide financial
protection and support to individuals and families in times of need. The approaches to these
procedures have not consistently adhered to a standardized approach. However, their general
characteristics can be easily recognized. 'Social Insurance' A key characteristic of most social
insurance schemes is that they are primarily funded through contributions from employers,
workers, or other recipients, and in some cases, supplemented by state grants. The majority of
these programs are legally mandated and have precise criteria for participation, which include
employers, workers, and other eligible individuals. The benefits provided under the social
insurance program are of a long-term nature and are administered by the government or under
its supervision. The recipients are entitled to receive benefits as a matter of right, but only after
meeting the specified eligibility requirements.

1
Mariappan K., Employment Policy and Labour Welfare in India, New century Publications, New Delhi, 2011.
2
The Indian Express (30 June 1984) (Chandigarh ed.).
'Social assistance' programs typically offer benefits to help those with limited financial
resources meet their basic requirements. The programs are funded by state funds or funds
organized by the state. The beneficiaries are not required to make any contributions in order
to be eligible for the benefits, but they receive them as a legal entitlement. Nevertheless, the
recipients must satisfy the specified qualifying criteria. The benefits provided by social
assistance programs typically vary based on the income and resources of the recipients.

The Employees' State Insurance Act of 1948, also known as the ESI Act, provides several
provisions to offer medical benefits and insurance coverage to employees employed in factories
that are registered with the ESI Corporation. This legislation offers beneficial features for
employees as it grants legal safeguards and inaugurates India's official social security initiative.
The ESI Act functions as a constitutional instrument due to its provision of insurance and
medical coverage. The implementation of the ESI Act is primarily overseen by the ESI
Corporation, while the Central Government has significant control over most of the processes.
Insurance, whether public or private, is categorized under the Union List in the Seventh
Schedule of the Indian Constitution. This means that only the Central Government has the
authority to create insurance laws. The Central Government's jurisdiction over insurance
significantly enhances the validity of the Act. The Employees' State Insurance Corporation, as
mandated by Section 3, is responsible for administering social security in accordance with the
ESI Act. The establishment occurred on February 24, 1952. If a medical emergency occurs, the
company is required to offer aid to the employees.
This research paper will examine the concept of "employment injury" as defined in Section
2(8) of the Act. According to this definition, an employment injury refers to a personal injury
suffered by an employee due to an accident or an occupational disease that occurs during the
course of their employment. This definition applies to insurable employment and is not limited
to incidents that happen within the territorial limits of India. The paper will also explore the
relevant provisions related to employment injury and provide examples that demonstrate the
effectiveness of the scheme in providing support to workers in times of need.

1.1 Aims & Objective

Aims

Throughout this research paper, I aim to elucidate the job injuries that fall under the job State
Insurance Act of 1948, as well as the advantages offered by the Act. Additionally, I will
examine the difficulties in implementing the Act for work-related injuries.
Objective
The objectives of this research paper are stated as follows:

1. To deliberate on the term "injuries" as defined in the 1948 Employees State Insurance Act.

2. To deliberate on the advantages that are made accessible via the Employees' State
Insurance Act of 1948.

3. Determine challenges associated with the implementation of the Act in the context of
occupational injuries.

1.2 Scope and Objective

The purpose of this research is to perform an exhaustive analysis of workplace injuries in

compliance with the stipulations of the Employees' State Insurance Act of 1948. The main
objective of this research is to enhance the understanding, implementation, and effectiveness
of the legislation pertaining to the provision of social security benefits to workers who sustain
injuries on the job.

The constraints that emerged during the course of the investigation can be attributed to
inadequate time allocation and appropriate primary sources.

1.3 Literature Review

P.L MALIK In his 'Handbook of Industrial and Labour Law', thoroughly examines the Act,
utilizing comprehensive case laws and interpretations. This resource greatly assisted me in my
study for this paper. The author has thoroughly examined the legal precedents related to
specific subjects, enhancing our comprehension of the subject matter in modern times. This
analysis highlights the importance of the Employees' State Insurance Act of 1948 in providing
social security to workers in case of work-related injuries. The reviewed literature offers
valuable information on various aspects, including challenges faced during implementation,
benefits and scope of coverage, impact on policyholders, rehabilitation programs, and measures
to ensure workplace health and safety. The results of these comprehensive investigations
improved my understanding of work-related injuries under the ESI Act, and provided me with
suggestions on how to improve its effectiveness and address any identified shortcomings.
DR. V.G. GOSWAMI, in his book "Labour and Industrial Laws: Vol 1," the author examines
the ESI Act. This act has been thoroughly analyzed by numerous scholars who have provided
a complete overview of its historical context, objectives, and important provisions related to
work-related injuries. The Act is a comprehensive measure designed to protect workers and
their families from financial difficulties arising from uncertainty relating to their work. The
requirements of the ESI Act regarding employment injuries have been extensively studied to
analyze the medical and financial advantages and coverage provided. However, the information
provided by Goswami stands out as unparalleled and has really assisted me in my research.
The author has also emphasized the research conducted on the effects of the ESI Act on insured
individuals and their families in case of work-related injuries.

1.4 Research Question

1.What are the various classifications and definitions of the covered injury categories as
outlined in the Employees' State Insurance Act of 1948?

2. Which specific advantages are afforded to employees in the case of work-related injuries
pursuant to the Workers' State Insurance Act of 1948, and how do these advantages enhance
the financial and medical welfare of the insured?

3. What are the most common challenges or concerns that arise during the implementation of
the Employees' State Insurance Act of 1948, particularly in regards to occupational injuries?

1.5 Research Methodology

This project exclusively employs qualitative research methodologies, with the researcher
relying on the descriptive 'Doctrinal' approach. Extensively relied upon were secondary
sources, which refer to materials authored by individuals who did not have firsthand experience
or involvement in the events being described, nor were they the creators of the notions being
discussed. These are documents that provide analyses and explanations of the creations of other
individuals. The researcher has employed many sources, including journal articles, library
sources, websites, and research papers, to comprehend job injuries inside the framework of the
Employees' State Insurance Act of 1948
 Chapter 2
2.THE EMPLOYEES’ STATE INSURANCE ACT OF 1948 and
INJURY

The health component is crucial for an average worker, particularly one who is impoverished
and reliant on employment for sustenance. If the worker is not in good physical condition, their
earnings will be adversely impacted. Given these circumstances, it is crucial to prioritize the
establishment of adequate healthcare provisions for workers in general, and specifically for
workers in the unorganized sector, particularly those in the urban informal sector. Currently,
Social Security is considered to be a powerful and influential concept in the modern era,
impacting both social and economic policies. The state provides security against risks that
individuals with little resources cannot afford. Assert his independence either individually or
in confidential collaboration with his peers. The concept of social security is fundamentally
connected to the lofty principles of human dignity and social fairness. In a welfare state,
extensive social security programs provide support for individuals throughout their whole lives,
from birth to death. As to the International Labour Organization (ILO), social security refers to
the protection provided by society, via proper organization, against certain hazards that
individuals with limited resources are unable to adequately address on their own or even
through private collaboration with others. Social security is to safeguard individuals against a
range of potential hazards, including as illness, disability, childbirth, work-related injuries,
joblessness, aging, death, and unexpected financial burdens. Typically, social security consists
of two fundamental foundations or approaches. 1. Welfare programs that provide financial
protection and support to individuals and families in times of need. 2. Welfare programs.The
approaches to these procedures have not consistently adhered to a standardized approach.
However, their general characteristics can be easily recognized. 'Social Insurance' A key
characteristic of most social insurance schemes is that they are primarily funded through
contributions from employers, workers, or other recipients, and in some cases, supplemented
by state grants.3The majority of these programs are legally mandated and require specified
groups of employers, workers, and other recipients to participate. The benefits provided under
the social insurance program are of a long-term nature and are managed by the government or

3
Sharma A.M , Aspect of Labour Welfare and Social Security,1981.
under its oversight. The beneficiaries have the right to receive benefits, but only after meeting
the specified eligibility criteria.

'Social assistance' programs typically offer benefits to help those with limited financial
resources meet their basic requirements. The programs are funded through state funding or
funds organized by the state. The recipients are not required to make any contributions in order
to be entitled to the benefits, but they get them as a matter of legal entitlement. Nevertheless,
the recipients must meet the specified qualifying criteria. The benefits provided by social
assistance programs are typically subject to variation based on the income and resources of the
recipients.

2.1 Analysis of the Injury under the Employees State Insurance Act of 1948 and their
Scope of Coverage
As per Section 2(8) of the Employees' State Insurance Act 1948, an employment injury is
defined as a personal injury suffered by an employee as a result of an accident or an
occupational disease that occurs while they are engaged in their insurable employment.4
Essentially, any damage suffered by an employee inside their assigned work hours or
timeframe will be categorized as an employment injury. The Insurance Act includes many
elements that provide protection to the employee who is insured. Nevertheless, there are also
specific inconsistencies about the subject under discussion.

In order to qualify for benefits under the ESI Act of 1948, it is necessary to have suffered a
work-related injury. An occupational injury is characterized by the employee's personal harm,
which must be caused by either an accident or an occupational sickness. The accident must
happen during the course of work and be directly related to it. Additionally, the employment in
question must be insurable. The ESI Act of 1948 does not provide a specific meaning for the
term 'accident'. However, it refers to an unforeseen event that causes harm or injury, for which
the person affected is not responsible. However, the person may qualify for legal restitution for
the consequences of the event. The incidence carries the possibility of causing either complete
or partial paralysis, or even death.

According to Section 51A, the "presumption of accident occurring in course of work" means
that if an accident takes place when an insured person is working, it is assumed that the accident
occured because of their job. Nevertheless, the assumption can be refuted and only pertains to

4
E.S.I Act,1948 Section (8)
this specific law. The injury is presumed to have arisen concomitantly with and as a
consequence of his occupation, wherein the term "employment" connotes a connection
between the employer and the employee. Consequently, in order to receive benefits, it is
necessary to demonstrate that the worker was on duty at the time of the accident. Employment
is a legally binding agreement between an employer and an employee, in which the employee
undertakes to deliver services to the employer according to the terms and conditions outlined
in the contract. The employer exerts authority and oversight over the employee throughout their
period of employment.

To qualify for disability benefits in the accident category, it is assumed that the accident
occurred as a result of and during work, under the following conditions. An accident that
happens while an insured individual is working will be considered to have occurred within the
scope of their employment, regardless of whether the individual is engaged in activities that
break the law, disregard their employer's orders, or act without instructions from their
employer. This provision states that if an insured employee has an accident, it will be
considered as happening during the course of their employment, regardless of whether it was
caused by disobeying instructions, violating laws applicable to the employee, or acting without
instructions from their employer. The accident will be treated as if it had occurred even if these
violations had not taken place. Additionally, it provides coverage for any harm sustained by an
employee when engaged in any action related to or in association with their employer's business
or operations. Any individual who violates the laws, instructions, or orders given by their
employer regarding trade or business conduct cannot seek damages from the employer.
However, this Act provides specific protections to employees in the situations mentioned
above, allowing them to claim benefits.
It is crucial to acknowledge that accidents occurring while an employee is commuting to or
from work using a car, whether explicitly or implicitly permitted by their employer, are deemed
to have taken place within the course of their employment. This remains valid regardless of
whether the employee is required to utilize that specific car for their daily travel. If an accident
occurs, a person who is not required by their job to travel can still be covered if they are in a
vehicle being driven by their employer or someone authorized by the employer, according to
the employer's agreement. If a vehicle is being used for public transport service in accordance
with the established guidelines, any accidents that may happen are not considered to be work-
related. 5In this context, both a vessel and an aeroplane are classified as vehicles.

Furthermore, if an insured person experiences an accident while on the premises where they
are employed for their employer's trade or business, and they are taking action to rescue, secure,
or protect individuals who are injured or in danger, or to prevent or reduce significant damage,
then the accident will be considered to have occurred during the course of their employment.
This provision safeguards against many contingencies that may arise during an emergency,
such as fire, flood, or other unforeseen occurrences. It is important to mention that, according
to this Act, if an accident happens when an insured person is working, it is considered, until
proven otherwise, to have occurred during their employment. This statement suggests that the
employer is responsible for providing evidence that the accident did not happen due to the
employee's work. This policy covers any accidents that occur during the employee's commute
to and from work.6

Furthermore, according to Section 38 of the Act, employment in a factory or facility is

considered insurable when it meets the criteria outlined in Schedule III of the Act. Insurance is
mandatory for everyone who seeks benefits under this Act. An insured individual refers to an
individual who is currently or was previously employed and has made or was required to make
payments under this Act. Additionally, this individual is or was eligible to receive any of the
benefits provided by this Act as a consequence. It is important to mention that if the
aforementioned criteria are fulfilled, the person in question may qualify for benefits under the
Act, irrespective of whether the accident or occupational illness occurs within or outside the
geographical boundaries of India. For an injury to be considered work-related, it must have
occurred while the individual was performing their job duties. The term of "employment" refers
to a contractual arrangement between an employer and an employee. 7 Therefore, in order to
qualify for benefits, it is imperative to present proof that the person was in active duty at the
time of the accident.8

5
E.S.I Act, 1948 Section 51-C
6
Employees State Insurance Act. 1948 Section 51- B
7
7(1982) ILL.T.29 (Karnataka)
8
Chintamani Rao v. State of M.P (AIR 1958 S.C 388)
 Chapter 3

3. Benefits provided by the Employees' State Insurance Act, 1948

Section 51 has been amended to incorporate provisions for the disablement benefit in two
specific situations. The first scenario refers to situations where a person suffers from temporary
incapacitation for at least three days, excluding the day of the incident. The second scenario
refers to situations in which an individual has persistent disability, regardless of whether it is
complete or partial.

Before the 1989 modification, the rate and eligibility conditions were controlled by the First
Schedule and specific provisions of Section 51. After the revision, the First Schedule and
certain sections of the stated Section have been eliminated. The Central Government has been
given the power to determine the rates, durations, and terms for the distribution of the indicated
benefit, instead of the current laws. Recipients of disablement benefits must comply with the
precise restrictions set for those receiving sickness benefits regarding prescribed medical care
and rest, as instructed by their doctor. However, those who qualify for benefits based on
permanent disability are not required to meet those conditions. It is crucial to have a discussion
on the exact definition and requirements of permanent entire disablement and permanent partial
disablement, as these conditions qualify for disablement benefits.

The health insurance benefits provided by the program can be categorized into two main
groups: Medical Benefits and Cash Benefits. The medical benefit is provided in the form of
medical treatment and care for insured individuals. Before 1989, the Act itself specified the
qualifying requirements, rates, duration, and other conditions for entitlement to certain benefits.
However, according to the modifications implemented in 1989, the authority to determine these
matters was given to the central government. It is crucial to note that one of the requirements
for qualifying for sickness, maternity, and medical benefits is that the requisite contributions
must have been paid during the specified previous time. The disablement and dependants'
benefits, as well as funeral expenses, are accessible without any qualifying criteria. The
Employees' Compensation Act allows for compensation to be paid to employees without any
contribution required from them. Similarly, the Employees' State Insurance Act, 1948, does
not mandate employees to make contributions in order to receive disablement and dependants'
benefits, as well as funeral expenses.

3.1 Kinds of disablement

"Permanent total disablement" refers to a state of permanent incapacitation that hinders an
employee from performing any activity they were previously capable of before to the
disaster.9Therefore, an employee is considered permanently incapacitated when an injury
hinders their ability to fulfill their previous duties. Permanent full impairment consists of two
elements. Initially, the individual is unable to work on a permanent basis. Furthermore, the
individual's capacity to earn income is utterly eradicated. Additionally, it diminishes an
employee's salary in all positions for which they possessed the necessary qualifications prior
to the occurrence of the accident. The employee sustained injuries as a result of a workplace
accident. The employee's actions precipitated the accident. Part I of the Second Schedule
injuries result in permanent and total disability. The individual's condition is characterized by
the absence of both hands, the loss of one hand and one foot, significant facial deformities, and
complete hearing impairment. According to Part II of the Second Schedule, if a person sustains
a combination of injuries that leads to a complete loss of their ability to earn, it is considered
permanent and total disablement. Amputation of the thumb and four fingers of one hand, or
amputation from a point 11.43 cm below the olecranon, might have a substantial negative
impact on one's ability to produce income. Shoulder-joint amputation can greatly diminish
one's capacity to earn income. Insufficient income. These injuries result in long-term disability.

"Permanent Partial Disablement" refers to a long-term condition where an individual's ability

to earn a living in any occupation they were qualified for at the time of the incident that caused
the condition is reduced. Moreover, it is explicitly stated that any injury mentioned in Part II
of the Second Schedule will be considered as causing ongoing partial impairment. Permanent
Total Disablement refers to situations where an individual sustains repeated injuries that result
in a complete or more than complete loss of their ability to produce income. The distinction
between permanent entire disablement and permanent partial disablement depends on the
extent to which the individual's ability to create revenue is reduced. Permanent total
disablement is a condition in which an individual completely loses their ability to make income,
potentially exceeding 100%. Conversely, permanent partial disablement refers to a decrease in
the ability to earn income that is below 100%. Permanent Partial Disablement refers to a
situation when an individual's ability to earn revenue is diminished, albeit not completely lost.
The distinguishing factor between the two categories of disablement is the degree to which the
individual's capacity to create money is diminished. Temporary disablement refers to a

9
E.S.I Act , Section 2 (15-B)
condition that occurs when an employee sustains an injury at work, needing medical treatment
and resulting a temporary inability to do their previous activities. The phrase above explains
that when someone is temporarily disabled due to an injury, they are unable to perform their
given jobs or obligations for a limited period of time. After completing the therapeutic
intervention, the individual is deemed competent in carrying out their duties. The E.S.I. Act
does not explicitly address temporary disablement circumstances, as it is presumed that the
individual will recover and restore their ability to work after obtaining suitable medical
treatment.10

3.2 Medical benefits

The medical benefit provided includes a comprehensive package of medical services at no cost.
This package includes outpatient and inpatient treatment, specialist consultations, X-rays and
laboratory tests, as well as the provision of medication, dressings, artificial limbs, aids and
appliances. Additionally, health improvement services such as vaccinations, preventive
inoculations, and regular health check-ups are offered. Antenatal care, postnatal care, and
family welfare services, including the supply of condoms, oral pills, and performing IUCDs,
vasectomy, and tubectomy, are also included. An individual who is insured, along with their
dependents, becomes eligible for medical care starting from the date they begin their insurable
employment. This entitlement remains in effect as long as the insured individual remains in
insurable employment or qualifies for sickness, maternity, or disablement benefits. The
Corporation primarily delivers medical care through a nationwide network of ESI dispensaries,
hospitals, and panel clinics. ESI Corporation directly pays for super specialist treatments
delivered by the country's most modern medical institutes. The Corporation also offers
treatment for occupational disorders through the established Occupational disorders Centres.
Medical care is predominantly administered to the recipients within the framework of modern
allopathic medicine. On-demand, beneficiaries are also receiving facilities from indigenous
systems such as Ayurvedic, Unani, Homoeopathic, and Sidha. The ESI Scheme offers an
extensive medical coverage to retired and disabled insured individuals, as well as their spouses.
This coverage may be obtained by paying a small fee of Rs.120 per year per couple.

3.3 Sickness benefits

10
Goswami v. V.G Labour and Industrial Law , Eighteen Edition.
The Employees' State Insurance Act (ESI Act) serves as a crucial safeguard for employees
during periods of illness or accident. According to Section 46(1)(a) of this act, employees who
fall under its jurisdiction are entitled to receive regular compensation while they are unwell, as
long as their condition is confirmed by a qualified medical professional. An outstanding
characteristic of the ESI Act regarding illness benefits is the compensation level, which is
usually fixed at around 70% of the employee's usual income. This financial assistance is
essential in assisting employees in managing the financial difficulties that emerge during times
of illness or injury. Nevertheless, there is a maximum restriction of 91 days per year for
employees to request compensation. Another essential factor for accessing illness benefits
under the ESI Act is the stipulation of a minimum number of employment days. According to
the legislation, an individual must have been employed for a minimum of 78 days in the
previous six months in order to qualify for illness payments. This requirement guarantees that
the benefits are specifically allocated to employees who have a steady and continuous
employment record, in accordance with the goal of the legislation to assist legitimate instances
of illness or accident. The purpose of providing sickness benefits under the ESI Act is to
provide employees with financial security during difficult periods, thereby reducing the
economic burden on them and their families. The act achieves a balance by providing
significant pay coverage and setting sensible limits on how long compensation can be received.
This approach supports employees while also preserving the scheme's long-term survival.

Moreover, the act emphasizes the importance of medical authentication by authorized

professionals. The purpose of this verification process is to act as a protective measure,
guaranteeing that only genuine instances of illness or injury are eligible for payments under the
ESI Act. This strategy effectively mitigates the risk of any possible abuse of the system, so
ensuring the preservation of its integrity and dependability. The provisions pertaining to
sickness benefits in the ESI Act essentially demonstrate the government's dedication to
protecting employee well-being and promoting a conducive work atmosphere. Providing
financial assistance during times of illness not only helps individual employees but also
improves the overall well-being and productivity of the workforce.

3.4 Maternity benefits

Section 46(1)(b) of the Employees' State Insurance Act (ESI Act) specifies the rights and
benefits that insured women are entitled to in different situations concerning maternity. These
events encompass instances such as labor confinement resulting in childbirth, births happening
after 26 weeks of pregnancy, miscarriage, illness directly related to pregnancy, or premature
births. The provision is intended to provide essential financial aid and support throughout the
important stages of pregnancy and childbirth, recognizing the distinct hardships and obligations
experienced by women during this time. According to this rule, women who have insurance
coverage are entitled to receive regular payments for an initial duration of three months.
However, in the event of medical circumstances or complications, if it becomes necessary, an
extra month of benefits can be obtained. This adaptability guarantees that mothers receive
sufficient assistance and resources during their recuperation or while tending to their newborns.

In order to be eligible for these regular payments, women who are insured must satisfy certain
requirements, which include having been employed for at least 70 days in the year before their
pregnancy. This requirement guarantees that the advantages are specifically targeted towards
women who have a well-documented employment background and are actively making
contributions to the labour force. Section 46(1)(b) includes a provision for regular payments,
which demonstrates a dedication to assisting employed women and dealing with the financial
aspects of problems relating to motherhood. Its objective is not solely to ensure economic
stability, but also to foster the holistic welfare and vitality of both the mother and the child.
This provision emphasizes the significance of guaranteeing that women have access to essential
benefits and safeguards during key life events like pregnancy, thereby promoting a more
inclusive and supportive work environment.

Chapter 4

4. Judicial Analysis

In Mr. A. Tehan V/S M/S. Associated Electrical Agencies & Anr.,11 defendant 1 hired the
plaintiff to perform television repair tasks. On July 17, 1987, the plaintiff sustained face injuries
while doing their duties as a result of an occurrence when a component of a television set
suddenly exploded. The plaintiff initially sought legal remedy by filing a claim for
compensation under Section 46 of the Employees' State Insurance Act (ESI Act) with the ESIC
Corporation.

11
1996 AIR 1990 1996 SCC (4) 255 JT 1996 (5) 648 1996 SCALE (4) 469
Afterwards, the plaintiff sought further remuneration under the Workmen's Compensation Act,
which required the defendant to make a payment. The defendant, however, challenged this
assertion before the Bombay High Court by filing an appeal. The main focus of their case
revolved around Sections 38 and 46 of the ESI Act, which establish the fundamental basis for
the insurance scheme outlined in the Act. Section 38 requires that insurance coverage be
provided to all workers, whereas Section 46 specifies the possible remedies for workers. After
careful scrutiny, the Division Bench of the High Court determined that the plaintiff's request
for compensation from the respondent could not be supported. However, the court ruled that
the plaintiff should receive appropriate redress, the details of which would be assessed by the
ESIC. This legal process emphasizes the extensive legal considerations and complications
associated with cases involving workers' compensation and insurance coverage regulated by
statutory acts such as the ESI Act and the Workmen's Compensation Act.

In the legal case Western India Plywood Ltd V/S Shri. P. Ashokan concerning P. Ashokan and
Western India Plywood Ltd.,12 an appeal was filed seeking compensation for an injury sustained
while employment. Ashokan had previously received compensation from ESIC under the ESI
Act for the identical injuries, due to his insurance coverage. The appeal focused on the
limitations imposed by Articles 53 and 61, which restrict claims under the Workers'
Compensation Act and prevent seeking compensation from any source other than the ESI Act,
as long as the employee has already received sufficient compensation. The Full Bench,
responsible for the case, discussed the definition of 'appropriate compensation' as outlined in
Sections 38 and 46 of the ESI Act, in relation to the damage. The researchers determined that
the relief provided by ESIC was sufficient as appropriate reparation. The ultimate verdict
sought to avoid redundant remuneration for the employee, guaranteeing that they did not
receive money twice for the identical injury, once from ESIC and once more from the employer.
The interpretation of Section 53 not only restricted the compensation to the essential amount
from ESIC, but also protected the employer from facing numerous claims for the same incident.
This prevents a situation similar to double jeopardy, where the employer would be compelled
to compensate twice for the same harm.

In the case of National Insurance Co. Ltd. v. Hamidia Khatoon and others, 13the Supreme Court
observed that after analyzing the relevant sections of the Workmen's Compensation Act of 1923
and the Employees' State Insurance Act of 1948, it is clear that both laws provide compensation

12
( 2005) 12 SCC 73
13
1994 SCC (L & S) 195
to workers or employees for any personal injury they suffer due to an accident that happens
while they are working. The ESI Act is a following legislative enactment that has a wider scope.
The topic matter has a wider breadth. Moreover, it provides a superior degree of compensation
in comparison to the benefits provided to a worker under the Workmen's Compensation Act.
The benefits that an employee can get under the ESI Act are considerably more substantial than
those available under the Workmen's Compensation Act. The only disadvantage is that the
person in issue will get compensation in the form of regular payments under the ESI Act,
instead of a single, combined payment according to the Workmen's Compensation Act. If the
Legislature determined that providing recurring payments rather than a single settlement is
more suitable, there is unquestionably no argument about the wisdom of its decision. Given the
assumption that the rights of the workers were better protected by the Workmen's
Compensation Act, it is nevertheless within the authority of the Legislature to withdraw or
modify these privileges.

The case of Regional Director, ESI Corporation v. Francis De Costa and others pertains to an
employee who was riding a bicycle to work on a route that leads to the factory, which is situated
around 1 kilometer distant. The employee was struck by a company-owned lorry and then
knocked to the ground on the road. The person in question experienced a persistent and total
incapacity to participate in productive work inside the manufacturing environment. As a result,
he claimed his right before the ESI Court. The Employees' State Insurance Court concluded
that he met the criteria for the benefits offered under the law. After the appeal, the High Court
confirmed and supported the previous conclusions. The case presented to the Supreme Court
involved a crucial and sensitive matter: determining whether an injury suffered in a car accident
while traveling to work, with only 15 minutes left before the scheduled reporting time, and 1
kilometer away from the factory premises, could be considered as occurring during the course
of employment. The phrase 'arising out of his employment' was determined to have a literal
interpretation that suggests a connection between the worker's employment and the injury they
suffered due to an accident. Nevertheless, it has enough scope to include situations where a
direct connection between the worker and the task may not be necessary. There are indications
that the worker suffered physical injury due to the occurrence that occurred while performing
their job duties.
 5. Conclusion

The Employee State Insurance Act of 1948 is a legislation designed to promote social welfare
by offering targeted benefits to employees in cases of illness, maternity, and work-related
injuries. Furthermore, the statute also includes provisions for other ancillary topics. The Act
aims to fulfill the goal of socio-economic fairness, which is enshrined in the Directive
Principles of State Policy established in Part 4 of the Constitution, particularly in Articles 41,
42, and 43. These provisions require the state to implement effective measures to guarantee the
right to employment, education, and public assistance in cases of unemployment, old age,
disease, and disability. The legislation discussed before relates to social security. It is a well-
established legal principle that, in order to prevent unfairness or promote fairness and meet the
objectives of social welfare legislation, a broad interpretation should be used, even if it requires
departing from a rigorous literal reading.

The ESI Act is a vital asset for the laboring population in India, offering them substantial
benefits. Furthermore, it provides advantages to industries beyond the laboring population. The
Act is remarkable for its capacity to generate mutually advantageous results for both employees
and businesses. The personnel are protected by the aforementioned act and receive financial
aid in case of an injury. Furthermore, companies are protected from facing several legal actions
for the same offense instead of offering financial compensation to their employees. The
Employees' State Insurance Act not only offers medical benefits to employees but also governs
several supplementary issues of efficiently managing the Corporation established under the
Act. These encompass several aspects such as sales techniques, financial practices, and the
allocation of authority among the Corporation's officials. Regarding my research topic on
"employment injury," I have aimed to clarify the many provisions regarding the types of
injuries and the accompanying benefits that employees can receive.

The ESI Act of 1948, which originated from Professor Adarkar's Committee recommendations
and discussions at the Indian Labour Conference, initiated an integrated social insurance
scheme covering health hazards, sickness, disablement, death, and maternity with a focus on
health insurance. Since its inception, the Act has seen multiple amendments, including a
significant revision in 2010. Initially targeting factories with 10 or more employees, the Act
allows the government to extend coverage to diverse establishments such as hotels, restaurants,
cinemas, road motor transport, newspaper establishments, and primary educational institutions
employing 20 or more individuals in specific states. The current wage limit for coverage is
₹15,000 per month. Functioning as a self-financing health insurance system, the ESI scheme
relies on contributions from covered employees and employers, set as a percentage of wages.
Employees contribute 1.75% of their wages, and employers contribute 4.75% of insured
employees' wages, with exemptions for those earning up to ₹70 per day. While most funding
comes from the ESI Corporation, state governments are obliged to contribute one-eighth of
medical benefit expenses, limited to ₹1,200 per insured person yearly. The scheme provides a
range of benefits, including medical, sickness, extended sickness, maternity, disablement,
dependents', and confinement benefits. This comprehensive structure aims to offer holistic
support, safeguarding the well-being and financial stability of covered individuals during
challenging times.
 BIBLIOGRAPHY

ARTICLES:

The Indian Express (30 June 1984) (Chandigarh ed.).

Mariappan K., Employment Policy and Labour Welfare in India, New century Publications,
New Dehli, 2011.

C. Jayaram “Scope Of Sections 53 And 61 Under The Employees’ State Insurance Act, 1948:
Kerala High Court’s Pioneering Judgement.” Journal of the Indian Law Institute, vol. 32, no.
2, 1990, pp. 259–63. JSTOR, http://www.jstor.org/stable/43953184. Accessed 19 May 2023.

Veer Singh “Employment Injury And Employees’ State Insurance Scheme : Functional
Perspectives.” Journal of the Indian Law Institute, vol. 29, no. 1, 1987, pp. 76–93. <JSTOR,
http://www.jstor.org/stable/43951057> Accessed 1 May 2023.

BOOKS:
P.L. Malik, Handbook of Labour and Industrial Law (16th edn. Eastern Book Company
2017).

V.G. Goswami , Labour and Industrial Law (9th edn. Central Law Agency 2011).

V.V. Giri, loc. cit., p. 310.

Websites:

Rai, D. (2022, January 11). Employees’ State Insurance Act, 1948: details you must know -

iPleaders. iPleaders. https://blog.ipleaders.in/employees-state-insurance-act-

1948/#Sickness_Benefits

Damini. (2022, May 13). Employees State Insurance Act 1948. Deskera Blog.

https://www.deskera.com/blog/employees-state-insurance-act-1948/