Provincial Social Security (ESSI) — Health, Maternity, Injury Cover in Pakistan
Reviewed by the Commoner Law editorial team. Sources: pakistancode.gov.pk, Punjab/Sindh/KP/Balochistan provincial codes, Supreme Court of Pakistan, FBR, EOBI, SBP, NEPRA, OGRA, PMDC, FIA, and provincial Healthcare Commissions. Provincial variations cite Punjab/Sindh/KP/Balochistan Acts and ICT-specific ordinances. Written in plain English with everyday Urdu legal terms (FIR, qabza, khula, NTN, CNIC) for a general audience — this is educational content, not legal advice. Our editorial standards
What is this right?
ESSI is Pakistan's compulsory worker health-and-injury cover. Each province runs its own institution after the 18th Amendment, but the structure is the same: any establishment with 5 or more workers registered under the provincial ESSI is required to contribute, and workers earning up to the notified ceiling are secured persons entitled to free medical care at ESSI hospitals and dispensaries, plus cash benefits.
- Medical care: outpatient, inpatient, surgery, and medicines at ESSI facilities for the secured worker and immediate family. Reimbursement at empanelled private hospitals where ESSI doesn't have a facility.
- Sickness benefit: daily cash benefit equal to 75% of wages for up to 121 days a year of certified illness.
- Maternity benefit: 12 weeks' fully paid leave (6 weeks before, 6 weeks after delivery). Sindh raised it to 16 weeks in 2018. The ESSI pays the cash benefit and provides the medical care.
- Injury benefit: employment injuries trigger temporary disablement (75% of wages until certified fit), permanent disablement pension, or survivor's pension if the worker dies on the job.
- Death grant: a one-time payment to the family on death of a secured worker, plus a pension to dependants.
The catch is the wage ceiling. ESSI raises it slowly, and as of 2024 it sits around Rs 30,000–37,000/month depending on province. That means many formal-sector workers earn above the ceiling and are technically out of compulsory cover. They can still be voluntarily covered if the employer chooses, and the medical cover for the worker's family continues even after promotion above the ceiling under transitional provisions.
When does it apply?
- You work in an establishment with 5+ workers covered by your province's Social Security Ordinance.
- You earn at or below the current notified wage ceiling (most provinces Rs 30,000–37,000/month — check the latest SRO).
- Your employer is registered (or should be registered) with the provincial ESSI.
What to do to use your ESSI cover
- Get your ESSI card from your employer. Without it, you cannot walk into an ESSI hospital. The card is free and the employer is legally bound to provide it within days of joining.
- For maternity benefit, apply through your employer with medical certificate from ESSI doctor. Cash benefit is paid by ESSI directly (not through employer payroll), so don't accept "the company doesn't have it."
- For injury at work, the employer must report the accident to ESSI within 48 hours. If they don't, file directly at the ESSI regional office with your hospital papers.
- If your employer hasn't registered you, file a complaint with the provincial Labour Department or directly at the ESSI head office. They can register you retrospectively and recover the contributions.
- Check the network of hospitals at the provincial ESSI website (e.g. pessi.punjab.gov.pk; sessi.gov.pk; kpessi.gov.pk; bessi.balochistan.gov.pk).
What should you NOT do?
- Don't pay out of pocket at private hospitals for treatment that ESSI covers, then ask for reimbursement — empanelment requirements are strict and pre-authorisation is often needed.
- Don't let the employer say maternity leave is unpaid. ESSI pays it directly; the employer just has to facilitate the application.
- Don't forget the wage ceiling cliff. If your basic wage crosses the threshold, get the employer to formally continue voluntary cover or transition to private medical insurance — don't end up uninsured by accident.
Use the province bar at the top of the page to choose your province — you'll see how provincial law differs from the federal baseline.
1 province available
Frequently asked questions
Is ESSI separate from EOBI?
Yes. EOBI is a federal pension scheme (old-age, invalidity, survivor). ESSI is a provincial scheme covering health, maternity, injury, and death during your working life. Most workers in covered establishments are enrolled in both — different cards, different contribution rates.
How long is paid maternity leave under ESSI?
12 weeks at full wages — 6 before and 6 after delivery — paid directly by ESSI, not the employer. Sindh extended it to 16 weeks in 2018. The Maternity and Paternity Leave Act 2023 set a federal floor of 6 months for first child (3 for second, 1.5 for third) for federal employees and ICT establishments.
What if I earn above the wage ceiling?
Compulsory ESSI cover ends, but many employers continue voluntary cover. Ask your HR. If voluntary cover is not available, you'll need private medical insurance — don't assume you're still automatically covered just because you used to be.
When does provincial social security (essi) — health, maternity, injury cover apply?
You work in an establishment with 5+ workers covered by your province's Social Security Ordinance.You earn at or below the current notified wage ceiling (most provinces Rs 30,000–37,000/month — check the latest SRO).Your employer is registered (or should be registered) with the provincial ESSI.
My employer hasn't given me an ESSI card — what do I do in Pakistan?
Get your ESSI card from your employer. Without it, you cannot walk into an ESSI hospital. The card is free and the employer is legally bound to provide it within days of joining.For maternity benefit, apply through your employer with medical certificate from ESSI doctor. Cash benefit is paid by ESSI directly (not through employer payroll), so don't accept "the company doesn't have it."For injury at work, the employer must report the accident to ESSI within 48 hours. If they don't, file directly at the ESSI regional office with your hospital papers.If your employer hasn't registered y...
What mistakes should I avoid with provincial social security (essi) — health, maternity, injury cover?
Don't pay out of pocket at private hospitals for treatment that ESSI covers, then ask for reimbursement — empanelment requirements are strict and pre-authorisation is often needed.Don't let the employer say maternity leave is unpaid. ESSI pays it directly; the employer just has to facilitate the application.Don't forget the wage ceiling cliff. If your basic wage crosses the threshold, get the employer to formally continue voluntary cover or transition to private medical insurance — don't end up uninsured by accident.