>> What Is 'Sickness Benefit'? 

If an insured person requires medical treatment and attendance and needs abstention from work on medical grounds, Sickness benefit is paid for the period of abstention duly certified by the Authorized Medical Officer, for a period not exceeding 91 days in two consecutive benefit periods (say one year) @ 60% of his wages, subject to payment of contribution for not less than 78 days in the corresponding contribution periods. 

>> What Is Extended Sickness Benefits? 

This is an additional sickness benefit provided by the Corporation in exercise of its powers under Section 99 of the Act. An insured person who has completed two years of insurable employment and contributed for not less than 156 days during this period is entitled to extended sickness benefit for a period of 309 days for the 34 specified long term diseases. This period can be extended up to 730 days or  till the insured person attains the age of 60 years which ever is earlier. The benefit is payable @ 140%, of the standard benefit rate which works out to 70% of his wages. The insured person and his family are also entitled to Medical Benefit during this extended period. 

>> What is 'Enhanced Sickness Benefit'? 

To promote the norms of small family, this cash benefit is paid to the Insured person for undergoing vasectomy/ tubectomy operation. This is paid at double the standard benefit rate i.e. full wages, for a period of 7 days for vasectomy operation and for 14 days for tubectomy operation. This period can be extended in case of any post operative complications. 

>> What Is Disablement? 

Disablement is a condition resulting from employment injury, which may render the insured person temporarily incapable of doing his work and necessitating medical treatment (temporary disablement). It may reduce his earning capacity (permanent partial disability) or it may totally deprive the insured person from the capacity of doing any work (permanent total disability). 

>> What is 'Employment Injury"? 

It is a personal injury to an employee caused by an accident or occupational disease arising out of and In the course of his insurable employment within or outside territorial Iimits of lndia. 

>> What is Occupational Disease? 

Contracting any disease, while in employment for a specified period in any of the dustries listed in Part A, B, or C of Schedule III to the Act is called Occupation disease. Occupational health hazards can be of two main types. Short term and high dose with acute on set, synonymous with acute poisoning, included by large dose of a toxic substance In an industrial environment, and the other one is chronic on set, which is the result of repeated or continuous exposure of small doses of substances. 

>> What is 'Temporary Disablement Benefit'? 

It is a periodical payment to an insured person suffering from Disablement as a result  of 'Employment injury' for the period of abstention from work duly certified by an authorized Medical Officer. This is paid till the temporary disability lasts and the employee is able to resume his normal duties, @150% of the standard benefit rate which is 75% of his wages. 

>> What is Permanent Disablement Benefit? 

If there is any residual disability of permanent nature due to employment injury, the insured person Is examined by a Medical Board to access the loss of earning capacity if any and its percentage. The insured person is paid monthly periodical payments of permanent disablement for life from the date following the date of termination of temporary disablement at that percentage out of full daily rate of disablement benefit Periodical increase in the benefit is also admissible due to erosion in the cost of living. The benefit can be drawn in cash at the Branch Office, by Money Order at the cost of the Corporation, or credited to the Bank Account of the insured person every month. The insured person can also opt for the payment in lump sum if his daily rate of PDP does not exceed rupees five or even if it exceeds five per day, but the commuted value does not exceed Rupees 30000. 

>> What is Dependants' Beneflt? 

Dependants' benefit is a monthly pension payable to the eligible dependants of a insured person who dies as a result of an employment injury or occupational disease. The benefit can be drawn in cash at the Branch Office or by Money order at the cost of the Corporation or it can be credited every month to the bank account of the beneficiary. 

>> How long is it paid and at what rate? 

The rate of dependants' benefit is the full rate of disablement benefit, which is 75% ( the wages of the deceased insured person. It is distributed among the dependant as follows:
1) Widow: Till death or remarriage at 3/5th of the full rate. 
2) Widowed mother till death @2/5th of the full rate. 
3) Sons @2/5th of the full rate each till he attains the age of twenty -five years. 
4) Unmarried daughters@2/5th of the full rate till they get married. 
5) If the son or daughter is infirm and wholly dependant on the earnings of the insured person at the time of his death, they continue to receive the benefit even after attaining the age of 25 years/ marriage as the case may be. If the total dependants' benefit for all the dependants worked out as above exceeds at any time, the full rate, the share of each of the dependants shall be proportionately reduced, so that the total amount payable to them does not exceed the amount at full rate. 

>> Whether the TDB/PDB/DB Is also admissible in the case of a casual or temporary employee If he meets with an employment injury on the very first day or on any day before he completes his first contribution period? 

No qualifying conditions or contributory conditions are attached for payment of temporary disablement benefit, permanent disablement benefit or Dependants benefit. Even if he meets with an employment injury on the very first day of his joining the insurable employment, the benefit is admissible. 

>> What Is maternity benefit? 

Maternity benefit is periodical payments to an Insured person for specified period of abstention from work, due to confinement, miscarriage or sickness out of pregnancy, pre-mature birth of child or miscarriage or confinement. 

>> What Is confinement? How long is the maternity benefit admissible In case of confinement? 

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. Maternity benefit at double the standard benefit rate (full wages) is payable for 84 days, subject to payment of contribution for not less than 70 days in the immediately preceding two contribution period. The benefit can be claimed at anytime prior to six weeks before the expected date of confinement or from the date of confinement as per the condition and the requirement of the insured woman. 

>> What Is 'miscarriage' and how long is the benefit admissible? 

'Miscarriage' means the expulsion of the contents of a pregnant uterus at any time prior to or during the 26th week of pregnancy, but does not include a miscarriage, the cause of which is punishable under the Indian penal code. Maternity benefit is payable for miscarriage for a period of 6 weeks (42 days) from the date following the date of miscarriage at double the standard benefit rate subject to fulfillment of the contributory condition prescribed. 

>> What is sickness arising out of pregnancy etc. How long is the Maternity benefit Is admissible for it? 

If the insured woman needs medical treatment and attendance and abstention from work due to sickness arising out of pregnancy. miscarriage, premature child birth or confinement, duly certified by an authorized Medical Officer, Maternity Benefit at doublet he standard benefit rate is payable for a period one month. 

>> What is medical bonus? 

Medical Bonus is lump sum payment made to an insured woman or an insured person in respect of his wife for each confinement to meet the confinement expenses, if the confinement occurs at a place where necessary facilities under the ESI Scheme are not available. At present the confinement expenses paid is Rs. 2500/- per confinement. 

>> What are funeral expenses? To whom is It paid? 

A lump sum payment not exceeding Rs.5000 towards expenditure on the funeral of a deceased insured person, is paid either to  the eldest surviving member of the family or if he has no family or not residing with his family at the lime of death, to  the person who actually performs the funeral of the deceased insured person. 


Twitter Delicious Facebook Digg Stumbleupon Favorites linkedin More