What is Employee State Insurance (ESI)?
ESI is a self-financing social security scheme that provides medical, sickness, maternity, disability, and death benefits to employees. It is governed by the ESI Act, 1948.
Educational Purpose: This information is for general awareness only.
Eligibility and Applicability
- Applicable to establishments with 10 or more employees
- Employees with monthly wages up to ₹21,000 (₹25,000 for persons with disability)
- Covers factories, shops, hotels, restaurants, cinemas, etc.
ESI Contribution Rates
- Employee Contribution: 0.75% of gross wages
- Employer Contribution: 3.25% of gross wages
- Total ESI contribution: 4% of gross wages
Benefits Under ESI Scheme
- Medical Benefit: Full medical care for self and family
- Sickness Benefit: 70% of wages for up to 91 days per year
- Maternity Benefit: Full wages for 26 weeks
- Disability Benefit: 90% of wages for temporary/permanent disability
- Dependents' Benefit: Monthly pension to dependents after employee's death
- Funeral Expenses: Up to ₹15,000
- Confinement Expenses: For maternity-related expenses
How to Get ESI Card
- Employer registers with ESIC
- Employee gets a temporary certificate (Pehchan Card)
- Permanent ESI card is issued later
- Use ESI card at ESI hospitals/dispensaries for treatment
Important Note: ESI benefits are available from the date of coverage. Medical benefit is available to family members as well.
How to Claim ESI Benefits
- Visit ESI dispensary/hospital for medical treatment
- For cash benefits, submit claim forms through employer
- Sickness benefit: Submit Form 9 with medical certificate
- Maternity benefit: Submit Form 19 with proof of pregnancy
ESI Grievance Redressal
Contact ESIC regional office or use ESIC online grievance portal. Helpline: 1800-11-2001