Employee State Insurance (ESI)
Written in plain language to promote general understanding. This is educational information, not legal advice. Based on Indian central (Union) law — Constitution of India, central Acts of Parliament, and Supreme Court decisions.
Indian Central Law
What is this right?
The ESI scheme provides health insurance and cash benefits to workers in the organised sector.
- Coverage: Employees earning up to ₹21,000/month (₹25,000 for persons with disabilities) in establishments with 10 or more workers (manufacturing) or 20+ workers (other).
- Contributions: Employee contributes 0.75% of wages; employer contributes 3.25% of wages. Employees earning below ₹137/day are exempt from the employee contribution.
- Benefits include:
- Free medical care at ESI dispensaries and hospitals for the insured and family.
- Sickness benefit: 70% of daily wages for up to 91 days during certified illness.
- Maternity benefit: 100% of average daily wages for 26 weeks (for the first two children).
- Disablement benefit: Periodic payments for temporary or permanent disability due to employment injury.
- Dependant's benefit: Periodic payments to family if the insured dies due to an employment injury.
When does it apply?
- You are employed in a covered establishment and earn up to ₹21,000/month (₹25,000 for PWD).
- You or a family member need medical treatment and you are an ESI insured person.
- You are unable to work due to illness, maternity, or a work-related injury.
What should you do?
- Obtain your ESI card (Pehchaan Card) from your employer or the ESI branch office — this is your identity document for accessing ESI medical facilities.
- For sickness benefit, obtain a sickness certificate from an authorised ESIC medical officer and submit it to your employer and the ESI branch office within the specified period.
- If your employer has not registered you under ESI despite being covered, file a complaint at the nearest ESI Regional/Sub-Regional office or via the ESIC grievance portal (esic.in).
- Disputes about benefits can be raised before the Employees' Insurance Court (s. 74, ESI Act) — no court fee is required.
What should you NOT do?
- Do not delay obtaining your ESI card — without it, accessing ESI hospitals in emergencies becomes difficult.
- Do not submit a sickness certificate after the prescribed period without a valid reason — late submission can result in benefit reduction.
- Do not use your ESI entitlement at private hospitals unless it is a genuine emergency — ESIC only reimburses private treatment under defined conditions.
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