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Which Act Provides Health Insurance For Workers?


As per labour law, medical insurance is available under the Employee State Insurance (ESI) Act, 1948 to those organised sector employees whose monthly wage is Rs 21,000 or less. An employee has to avail ESI benefits from the ESIC.

What are the provisions of ESI Act 1948?

The ESI Act 1948, encompasses certain health related eventualities that the workers are generally exposed to; such as sickness, maternity, temporary or permanent disablement, Occupational disease or death due to employment injury, resulting in loss of wages or earning capacity-total or partial.

Which benefit is provided under the ESI Act?

Employees of covered units and establishments drawing wages upto Rs. 10,000/- per month come under the purview of the ESI Act, 1948 for multi-dimensional social security benefits. Employees covered under the scheme are entitled to medical facilities for self and dependants.

What is the ESI Act?

ESI is a social security scheme offered by the Government of India as per the Employees’ State Insurance Act, 1948. The scheme provides protection to employees against disablement/death due to employment injury, sickness, and maternity.

Do employees have to pay for health insurance?

No law directly requires employers to provide health care coverage to their employees. Under the ACA, employers with 50 or more full-time employees (or the equivalent in part-time employees) must provide health insurance to 95% of their full-time employees or pay a penalty to the IRS.

Who is eligible for employees State insurance?

The ESI scheme is applicable to all factories and other establishments as defined in the Act with 10 or more persons employed in such establishment and the beneficiaries’ monthly wage does not exceed Rs 21,000 are covered under the scheme.

Which diseases are covered under ESIC?

IV Disorders of Nervous System

  • Monoplegia.
  • Hemiplegia.
  • Paraplegia.
  • Hemiparesis.
  • Intracranial Space Occupying Lesion.
  • Spinal Cord Compression.
  • Parkinson’s disease.
  • Myasthenia Gravis/Neuromuscular Dystrophies.

What is the limit for ESI coverage?

The existing wage limit for coverage under the Act effective from 01.01. 2017 is Rs. 21,000/- per month (Rs. 25,000/- per month in the case of Persons with Disability).


What is minimum maximum bonus?

THE PAYMENT OF BONUS ACT, 1965 The minimum bonus of 8.33% is payable by every industry and establishment under section 10 of the Act. The maximum bonus including productivity linked bonus that can be paid in any accounting year shall not exceed 20% of the salary/wage of an employee under the section 31 A of the Act. 1.

Can I claim ESI in private hospital?

NEW DELHI: The Employees’ State Insurance Corporation (ESIC) on Monday allowed its beneficiaries to avail health services directly in any nearby private hospital in case of emergency.

Who is eligible for ESI?

To be eligible for the ESI scheme, the employee or the worker’s monthly salary should not exceed Rs. 21,000 and Rs. 25,000 for people with disability.

How many types of benefits are there in ESI Act?

The Employees’ State Insurance Act, 1948 is one of the most important laws that provide social security. It contains six kinds of ESI benefits that injured employees can avail. All of these benefits must arise in the course of employment in order to enable workers to access them.

What is ESI in salary?

The Employee State Insurance (“ESI”) is a contributory fund that has contributions both from the employer and employee and enables Indian employees to take part in a self-financed, healthcare, insurance fund. The ESI is the largest integrated need-based social insurance scheme for employees.

What is minimum bonus?

The Payment of Bonus Act, 1965 provides for a minimum bonus of 8.33 percent of wages. 3,500 per month and the payment is subject to the stipulation that the bonus payable to employees drawing wages or salary not exceeded to Rs. 10000 per month would be calculated as if their salary or wages is Rs. 3,500 per month.

How do I claim ESI?

Claims to get the relief can be made online at website along with submission of the physical claim with an affidavit, photocopy of Aadhaar Card and Bank Account details to the designated ESIC Branch Office by post or in person.

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