Employee State Insurance Act, [ESI] 1948

Employee State
Insurance Act, [ESI]
1948
Presented by: Sneha Rosalio Minj
Srinath Banerjee
Sunny Mervyne Baa
Vikas kumar

OBJECT OF THE ACT
◈The Employees* Slate Insurance Act (ESI
Act) was enacted with the object of
introducing a scheme of health
insurance for industrial workers. The
scheme envisaged by it is one of
compulsory State Insurance providing
for certain benefits in the event of
sickness, maternity and employment
injury to workmen employed in or in
connection with the work in factories
other than seasonal factories. The ESI
Act, which has replaced the Workmen's
Compensation

DEFINITIONS. [Section 2]
(3)
"confinement"
• means labour resulting in the issue of a living child or labour after 26
weeks of pregnancy resulting in the issue of a child whether alive or
dead;
(4) "contribution"
• means the sum of money payable to the Corporation by the principal
employer in respect of an employee and includes any amount payable
by or on behalf of the employee in accordance with the provisions of
this Act;
(6)
"Corporation"
• means the Employees' State Insurance Corporation set up under this
Act;

(6A) "dependant"
(6A) "dependant" means any of the following
relatives of a deceased insured person,
namely,-
(i) a widow, a legitimate or adopted son
who has not attained the age of 25 years, an
unmarried legitimate or adopted daughter.
(2010 amendment) (ia) a widowed mother;
(ii) 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; (2010 amendment)

(6A) "dependant"
iii) if wholly or in part dependent on the earnings of the insured person at the time of his
death,-
(a) a parent other than a widowed mother,
(b) a minor illegitimate son, an unmarried illegitimate daughter or a
daughter legitimate or adopted or illegitimate if married and a minor or
if widowed and a minor,
(c) a minor brother or an unmarried sister or a widowed sister if a minor,
(d) a widowed daughter-in-law,
(e) a minor child of a pre-deceased son,
(f) a minor child of a pre-deceased daughter where
no parent of the child is alive, or
(g) a paternal grand-parent if no parent of the insured person is alive,

(11)
"family"
• means all or any of the following relatives of an insured person,
namely,-
• (i) a spouse;
• (ii) a minor legitimate or adopted child dependent upon the insured
person;
• (iii) 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 twenty-one
years,
• (b) an unmarried daughter;
• (iv) 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;
• (v) Dependant parents, whose income from all sources does not
exceed such income as may be prescribed by the Central
Government;
• (vi) 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. (2010 amendment)
(8) "employment
injury"
• means a personal injury to an employee caused by accident or an
occupational disease arising out of and in the course of his employment,
being an insurable employment, whether the accident occurs or the
occupational disease is contracted within or outside the territorial
limits of India;

(12)"factory"
• means any premises including the precincts thereof whereon 10 or more
persons are employed or were employed on any day of the preceding 12
months, and in any part of which a manufacturing process is being carried on
or is ordinarily so carried on, but does not include a mine subject to the
operation of the Mines Act, 1952 or a railway running shed. (2010
amendment)
(14A)
"managing
agent"
• means any person appointed or acting as the representative of another
person for the purpose of carrying on such other person's trade or business,
but does not include an individual manager subordinate to an employer;
(14B) "mis-
carriage"
• means expulsion of the contents of a pregnant uterus at any period prior to
or during the 26 weeks of pregnancy but does not include any mis-carriage,
(15A)
"permanent
partial
disablement"
• means such disablement of a permanent nature, as reduces the earning
capacity of an employee in every employment which he was capable of
undertaking at the time of the accident resulting in the disablement:

(22) "wages"
• means all remuneration paid or payable, in cash to
an employee, if the terms of the contract of
employment, express or implied, were fulfilled and
includes any payment to an employee in respect of
any period of authorized leave, lock-out, strike
which is not illegal or lay -off and other additional
remuneration, if any, paid at intervals not
exceeding two months, but does not include-
• (a) any contribution paid by the employer to any
pension fund or provident fund, or under this Act;
• (b) (any travelling allowance or the value of any
travelling concession;
• (c) any sum paid to the person employed to defray
special expenses entailed on him by the nature of
his employment; or
• (d) any gratuity payable on discharge.

CHAPTER II:
CORPORATION,
STANDING COMMITTEE
AND MEDICAL BENEFIT
COUNCIL

ESTABLISHMENT OF EMPLOYEES’ STATE
INSURANCE CORPORATION. [Section 3]
Central government establishes the corporation
to be known as the employees' state insurance
corporation. This corporation will be having
following characteristics
Separate corporate body.
Having perpetual succession. (No death)
Have a common seal.
Employees' state insurance corporation can
sue. (File a suit in court on other)
Other can sue employees' state insurance
corporation.

CHAPTER II:
CORPORATION, STANDING COMMITTEE AND
MEDICAL BENEFIT COUNCIL
(a) Chairman, Vice-
Chairman to be appointed
by the Central Government;
(b) not more than 5 persons to be
appointed by the Central
Government;
(c) one person each representing
each of the States in which this
Act is in force to be appointed by
the State Government concerned;
(d) one person to be
Government to represent
the 3Union Territories;
(e) 10 persons representing
employers to be appointed by the
Central Government in consultation
with such organisations of employers.
(f) 10 persons representing
employees to be appointed by
the Central Government in
consultation with such
organisations of employees.
(g) 2 persons representing the
medical profession to be
Government in consultation with
such organisation of medical
practitioners.
(h) 3 members of Parliament of whom two shall be members of the
House of the People (Lok Sabha) and one shall be a member of the
Council of States (Rajya Sabha) elected respectively by the
members of the House of the People and the members of the
Council of States; and
• (i) The Director-General of the Corporation ex-officio.
THE CORPORATION SHALL CONSIST OF THE FOLLOWING MEMBERS. [Section 4]

TERM OF OFFICE OF MEMBERS OF THE
CORPORATION. [Section 5]
Members referred to in clauses (f), (g), (h) shall be four years, commencing from the date
on which their appointment or election. The members of the Corporation referred to in
clauses (a),(b),(c) and (e)of Sectiontion 4 shall hold office during the pleasure of the
government appointing them.

CONSTITUTION OF STANDING COMMITTEE. [Section 8]
Standing Committee of the Corporation shall be constituted from among its members,
consisting of
(a) A chairman, appointed by the central
government;
(b) Three members of the corporation appointed by the central
government;(bb) Three members of the corporation representing such three state
governments thereon as the central government may, by notification
gazette, specify from time to time;
(c) eIght members elected by the corporation as
follows-
(ii) 3 members from among the members of the Corporation representing employers;
(iii) 3 members from among the members of the Corporation representing employees;
(iv) 1 member from among the members of the Corporation representing the medical profession; and
(v) 1 member from among the members of the Corporation elected by Parliament;
(d) the Director General of the Corporation, ex
officio

TERM OF OFFICE OF MEMBERS OF STANDING
COMMITTEE. [Section 9]
a member of the Standing Committee shall cease to hold office when he ceases to be a
member of the Corporation.
the term of office of a member of the Standing Committee, other than a member referred
to in clause (a) or clause (b) or clause (bb) of Section 8, shall be two years from the date on
which his election.
A member of the Standing Committee referred to in clause (a) or clause (b) or clause (bb) of
Section 8 shall hold office during the pleasure of the Central Government.

MEDICAL BENEFIT COUNCIL. [Section 10](2010
AMENDMENT)
(a) the Director General, the Employees' State Insurance Corporation, ex officio
as Chairman;
(b) The Director General, Health Services, ex officio as Co-chairman;".
(c) one member each representing each of the States
(d) 3 members representing employers to be appointed by the Central
Government in consultation with such organisations of employers.
(e) 3 members representing employees to be appointed by the Central
Government in consultation with such organisations of employees.
(f) 3 members, of whom not less than one shall be a woman, representing the
medical profession, to be appointed by the Central Government.

DUTIES OF MEDICAL BENEFIT COUNCIL. [Section 22]
Advise the corporation and the standing committee on matters relating to the
administration of medical benefit, the certification for purposes of the grant of
benefits and other connected matters;
Have such powers and duties of investigation as may be prescribed in relation to
complaints against medical practitioners in connection with medical treatment and
attendance; and
Perform such other duties in connection with medical treatment and attendance.

CESSATION OF MEMBERSHIP. [Section 12]
3 members of Parliament of whom 2 shall be members of the House of the
People (Lok Sabha) and one shall be a member of the Council of States
(Rajya Sabha) shall cease to be a member of the Corporation when he ceases
to be a Member of Parliament.
Other members Membership of Employees' State Insurance Corporation,
Standing Committee or the Medical Benefit Council will be ended when that
person ends representing such employers, employees, or the medical
profession.

Disqualification. [Section 13]
A person shall be disqualified for being chosen as or for being a member of the
Corporation, the Standing Committee or the Medical Benefit Council-
if he is declared to be of unsound mind by a competent court; or
if he is an undischarged insolvent; or
If he a shareholder or a partner of company.
If he has been convicted of an offence involving moral turpitude.

FEES AND ALLOWANCES. [Section 15] 3
Members of the Corporation, the Standing Committee and the Medical Benefit Council
shall receive such fees and allowances as may from time to time be prescribed by the
Central Government.3
PRINCIPAL OFFICERS. [Section 16]
The Central Government may, in consultation with the Corporation, appoint a director
general and a financial commissioner.
The director general shall be the chief executive officer of the Corporation.
The director general and the financial commissioner shall be whole-time officers of the Corporation and
shall not undertake any work unconnected with their office without the sanction of the Central
Government and of the Corporation.
The director general or the financial commissioner shall hold office for such period, not exceeding five
years, as may be specified in the order appointing him. An outgoing director general or financial
commissioner shall be eligible for re-appointment if he is otherwise qualified.
The director general or the financial commissioner shall receive such salary and allowances as may be
prescribed by the Central Government.

CHAPTER III:
FINANCE AND AUDIT

EMPLOYEES’ STATE INSURANCE FUND. [Section 26]
All contributions paid under this Act and all other moneys received on
behalf of the Corporation shall be paid into a fund called the Employees'
State Insurance Fund.
The Corporation may accept grants, donations and gifts from the
Central or any State Government, local authority, or any individual or
body whether incorporated or not, for all or any of the purposes of this
Act.
All money received will be paid in to reserve bank of Indian or government
approved bank credited to the account of the Employees’ State Insurance Fund.
account shall be operated on by such officers as may be authorised by the Standing
Committee with the approval of the Corporation.

THE EMPLOYEES’ STATE INSURANCE FUND SHALL
BE EXPENDED ONLY FOR THE FOLLOWING
PURPOSES. [Section 28]
Payment of benefits and provision of medical treatment.
Payment to insured persons.
Payment of medical benefits to insured person families.
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.
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.
meeting the expenditure in respect of offices and other services set.

THE EMPLOYEES’ STATE INSURANCE FUND SHALL
BE EXPENDED ONLY FOR THE FOLLOWING
PURPOSES. [Section 28]
Establishment and maintenance of hospitals, dispensaries and other institutions.
Payment of contributions to any state government, local authority or any private body or
individual, towards the cost of medical treatment.
Payment of expenses of auditing the accounts of the corporation and of the valuation of its assets
and liabilities.
Payment of expenses of the employees’ state insurance courts set up under this act.
Payment of sums under any decree, order or award of any court or tribunal against the
corporation.
Payment of the cost and other charges of instituting or defending any civil or criminal
proceedings arising out of any action taken under this act;
Payment of expenditure, within the limits prescribed, on measures for the improvement of the
health and welfare of insured persons and for the rehabilitation and re-employment of insured
persons who have been disabled or injured.

HOLDING OF PROPERTY. [Section 29]
Employees' State Insurance Corporation can hold
both movable property and immovable property.
It can sell or transfer the both movable property
and immovable property for the purposes for which
the Corporation is established.
It can raise loans and take measures for
discharging such loans.
It can provide benefits for its staff.
[Section 30] all the above details or properties, income derived and
expenditure incurred should be maintained in the books of the corporation.

ACCOUNTS. [Section 33]
The Corporation should maintain correct accounts of its income and expenditure in such
form and in such manner as may be prescribed by the Central Government.
The accounts of the Corporation should be audited annually by the Comptroller and
Auditor-General of India and any expenditure incurred by him in connection with such
audit shall be payable by the Corporation to the Comptroller and Auditor-General of
India.
AUDIT. [Section 34]
He has the right to demand the production of books, account, connected
vouchers and other documents and papers and to inspect any of the offices of
the Corporation.
Audit report thereon should be forwarded to the Corporation which shall
forward the same to the Central Government along with its comments on the
report of the Comptroller and Auditor General.

ANNUAL REPORT. [Section 35]
The Corporation shall submit to the Central Government an annual report of its work
and activities.
The corporation should make valuation of its assets and liabilities for every 3 years of
period. (2010 amendment)
VALUATION OF ASSETS AND LIABILITIES. [ Section 37]

ALL EMPLOYEES TO BE INSURED. [Section 38]
Factory or establishment having more than 10 employees should be insured under the
Employee State Insurance Act
CONTRIBUTION. [Section 39]
Employer and employer liable for payment of the contribution to the Employee State Insurance
Corporation.
The rate of contribution paid by employer and employee will be decided by
the central government.
Currently, the employee’s contribution rate (w.e.f. 1.1.97) is 1.75% of the
wages and that of employer’s is 4.75% of the wages paid/payable in respect
of the employees in every wage period.
If wage is received every month by employee, the Contribution to the ESI
Corporation should be made by employer and employee every month
without fail.
@ 12% of interest per year should be paid If employer delays in payment of
the contribution to ESI corporation

PRINCIPAL EMPLOYER TO PAY CONTRIBUTIONS IN
THE FIRST INSTANCE. [Section 40]
Employer should pay the contribution to ESI Corporation of behalf of his
employee.
Employer may deduct employee contribution from employee wage for payment
of contribution to ESI Corporation.
Employer may recover the employee contribution paid from the wage of the employee
which should not exceed the amount equivalent to employer contribution.
Employer will become responsible for the payment to the ESI contribution after
deduction of the employee contribution from the employee wage
Employer should bear the expenses occurred in payment of contributions to the
Corporation.

GENERAL PROVISIONS AS TO PAYMENT OF
CONTRIBUTIONS. [Section 42]
No employee's contribution shall be payable by or on behalf of an employee whose average daily wages
during a wage period are below such wages as may be prescribed by the Central Government.
The average daily wages of an employee shall be calculated in such manner as may
be prescribed by the Central Government.
For Andhra Pradesh Employees in receipt of a daily average wage up to Rs.70/- are
exempted from payment of contribution.

METHOD OF PAYMENT OF CONTRIBUTION. [Section
43]
The ESI Corporation can make following rules and regulation in payment and collection
of contributions payable under this Act.
The manner of payment of contribution
The time of payment of contribution.
Fixation of stamps for payment of contribution.
Benefits distributed in the case of the insured persons by the corporation.
Maintenance of books and cards of contribution of insured person by
ESI Corporation.
The issue, sale, custody, production, inspection and delivery of books or
cards and the replacement of books or cards which have been lost, destroyed
or defaced.

EMPLOYERS TO FURNISH RETURNS AND MAINTAIN
REGISTERS IN CERTAIN CASES. [Section 44]
Every principal and immediate employer should submit to the Corporation or to such officer of the
Corporation as it may direct such returns in such form and containing such particulars relating to
persons employed by him.
Every principal and immediate employer shall maintain such registers or records in respect of his
factory or establishment
[Section 45A] (2010 amendment)
If no records or particular of employed persons are not maintain as required under this act by the his
employer, social Security officer by order, determine the amount of contributions payable in respect of
the employees of that factory or establishment. No order shall be passed by the Corporation in respect
of the period beyond 5 years from the date on which the contribution shall become payable.

SOCIAL SECRITY OFFICERS, THEIR FUNCTIONS AND
DUTIES. [SECTION 45] (2010 amendment)
The Corporation may appoint such person as Social Security Officers, as it thinks fit, for
the purposes of this Act. The following are his functions and duties.
Enquiring into the correctness of any of the particulars stated in any return referred to in
Section 44.
Social Security Officers can demand any principal or immediate employer to furnish to him such
information as he may consider necessary for the purposes of this Act.
Social Security Officers can at any reasonable time enter any office, establishment, factory or other
premises for inspection of examine such accounts, books and other documents relating to the
employment of persons and payment of wages or to furnish to him such information as he may consider
necessary.
He can examine the employer, his agent or servant or any person found in such factory, establishment,
and office.
He can make copies of, or take extracts from, any register, account book or other document maintained
in such factory, establishment, office or other premises.
He can do re-inspection whether the records and returns submitted under Section 44 are correct or not.

The following benefits will be paid to insured persons or to their dependents [Section 46]
Periodical payments to any insured person in case of his sickness certified by a
duly appointed medical practitioner.
Periodical payments to an insured woman in case of confinement or miscarriage
or sickness arising out of pregnancy, confinement, premature birth of child or
miscarriage, such woman being certified to be eligible for such payments.
periodical payments to an insured person suffering from disablement as a result
of an employment injury
periodical payments to such dependants of an insured person who dies as a
result of an employment injury
medical benefits

FUNERAL BENEFIT. [Section 46]
As prescribed by the central government, an amount of Rs. 5000/- is payable to the
dependents or to the person who performs last rites from day one of entering insurable
employment.
SICKNESS BENEFIT. [Section 49]
As prescribed by the central government, Sickness Benefit represents periodical cash
payments made to an IP during the period of certified sickness occurring in a benefit
period when IP requires medical treatment and attendance with abstention from work
on medical grounds. Sickness benefit is roughly 60% of the average daily wages and is
payable for 91 days during 2 consecutive benefit periods.
Qualifying Conditions
To become eligible to Sickness Benefit, an Insured Person
should have paid contribution for not less than 78 days
during the corresponding contribution period.
A person who has entered into insurable employment for
the first time has to wait for nearly 9 months before
becoming eligible to sickness benefit, because his
corresponding benefit period starts only after that interval.

IPs suffering from long term diseases was experiencing great hardship on expiry of 91
days Sickness benefit. Often they, though not fit for duty, pressed for a Final certificate.
Hence, a provision for paying Sickness Benefit for an extended period (Extended Sickness
Benefit)of up to 2 years in a ESB period of 3 years.
An Insured Person suffering from certain long term diseases is entitled to ESB, only after
exhausting Sickness Benefit to which he may be eligible. A common list of these long
term diseases for which ESB is payable, is reviewed by the Corporation from time to
time. The list was last reviewed on 5.12.99 and revised provisions of ESB became
effective from 1.1.2000 and at present this list includes 34 diseases which are grouped in
11 groups as per International Classification of diseases and the names of many existing
diseases have been changed as under :-
Extended Sickness Benefit (ESB)

I Infectious
Diseases
• 1. Tuberculosis
2. Leprosy
3. Chronic Empyema
4. AIDS
II Neoplasms
• 5. Malignant Diseases
III Endocrine,
Nutritional and
Metabolic Disorders
• 6. Diabetes Mellitus-with proliferative retinopathy/diabetic
foot/nephropathy.
IV Disorders of
Nervous System
• 7. Monoplegia
8. Hemiplegia
9. Paraplegia
10. Hemiparesis
11. Intracranial Space Occupying Lesion
12. Spinal Cord Compression
13. Parkinson’s disease
14. Myasthenia Gravis/Neuromuscular Dystrophies
V Disease of Eye
• 15. Immature Cataract with vision 6/60 or less
16. Detachment of Retina
17. Glaucoma

VI Diseases of
Cardiovascular System
• 18. Coronary Artery Disease:- a. Unstable Angina
b. Myocardial infraction with ejection less than 45%
19. Congestive Heart Failure- Left , Right
20. Cardiac Valvular Diseases with failure/complications
21. Cardiomyopathies
22. Heart disease with surgical intervention alongwith complications
VII Chest Diseases
• 23. Bronchiectasis
24. Interstitial Lung Disease
25. Chronic Obstructive Lung Diseases (COPD) with congestive heart
failure (Cor Pulmonale)
VIII Diseases of the
Digestive System
• 26. Cirrhosis of liver with ascities/chronic active hepatitis
IX Orthopaedic
Diseases
• 27. Dislocation of vertebra/prolapse of intervertebral disc
28. Non union or delayed union of fracture
29. Post Traumatic Surgical amputation of lower extremity
30. Compound fracture with chronic osteomyelitis
X Psychoses
• 31. Sub-group under this head are listed for clarification
• a. Schizophrenia
b. Endogenous depression
c. Manic Depressive Psychosis (MDP)
d. Dementia

In addition to the above list, Director General/Medical Commissioner are authorised to
sanction ESB for a maximum period up to 730 in cases of rare but treatable diseases or
under special circumstances, such as, adverse reaction to drugs which have not been
included in the above list, depending on the merits of each case, on the
recommendations of RDMC/AMO or either authorised officers running the medical
scheme.
To be entitled to the Extended Sickness Benefit an Insured Persons should have been in
continuous employment for 2 years or more at the beginning of a spell of sickness in
which the disease is diagnosed and should also satisfy other contributory conditions.
According to Section 69, employer shall be liable for payment of excess sickness benefit,
if the sickness to the insured person/ employee is caused by the negligence and
improper maintenance & no cleanliness of factory or establishment.
Extended Sickness Benefit (ESB)
XI Others
• 32. More than 20% burns with infection/complication
33. Chronic Renal Failure
34. Reynaud’s disease/Burger’s disease.

50. MATERNITY BENEFIT.
As prescribed by the central government, Maternity Benefit is payable to an Insured
Woman in the following cases subject to contributory conditions:-
Confinement-payable for a period of 12 weeks (84 days)
Miscarriage or Medical Termination of Pregnancy (MTP)-
payable for 6 weeks (42 days) from the date following
miscarriage.
Sickness arising out of Pregnancy, Confinement, Premature
birth-payable for a period not exceeding one month.
In the event of the death of the Insured Woman during
confinement leaving behind a child, Maternity Benefit is
payable to her nominee
Maternity benefit rate is double the Standard Benefit Rate,
or roughly equal to the average daily wage..

51. DISABLEMENT BENEFIT.
As prescribed by the central government
•Temporary disablement benefit (TDB)
Eligibility for TDB:
•The benefit is not subject to any contributory conditions. An Insured Person is eligible
from the day he joins the insurable employment.
•TDB Rate is 40% over and above the normal sickness benefit rate. This works out to
nearly 85% of the average daily wages.
Duration of TDB:
There is no prescribed limit for the duration of TDB. This is payable as long as temporary
disablement lasts and significant improvement by treatment is possible. If a Temporary
Disablement spell lasts for less than 3 days (excluding day of accident), IP will be paid
sickness benefit, if otherwise eligible.

51. DISABLEMENT BENEFIT.
Permanent Disablement Benefit (PDB)
PDB is payable to an Insured Person who suffers permanent residual disablement as a
result of EI (including Occupational Diseases) and results in loss of earning capacity. The
PDB rate is calculated as percentage of loss of earning capacity as assessed by the
Medical Board.
Employer will be liable for the accidents caused to his employer in the following
circumstance
•Accident caused to an employee even if he obeyed the safety instruction of his employer [Section 51B]
•Accident caused to employee while travelling in employer’s transportation vehicles. [Section 51C]
•At the time of employment the accident caused to the employee while protection or rescuing other
employer from occurring accident. [Section 51D]
•An accident occurring to an employee while commuting from his residence to the place of employment
for duty or from the place of employment to his residence after performing duty, shall be deemed to have
arisen out of and in the course of employment. [Section 51E] (2010 amendment)

RECIPIENTS OF SICKNESS OR DISABLEMENT
BENEFIT TO OBSERVE CONDITIONS. [Section 64]
A person who is in receipt of sickness benefit or disablement benefit (other than benefit
granted on permanent disablement)-
should remain under medical treatment at a dispensary, hospital,
clinic or other institution provided under this Act and shall carry out
the instructions given by the medical officer or medical attendant in
charge thereof;
should not while under treatment do anything and have chances of
recovery;
shall not leave the area in which medical treatment provided by this
Act is being given, without the permission of the medical officer,
medical attendant or such other authority as may be specified in this
behalf by the regulations; and
Should allow himself to be examined by any duly appointed medical
officer or other person authorized by the Corporation in this behalf.

BENEFITS NOT TO BE COMBINED. [Section 65]
(1) 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; or
(c) both maternity benefit and disablement benefit for temporary disablement.
(2) Where a person is entitled to more than one of the benefits mentioned in sub-Section
(1), he shall be entitled to choose which benefit he shall receive.

EMPLOYER NOT TO DISMISS OR PUNISH EMPLOYEE
DURING PERIOD OF SICKNESS, ETC. [Section 73]
No employer shall dismiss, discharge, or reduce or otherwise punish an employee during
the following circumstances
sickness maternity leave pregnancy or confinement
under the treatment in the
hospital
temporary disablement

CHAPTER VI
ADJUDICATION OF
DISPUTES AND CLAIMS

CONSTITUTION OF EMPLOYEES' INSURANCE COURT.
[Sec 74]
•The Court shall consist of such number of Judges as the State Government may think fit.
•Any person who is or has been a judicial officer or is a legal practitioner of 5 years'
standing shall be qualified to be a Judge of the Employees' Insurance Court.
•The State Government may appoint the same Court for two or more local areas or 2 or
more Courts for the same local area.
•Where more than one Court has been appointed for the same local area, the State
Government may by general or special order regulate the distribution of business
between them.

75. MATTERS TO BE DECIDED BY EMPLOYEES'
INSURANCE COURT.
If any question or dispute arises as to-
Payment of pay the employee's contribution
Payment of benefits and duration.
the rate of contribution payable by a principal employer in respect of any
employee
dispute between a principal employer and the Corporation, or between a
principal employer and an immediate employer or between a person and the
Corporation or between an employee and a principal or immediate employer,

75. MATTERS TO BE DECIDED BY EMPLOYEES'
INSURANCE COURT.
[Section 75
(2A)]
• The following claims shall be decided by the
Employees' Insurance Court, namely:-
claim for the recovery of contributions from
the principal employer; claim by a principal
employer to recover contributions from any
immediate employer;
[Section 77
(1A)]
• Every such application shall be made within
a period of three years from the date on
which the cause of action arose.
[Section 82
(3)]
• Appeal can be made to high court after the
ESI courts. The period of limitation for an
appeal to the high court of that state should
be within 60days when there is question
law.

SECTION
• 84
REASON
• Whoever, for the purpose of
causing any increase in
payment
causing any payment or
benefit to be made where
no payment
avoiding any payment to be
made by himself under this
Act
• Whoever, enabling any
other person to avoid any
such payment, knowingly
makes
• Whoever, made any false
statement or false
representation,
PENALITY
• punishable with
imprisonment for a term
which may extend to 6
months, or with fine not
exceeding 2000/- rupees,
or with both.
• PROVIDED that where an
insured person is convicted
under this Section, he shall
not be entitled for any cash
benefit under this Act for
such period as may be
prescribed by the Central
Government.

SECTION
• 85
REASON
• fails to pay any contribution
which under this Act he is liable
to pay
• in case of failure to pay the
employee's contribution which
has been deducted by him from
the employee's wages
• fails or refuses to submit any
return required by the
regulations, or makes a false
return,
• deducts or attempts to deduct
from the wages of an employee
the whole or any part of the
employer's contribution,
• obstructs any Inspector or
other official of the Corporation
in the discharge of his duties,
PENALITY
• imprisonment for a term which
may extend to 3 years but
which shall not be less than
one year,
• fine of 10,000/- rupees and
imprisonment which shall not
be less than six months
• Imprisonment for a term which
may extend to one year or with
fine which may extend to
4000/- rupees, or with both.

SECTION
• 85A
REASON
• Repeated
failure by the
employer to pay
any contribution
which under
this Act he is
liable to pay,
PENALITY
• Imprisonment
for a term which
may extend to 5
years but which
shall not be less
than 2 years
and shall also
be liable to fine
of 25,000/-
thousand
rupees.

POWER OF STATE GOVERNMENT TO MAKE RULES.
[Section 96]
The State Government may, after consultation with the Corporation, subject to the
condition of previous publication, make rules not inconsistent with this Act in regard to
all or any of the following matters, namely-
the constitution of Employees' Insurance Courts, the qualifications of persons who may be appointed
Judges thereof, and the conditions of service of such Judges;
the procedure to be followed in proceedings before such Courts and the execution of orders made by
such Courts;
the fee payable in respect of applications made to the Employees' Insurance Court, the costs incidental
to the proceedings in such Court, the form in which applications should be made to it and the particulars
to be specified in such applications;
the establishment of hospitals, dispensaries and other institutions, the allotment of insured persons or
their families to any such hospital, dispensary or other institution;
the scale of medical benefit which shall be provided at any hospital, clinic, dispensary or institution, the
keeping of medical records and the furnishing of statistical returns; the nature and extent of the staff,
equipment and medicines that shall be provided at such hospitals, dispensaries and institutions;
the conditions of service of the staff employed at such hospitals, dispensaries and institutions; and
any other matter which is required or allowed by this Act to be prescribed by the State Government.

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Employee State Insurance Act, [ESI] 1948

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