THE EMPLOYEES’ STATE INSURANCE (CENTRAL) RULES, 1950

THE EMPLOYEES’ STATE INSURANCE (CENTRAL) RULES, 1950

Preliminary

  • Short title and extent:

    • These rules are called the Employees’ State Insurance (Central) Rules, 1950.
    • They extend to the whole of India.

  • Definitions:

    • The Act: Refers to the Employees’ State Insurance Act, 1948 (34 of 1948).
    • Average daily wages during a contribution period: The total wages payable to an employee during the period divided by the number of days for which wages were payable.
    • Average daily wages during a wage period:
      • For time-rate employees: Wage payable for the complete wage period, had the employee worked all working days, divided by:
        • 26 if monthly rated
        • 13 if fortnightly rated
        • 6 if weekly rated
        • 1 if daily rated
      • For employees on any other basis: Wages earned during the complete wage period in the contribution period divided by the number of days worked.
      • If an employee receives wages without working, they are deemed to have worked:
        • 26 days for a monthly period
        • 13 days for a fortnightly period
        • 6 days for a weekly period
        • 1 day for a daily period
      • Explanation: If a night shift extends past midnight, the post-midnight period counts as part of the preceding day.
    • Benefit period: A period not exceeding six consecutive months, corresponding to the contribution period, as specified in regulations.
    • Chairman: The Chairman of the Corporation, Standing Committee, or Medical Benefit Council.
    • Contribution period: A period not exceeding six consecutive months, as specified in regulations.
    • Form: A form appended to these Rules.
    • Fund: The Employees’ State Insurance Fund.
    • Government securities: As defined in the Indian Securities Act, 1920.
    • Immovable property: Includes land, benefits arising from land, things attached to the earth, or permanently fastened to it.
    • Insured woman: A woman who is or was an employee with payable contributions under the Act, entitled to benefits, including:
      • A commissioning mother who wants a child and prefers embryo implantation in another woman.
      • A woman who legally adopts a child up to three months of age.
    • Movable property: Property of every description except immovable property.
    • Standard benefit rate: Average daily wages, calculated by dividing total wages paid during the contribution period by the number of days for which wages were paid.
    • State medical officer: A duly registered medical practitioner appointed by the Corporation.
    • Year: The financial year, from April 1st to March 31st.
    • All other words and expressions shall have the meanings respectively assigned to them in the Act.
Corporation Membership

  • Election of members of Parliament to the Corporation:

    • The House of the People (Lok Sabha) elects two members.
    • The Council of States (Rajya Sabha) elects one member.
    • Elections are conducted as directed by the Speaker of the House of the People or the Chairman of the Council of States.

  • Election of members to the Standing Committee:

    • The Chairman invites members to propose names from the relevant group.
    • Proposed names must be seconded by another member of the Corporation.
    • If the number of proposed candidates does not exceed vacancies, they are declared elected.
    • If the number of candidates exceeds vacancies, a ballot is held.
    • Members vote for as many candidates as there are vacancies, with only one vote per candidate.
    • Voting for more candidates than vacancies or giving more than one vote to a candidate invalidates the ballot.
    • Candidates with the highest number of votes are declared elected.
    • In case of a tie, the determination is made by drawing lots in the presence of the Chairman.
    • Any question regarding the validity of an election is referred to the Central Government, whose decision is final.

  • Restoration to membership:

    • A member who ceases to be one under section 12 is informed by registered post.
    • The letter indicates the member can apply for restoration within 30 days of receipt.
    • The application must state reasons for missing three consecutive meetings and be addressed to the Chairman.
    • The application is considered at the next meeting, and if a majority finds the reasons adequate, membership is restored.
    • Restoration is allowed only once per term as a member.

  • Fees and allowances of members:

    • Non-official members:
      • Travelling Allowance:
        • Members residing at the meeting place get actual conveyance expenses up to rupees 338 per day for city travel.
        • Members not residing at the meeting place get:
          • Actual airfare in economy class.
          • Actual rail fare in 2nd Class A.C. two-tier sleeper or First Class.
          • Actual road fare by taxi, car, auto-rickshaw, or bus (excluding air-conditioned bus) not exceeding rates set by the Director of Transport.
          • If the journey is between places connected by rail, mileage is limited to the admissible rail fare.
      • Daily allowance:
        • Members residing at the meeting place are not entitled to a daily allowance.
        • Members not residing at the meeting place get Rs. 2250 per day if staying in a hotel, and up to Rs. 900 per day for food.
      • Allowances are calculated from midnight to midnight:
        • Absence not exceeding 6 hours: Nil
        • Absence exceeding 6 hours but not exceeding 12 hours: 70%
        • Absence exceeding 12 hours: 100%
    • Members of Parliament or State Legislature:
      • Paid travelling and daily allowances according to the provisions of the Salary, Allowances and Pension of Members of Parliament Act, 1954 (30 of 1954) or relevant state law.
    • Members must certify they have not drawn allowances from any other source for the same journey and halt.
    • Daily and travelling allowances are also payable for sub-committee meetings.
    • Official members of the Central Government:
      • Draw travelling allowance from their department, reimbursed by the Corporation upon demand.
    • Payments to non-official members are made no earlier than the claim's last date.
    • Travelling allowance includes both onward and return journeys, with payment treated as final upon completion, with formal intimation obtained from the member regarding the return journey.
Meetings

  • Minimum number of meetings:

    • The Corporation and the Medical Benefit Council must meet at least twice a year.
    • The Standing Committee must meet at least four times a year.
    • The Chairman can call a meeting whenever deemed fit and must do so within 15 days of receiving a written request from at least half the members of the body concerned.
    • Requisitions must specify the meeting's purpose.

  • Roll of members:

    • The Corporation maintains a roll of members for the Corporation, Standing Committee, and Medical Benefit Council, including each member’s name and address.
    • Members must notify the Corporation of any address changes for correction in the roll.

  • Notice of meeting and list of business:

    • The Chairman decides the date, time, and place of each meeting.
    • A notice of at least 21 days from the date of issue is typically given to each member by post or another suitable method.
    • A list of business is posted along with the notice after approval by the Chairman, including brief notes on each agenda item.
    • Reasonable notice is given for emergency meetings.
    • No business beyond the convened meeting's purpose is considered without the Chairman’s permission.

  • Chairman of the meeting:

    • The Chairman, or in their absence the Vice-Chairman, presides over meetings of the Corporation, Standing Committee, or Medical Benefit Council.
    • If both are absent, members elect one of themselves to preside.

  • Quorum:

    • No business is transacted unless a quorum is present:
      • 15 members for the Corporation
      • 5 members for the Standing Committee
      • 7 members for the Medical Benefit Council
    • If a quorum is not present, the Chairman may adjourn the meeting to a date no more than seven days later, at which time business can be disposed of regardless of the number of members present.

  • Disposal of business:

    • Any business for consideration by the Corporation, Standing Committee, or Medical Benefit Council is reviewed at a meeting.
    • The Chairman may direct that papers be referred to all members for their opinion.
    • Decisions on referred questions are acted upon if supported by at least a two-thirds majority of the body concerned; otherwise, the question is considered at a duly convened meeting.

  • Proceedings of the meetings:

    • The proceedings of each meeting, including the names of those present, are forwarded to each member of the Corporation, Standing Committee, or Medical Benefit Council, and to the Central Government, as soon as possible, but no later than four weeks after the meeting.
    • Minutes are confirmed with any necessary modifications at the next meeting.

  • Minutes Books:

    • Minutes are kept in separate books for the Corporation, Standing Committee, and Medical Benefit Council, signed by the Chairman of the meeting where the proceedings are confirmed.
    • A copy of the confirmed minutes is sent to the Central Government within 15 days of confirmation.
    • Minute books are open for inspection free of charge by any member of the respective body at the Corporation's principal office during office hours on working days.
Powers and Duties of the Medical Benefit Council
  • Advise the Corporation on the constitution, setting up, duties, and powers of Regional and Local Medical Benefit Councils.
  • Make recommendations to the Corporation regarding:
    • The scale and nature of medical benefit provided at hospitals, dispensaries, clinics, and other institutions, including the medicines, staff, and equipment maintained there, and the extent to which these fall short of the desired standard.
    • The medical formulary for use in connection with the medical benefit provided under the Act.
    • Medical certification, including the procedure and forms for such certification, statistical returns, registers, and other medical records.
    • Measures undertaken for the improvement of the health and welfare of insured persons and their rehabilitation and re-employment if disabled or injured.
  • Advise the Corporation on matters relating to the professional conduct of any medical practitioner employed to provide medical benefit under the Act.
Director General and Financial Commissioner

  • Salaries, allowances, and conditions of service:

    • Director General's scale of pay: Rs. 22400 - 24500
    • Financial Commissioner's scale of pay: Rs. 18400 – 22400
    • Dearness allowance, city compensatory allowance, house rent allowance, travelling allowance, and other allowances are provided at Central Government rates for similar salaries.
    • Provident fund, leave, and medical benefits are as sanctioned for Central Government officers with similar salaries.
    • If the Director General or Financial Commissioner is already a Corporation employee, they retain pension, gratuity, and superannuation benefits.
    • If they are government employees, their pay, allowances, and service conditions are determined by the Central Government.

  • Powers and duties of the Director General:

    • Act as the Chief Executive Officer of the Corporation.
    • Convene meetings of the Corporation, Standing Committee, and Medical Benefit Council under the Chairman's orders.
    • Implement decisions made at these meetings.
    • Enter into contracts on behalf of the Corporation.
    • Furnish required returns and documents to the Central Government.
    • Correspond with the Central Government and State Governments on Corporation matters.
    • Undertake other duties and exercise other powers as delegated.
    • The Director General may delegate powers or duties to subordinates with Standing Committee approval, subject to restrictions and conditions.

  • Powers and duties of the Financial Commissioner:

    • Subject to the Director General's control, the Financial Commissioner is responsible for:
      • Maintaining the Corporation's accounts and compiling them from returns.
      • Preparing the Corporation's budget.
      • Arranging internal audits of accounts in centers and regions.
      • Making recommendations for the investment of the Corporation's funds.
      • Undertaking other duties as delegated.

  • Creation of posts by the Corporation:

    • The Corporation can create posts with a maximum pay scale of Rs. 37400 - 67000 with a Grade Pay of Rs. 8900.
Appeals

  • Appeals to Medical Appeal Tribunal:

    • If an insured person or the Corporation is not satisfied with the medical board’s decision, an appeal can be made to the Medical Appeal Tribunal within three months of the decision.
    • The Tribunal may accept appeals after three months if there is sufficient reason for the delay.
    • The application must be in Form 2 and include the grounds for the appeal.
    • The application can be sent by registered post or presented personally to the Chairman of the Medical Appeal Tribunal.

  • Appeals to Employees’ Insurance Court:

    • Appeals can be made to the Employees’ Insurance Court within three months of the decision of the medical board or Medical Appeal Tribunal.
    • The Court may accept appeals after three months if there is sufficient reason for the delay.
    • The rules made by the State Government regarding the form and manner of presenting applications to the Employees’ Insurance Court apply to applications under this rule.
Financial Management

  • Bank or banks for depositing the Fund:

    • All money payable to the Fund is received by authorized Corporation officers.
    • Amounts received are acknowledged with a receipt in Form I and deposited in the Reserve or the State Bank of India or any of its subsidiaries or the Nationalized Banks to the Fund account.
    • Money may also be paid directly to the Fund account in any scheduled bank authorised for Government agency business.
    • Receipt books in Form I are serially numbered by machine and kept in the custody of the Financial Commissioner or another authorized officer.

  • Procedure for crediting moneys to the Banks:

    • All money payable to the Corporation is credited to the approved bank and not used directly for any purpose.
    • Banks must provide the Corporation with monthly statements of deposits and withdrawals.
    • The Director General examines these statements within two months of the statement period.

  • Purpose and manner of payment out of the Fund:

    • Accounts of the Fund are operated by officers authorized by the Standing Committee with Corporation approval.
    • Payments from the Fund are made via cheque signed by authorized officers.
    • Payments over one hundred rupees require a cheque, unless specifically authorized by the Standing Committee.
    • Salaries to employees drawing a basic salary not exceeding rupees two hundred and fifty a month may be paid in cash.
    • Payments must be covered by a current budget grant.
    • Payments of benefits to insured persons and pay and allowances of sanctioned posts are not withheld due to a lack of a sanctioned budget grant.

  • Promotion of measures for health, etc., of insured persons:

    • The Corporation may spend up to Rupees three hundred crores per year from the Employees’ State Insurance Fund to improve the health and welfare of insured persons and to rehabilitate and re-employ those disabled or injured.

  • Circumstances in which cheques may be drawn:

    • Before signing a cheque, an authorized person must ensure the sum is:
      • Required for a purpose specifically sanctioned by the proper authority and covered by a current budget grant.
      • Required for any payment specified under section 28.
    • In the absence of a current budget grant, the Corporation may authorize payments generally or for specific cases.
    • Payments of benefits to insured persons and pay and allowances of sanctioned posts are not withheld even without a sanctioned budget grant.

  • Acquisition of property:

    • Subject to rule 29 and conditions laid down by the Corporation, the Director General may acquire movable or immovable property on behalf of the Corporation.
    • Sanction of the Standing Committee is required for exchanging immovable property, leasing property for over twelve months, or accepting gifts or bequests of property with obligations.

  • Disposal of property:

    • Subject to rule 29 and Corporation conditions, the Director General may:
      • Dispose of movable property with a value not exceeding ten thousand rupees in each case or grant leases of immovable property for up to twelve months.
      • With Standing Committee sanction, lease, sell, or otherwise dispose of any movable or immovable property.

  • Investment, transfer, or realization of the Fund:

    • Money not immediately needed may be invested by the Director General with Standing Committee approval in:
      • Government securities, including Treasury Deposit Receipts.
      • Securities mentioned in clauses (a) to (d) of section 20 of the Indian Trust Act, 1882 (2 of 1882).
      • Fixed deposits in the Reserve or the State Bank of India or any of its subsidiaries or a corresponding new bank constituted under section 3 of the Banking Companies (Acquisition and Transfer of Undertakings) Act, 1970 (5 of 1970).
    • Other investments require Central Government approval.
    • Investments may be varied, transposed, or realized, subject to sub-rules (1) and (2).
    • Prior Central Government approval is needed if variation, transposition, or realization is likely to result in a loss.
    • The Central Government may direct the partial or complete vacation of investments or prohibit investment in certain securities or property.
    • Dividends, interest, or other sums received are paid into the Fund.
    • Investment expenses or losses are charged to the Fund, and profits accrue to the Fund.
    • Approvals from the Standing Committee or Central Government may be conditional.

  • Raising and repayment of loans:

    • The Corporation may, with Central Government approval, raise loans for the purposes of the Act, particularly for:
      • Acquiring land and/or raising buildings.
      • Repaying existing loans.
      • Any other purpose approved by the Central Government.
    • Loans may be obtained from:
      • The Central Government at specified rates and terms.
      • The Reserve or the State Bank of India or any of its subsidiaries or any other scheduled bank with Central Government approval.
    • The Corporation may grant mortgages to secure loans from the Reserve or the State Bank of India or their subsidiaries, subject to Central Government approval.
    • Payments of interest on and repayment of loans are made as agreed.
    • The Corporation may apply available sums to repay the principal of any loan, even if not due.
    • Expenditure from a loan is not charged to capital without Central Government sanction.
    • An annual statement of loans raised and repayments made is submitted to the Central Government by April 30th each year.

  • Procedure for execution of contracts:

    • The Corporation may enter into contracts necessary or expedient for carrying out the Act's provisions.
    • Contracts are made on behalf of the Corporation by:
      • The Director General.
      • Other authorized members or officers, subject to specified conditions.
    • Contracts must be made in a manner that would bind the person if it were on their own behalf and can be varied or discharged in like manner; contracts involving expenditures exceeding rupees twenty-five crores require prior sanction of the Standing Committee.
    • The Corporation’s common or official seal must be affixed to every contract exceeding one thousand rupees.

  • Seal:

    • The common seal of the Corporation remains in the Director General's custody and is affixed only in the presence of the Director General or two members of the Standing Committee, who must sign the contract confirming its sealing.
    • The Corporation has official seals for use at specified offices, each a facsimile of the common seal with the office's name added.
    • Official seals are affixed only in the presence of authorized persons, who must sign the instrument confirming its sealing.
    • Instruments with an official seal duly affixed bind the Corporation as if sealed with the common seal.
Budget and Accounts

  • Preparation and submission of annual budget estimates:

    • The Chief Accounts Officer prepares the budget estimates in the form directed by the Central Government.
    • The Director General submits these estimates with recommendations to the Standing Committee for approval before February 1st of the preceding year.
    • A copy of the budget is sent to each member of the Standing Committee and the Corporation at least seven days before the meeting.
    • The Standing Committee approves the budget estimates with necessary changes.
    • The budget estimates, as approved by the Standing Committee, are presented to the Corporation before February 20th of the preceding year.
    • The budget estimates, as passed by the Corporation, are authenticated with the common seal and submitted to the Central Government under section 32 by March 1st.
    • The Central Government may make alterations to the budget estimates before approval.
    • The budget estimates as finally adopted and approved by the Central Government are placed before Parliament by the administrative ministry in March and published in the Official Gazette.

  • Administrative expenses:

    • Expenditure on the following items is termed as administrative expenses:
      • Fees and allowances to members of the Corporation, Standing Committee, Medical Benefit Council, Regional Boards, and Local Committees.
      • Salaries, leave and joining time allowances, travelling and compensatory allowances, bonus, gratuities, compassionate allowances, pension, and contributions to benefit funds of Corporation officers and employees.
      • Expenses on depreciation and maintenance of staff cars, office buildings, staff quarters, hiring accommodations, and purchasing furniture, office equipment, stationery, and printing.
      • Membership subscription to International Organizations and other services.
      • Auditing accounts and valuing assets and liabilities.
      • Expenses of Employees’ State Insurance Courts.
      • Payments under contracts for the Act's purposes.
      • Payments under court decrees or awards against the Corporation or its officers.
      • Costs of civil or criminal proceedings arising from actions taken under the Act.
      • Expenditure on publicity for the E.S.I. Scheme, including printing publicity materials and courses.
      • Expenditure on conducting evaluation studies.
    • The percentage of total revenue income spent on administrative expenses shall not exceed fifteen percent starting from 1997-98.

  • Supplementary estimates:

    • The Standing Committee may prepare and submit supplementary estimates if further expenditure is likely.
    • Such estimates are considered, sanctioned, and submitted to the Central Government like the original estimates, no later than February 15th of the financial year.
    • The provisions of rule 31 apply to supplementary estimates.

  • Re-appropriation:

    • If the Director General anticipates excess expenditure under any budget head, they examine allotments to discover potential savings and effect a re-appropriation, subject to Central Government conditions.
    • Funds cannot be re-appropriated to meet expenditure on a new service not in the budget without Central Government approval.
    • Re-appropriation is not permitted between the grant sanctioned for administrative expenses (two-thirds met by the Central Government) and other expenditure grants.

  • Maintenance of accounts:

    • The Corporation maintains complete and accurate accounts in the form specified by the Standing Committee with Central Government approval.
    • The books are balanced on March 31st each year.

  • Revenue Accounts:

    • The Corporation prepares Revenue Accounts for the financial year ending March 31st and a Balance Sheet as of March 31st, by May 31st.
    • The Central Government may extend this date by up to thirty days upon the Corporation's application.
    • The Corporation may, or if required by the Central Government shall, prepare Revenue Accounts and the Balance Sheet for any other period or as of any other date.

  • Production of accounts before the Comptroller and Auditor General of India:

    • Annual accounts are produced before the Comptroller and Auditor General of India for scrutiny by June 15th each year.
    • The Central Government may extend this date by up to thirty days upon the Corporation's application.

  • Powers of the Comptroller and Auditor General of India:

    • The Corporation submits all accounts as required.
    • The Comptroller and Auditor General of India may:
      • Require the production of necessary documents.
      • Require accountable persons to appear in person.
      • Require persons to make and sign declarations or answer questions.

  • Report of Comptroller and Auditor General of India:

    • The Comptroller and Auditor General of India submits a report on the annual accounts, stating whether the Balance Sheet is full, fair, and properly drawn up, and whether explanations or information called for have been given satisfactorily.
    • The report is submitted in such form and on such date as the Central Government may specify.

  • Consideration of reports:

    • The annual report on the Corporation’s work and activities is considered by the Standing Committee and placed for adoption at a Corporation meeting before December 10th following the financial year.
    • The annual accounts, duly authenticated and approved by the Standing Committee, are submitted for audit, and the audited accounts with the Comptroller and Auditor General of India’s report are placed for adoption at a Corporation meeting before December 10th.
    • This is conditional on the report being received by November 20th.

  • Authentication of annual accounts and reports:

    • The annual accounts, auditor’s report, and the annual report are authenticated with the Corporation's common seal and submitted to the Central Government by December 20th for presentation before Parliament.

  • Cost of audit:

    • The Corporation pays the cost of the audit by the date specified by the Central Government.

  • Impropriety or irregularity in accounts:

    • Auditors submit a separate statement on:
      • Any material impropriety or irregularity in expenditure or recovery of money.
      • Any loss or waste of money or property due to neglect or misconduct, including the names of responsible persons.
    • The Standing Committee must remedy any defect or irregularity and report to the Central Government within ninety days.
    • If there is a disagreement between the Standing Committee and the auditors, or if the Standing Committee fails to remedy the issues, the Central Government may issue orders that the Standing Committee must follow within a specified time.

  • Disallowance of expenditure incurred and surcharge for loss or deficiency:

    • The Standing Committee may disallow any item of account contrary to the Act or rules, surcharge the person authorizing the payment, and charge any person for deficiencies or losses due to negligence or misconduct after providing an opportunity for explanation.
    • The Standing Committee must state reasons for disallowances, surcharges, or charges and serve a certificate of the amount due with reasons on the person concerned, with copies to the Central Government.
    • Persons aggrieved by a certificate may apply to the Central Government within one month for setting aside or modifying the decision.
    • The Central Government may pass orders confirming, modifying, or setting aside the decision, and the Standing Committee must act accordingly.
    • The Central Government may stay further action under the certificate until the matter is resolved.

  • Recovery of amounts certified to be due:

    • Any sum certified as due must be paid to the Corporation within three months or a longer period allowed by the Central Government; if not paid, it will be recovered as an arrear of land revenue.
    • Sums paid or recovered are wholly or partly refunded if the certificate is set aside or modified.
Provident Fund

  • Establishment of Provident Fund:

    • The Corporation establishes and maintains the Employees’ State Insurance Corporation Provident Fund for its employees (excluding those on deputation from Central or State Governments).

  • Administration of the Provident Fund:

    • The Standing Committee or another approved committee administers the Provident Fund, subject to conditions they deem fit.

  • Framing of Provident Fund Regulations:

    • The Corporation may make regulations for all matters incidental to or necessary for the Provident Fund, subject to Central Government approval.
Contributions and Benefits

  • Wage limit for coverage of an employee under the Act:

    • The wage limit for coverage is twenty-one thousand rupees a month.
    • Employees exceeding this limit after the contribution period begins remain covered until the period's end.
    • For employees with disabilities under specified Acts, the wage limit is twenty-five thousand rupees per month.

  • Rate of contribution:

    • Employer’s contribution: Equal to four and three-fourth percent of the wages payable to an employee.
    • Employee’s contribution: Equal to one and three-fourth per cent of the wages payable to an employee.

  • Employer’s contribution in respect of certain employees:

    • Employers are not required to pay their share of contribution for employees with disabilities for a maximum period of three years.
    • The Central Government reimburses the Corporation for the employer’s share of contribution for these employees.

  • Exemption from payment of employee’s contribution:

    • Employees with average daily wages up to and including rupees one hundred seventy-six only are exempt from paying employee’s contribution.

  • Writing off of losses:

    • The Corporation may write off irrecoverable amounts of contribution, interest, and damages if:
      • The establishment or factory has been closed for over five years, and the employer's whereabouts are unknown.
      • A decree obtained by the Corporation could not be executed due to insufficient assets of the defaulting employer.
      • The claim for contribution is not fully met by the Official Liquidator or the Commissioner of Payments.

  • Sickness benefit:

    • A person qualifies for sickness benefit if contributions were payable for at least seventy-eight days in the corresponding contribution period.
    • The benefit is paid at the daily standard benefit rate for the sickness period.
    • No benefits are paid for the first two days of sickness if the spell follows another with paid benefits within fifteen days.
    • Sickness benefits are limited to ninety-one days in any two consecutive benefit periods.
    • The daily rate of sickness benefit is seventy per cent of the standard benefit rate during the corresponding contribution period.

  • Maternity benefit:

    • An insured woman qualifies for maternity benefits if contributions were payable for at least seventy days in the preceding two consecutive contribution periods.
    • Benefits are paid at the specified daily rate for twenty-six weeks, with not more than eight weeks preceding the expected confinement date.
    • In case of death of the insured woman, benefits are paid to the nominee or legal representative.
    • The insured woman adopting a child is entitled to twelve weeks of maternity benefit.
    • In case of miscarriage or medical termination of pregnancy, benefits are provided for six weeks.
    • Additional maternity benefits are available for sickness arising out of pregnancy.
    • The daily rate of maternity benefit is equal to the standard benefit rate, or rupees twenty-five, whichever is higher.

  • Confinement Expenses:

    • Insured women or insured persons in respect of his wife are paid a sum of rupees seven thousand five hundred as medical bonus on account of confinement expenses.
    • Confinement expenses are paid for a maximum of two confinements.

  • Disablement benefits:

    • Persons qualify for disablement benefits for temporary disablement lasting at least three days or for permanent disablement sustained as an employee.
    • Disablement benefits are payable for the limited period of provisional assessment or for life in cases of final assessment.
    • The daily rate of disablement benefit is ninety per cent of the standard benefit rate.
    • Disablement benefits are payable as follows:
      • Temporary disablement: full rate
      • Permanent total disablement: full rate
      • Permanent partial disablement: specified percentage of full rate

  • Dependants’ benefits:

    • Dependants’ benefit is paid to the dependants of an insured person who dies due to an employment injury.

  • Widow, children, and widowed mother:

    • Widow: equivalent to three-fifths of the full rate until remarriage
    • Each legitimate or adopted son: equivalent to two-fifths of the full rate until he attains the age of twenty-five years, or while infirmity lasts.
    • Each legitimate or adopted unmarried daughter: equivalent to two-fifths of the full rate ,or while infirmity lasts.
    • Widowed mother: equivalent to two-fifths of the full rate.

  • Other dependants:

    • Parent or grandparent: equivalent to three-tenths of the full rate for life.
    • Other dependants: equivalent to two-tenths of the full rate.
    • The daily rate of dependant’s benefit is ninety per cent of the standard benefit rate.

  • Funeral expenses:

    • Funeral expenses are set at fifteen thousand rupees.

  • Medical benefits to insured person who ceases to be in an insurable employment on account of permanent disablement:
    Medical benefits to insured person who ceases to be in an insurable employment on account of permanent disablement:

    • An insured person who ceases to be in an insurable employment on account of disablement shall be eligible to receive medical benefits for himself and his spouse the date on which he would have vacated the employment on attaining the age of superannuation, had he not sustained such permanent disablement.
    • The insured person should provide the proof of permanent disablement.
      • The insured person do the “the payment of contribution at the rate of ten rupees per month in lumpsum for one year at a time in advance to the concerned office of the Corporation in the manner prescribed by it”.

  • Medical benefits to retired insured persons:

    • Insured persons who leave insurable employment after superannuation or retirement after being insured for five years are eligible for medical benefits.
    • Contribution to be paid at the rate of rupees then per month in lump sum for one year at a time.

  • Income limit of dependant parents for eligibility to medical benefit:

    • Income of dependent parents should not exceed Nine Thousand rupees in a month

  • Bar on grant of cash benefits:

    • Insured persons convicted under section 84 of the Act are not entitled to cash benefits for three months (first conviction) or six months (subsequent convictions).
Forms
  • Form 1: Receipt form for money received by the Corporation.
  • Form 2: Application to the Medical Appeal Tribunal.