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Aug 08

ESIC West Bengal, Employees’ State Insurance Scheme

ESIC West Bengal

The ESIC West Bengal, Employees’ State Insurance Scheme provides social security to workers in organized industry and some other sectors of employment. ESIC West Bengal was introduced in West Bengal, with the issuance of Notification U/s. 1(3) of the E.S.I. Act, 1948, w.e.f. 14th August, 1955. The Scheme is the largest Social Security Scheme of the Government of India for the workmen employed in Factories / Establishments throughout the country. ESIC West Bengal is a complete Social Security Scheme, which provides various Cash Benefits and Medical Benefit to the workers and their families through single contribution under the Scheme.

The ESIC West Bengal Scheme is based on the principle of ‘pooling of risks and resources’ in which every contributor, at any given point of time, emerges as a beneficiary of a benefactor and society at large is the net gainer. Employees, Employers, State Governments& the ESI Corporation are the major stake holders in the system of organized and coordinated effort providing social protection to benefactors. The role of employers in particular remains pivotal to the success of the scheme, be it surveys for coverage, implementation, registration of factories/ establishments, registration of employees, regular payment of contribution, facilitating inspections and timely action to ensure steady flow of benefits to the employees.

ESIC West Bengal Applicability

The ESI Act applies to non-seasonal factories or manufacturing units, shops & establishments, Private Medical & Educational Institutionsemploying 10 or more persons. Under the enabling provisions of the Act, a factory or establishment, located in a geographical area, notified for implementation of the scheme falls in the purview in the Act. Employees of the aforesaid categories of factories and establishments and drawing wages o upto Rs.15,000/- a month are entitled to health Insurance cover under the ESIC West Bengal Act. The wage ceiling for purpose of coverage is revised from time to time to keep pace with rising cost living and subsequent wage hikes. The present ceiling of Rs.15,000/- has been effective from 1.5.2010. However, this is a mere guidance and details may be seen from ESI Act 1948, as amended.

ESIC West Bengal Medical Benefits

The Scheme provides full range of medical care, namely Out-patient services, Specialists’ services and Hospital services through a network of dispensaries, diagnostic centers and ESI Hospitals etc.
Super-specialties are provided to the beneficiaries through the country’s most advanced medical institutions for which payments are made directly by the ESI Corporation to the institution concerned.

Sickness Benefit (cash)

Sickness Benefit is payable to an insured person in cash, in the event of sickness resulting in absence from work and duly certified by an authorized insurance medical officer/practitioner.

Extended Sickness Benefit (Cash)

Extended Sickness Benefit becomes payable to insured persons for the period of certified sickness in case of specified 34 long term diseases which need prolonged treatment and absence from work on medical advice.

Enhanced Sickness Benefit (Cash)

This cash benefit is payable to insured persons in the productive age group for undergoing sterilization operation, viz. vasectomy/tubectomy.

Disablement Benefit (Cash)

Disablement Benefit is payable to insured employees suffering from physical disablement due to employment injury or occupational disease.

Dependants’ Benefit (Cash)

Dependants benefit (family pension) becomes payable to dependants of a deceased insured person where death occurs due to employment injury or an occupational disease.

Maternity Benefit (Cash)

Maternity Benefit is payable to insured women in case of confinement or miscarriage or sickness arising out of pregnancy.

Other Benefits

Some other benefits of ESIC West Bengal like funeral expenses, rehabilitation allowances etc. are also admissible to deserving insured persons.

The ESI Scheme was implemented in the cities of Kolkata and Howrah of West Bengal Region on 14th August 1955. Later the scheme extended to other centers in the state in a phased manner and the scheme is now working in 17centers spread over in 12districts of the state. The list of centers the ESIC West Bengal Scheme in West Bengal is in force with the date of implementation.

Presently the ESIC West Bengal scheme covers 26,214 industries and establishments with 10 lakhs employees of such factories/establishments and about 39 lakhs beneficiaries including family members getting ESI benefits in the state.