File Copyright Online - File mutual Divorce in Delhi - Online Legal Advice - Lawyers in India

The Role of Employees State Insurance Corporation In Securing Social Security

Social security is an important component of any social development agenda and is as relevant as physical security in the evolving concept of human security. Right to social security is a human security. Right to social security is human right[1]and hence everyone has a right to a standard of living adequate for the health and well being of himself and his family. India being a socialistic democratic state, has a commitment of providing social and economic justice to its citizens for the survival of democracy. Moreover, the creation of the welfare state is to execute instrumentalities which are enshrined in the directive principles of state policy serve as fundamental guides for the states action towards social, economic and welfare programmes with a view to ameliorate the conditions of labour[2]. In pre independence period, a beginning was made to provide social security measures with the passing of the workmens compensation act, 1923. After independence, the government of india has enacted a number of legislations to provide social security to industrial workers as productivity of labour is an essential condition for all round prosperity of the country. But efficient production depends upon the sincere functioning of labour and industry. If an industry exploits labour, it will affect the attainment of socio economic objectives of the country itself.

When social justice is the primary objective of the state as envisaged in our constitution, a reasonable return on labour is facilitated by social security laws which are as follows:
(i) The Employees Compensation Act,1923
(ii) The Employees State Insurance Act, 1948
(iii) The Employers Provident Funds and Miscellaneous provisions Act, 1952
(iv) The Maternity Benefit Act, 1961
(v) The Payment of Bonus Act, 1965
(vi) The Payment of Gratuity Act, 1972
(vii) The Unorganised Workers Social Security Act,2008

Objectives of The Study
·The aim is to provide certain benefits to employees in case of sickness, maternity, health and employment injury
·To secure the health of employees of factories and establishment
·The aim is to pay dependants benefits to dependants of each employees
·The aim is to absolve the liability under employer compensation Act, 1923 and the maternity enefit Act, 1961

Social security is a important component of any social development agenda which is to provide protection against the economic and social distress, following hypothesis have been formulated:
·ESI corporation to establish medical colleges, nursing colleges and training institutes for para-medical staff and other employees to improve the quality of services provided under ESI scheme
·ESI corporation to provide for certain benefits to empoyees in cases of sickenss, maternity, medical benefits, disablement benefits, dependents benefits.

Limitations of The Study
This study is intended to be limited to review the role of employees state insurance corporation in securing the social security and to analyse the existing social security measures under employees state insurance act, 1948.

The project work is doctrinal in nature on the basis of secondary sources. Secondary data is one type of quantitative data that has already been collected by someone else for a different purpose to our topic in discussion. It is always in convenient to use data collected by someone else if exists it may be on a much larger scale than we could hope to collect and could contribute to our findings considerably. Secondary sources can be classified as:
·Paper based sources: books, journals, periodicals, abstracts, indexes, directories, research reports, conference papers, market reports. Annual reports, internal records of organizations, newspapers and magazines.

·Electronic sources: CD-ROMS, online databases, internet, videos and broadcast. To appreciate the contribution made by the judiciary in promoting social justice to the workers case laws are also analysed.

Scope of social security:
·The quest for social security and freedom from want and distress has been the consistent urge of man through ages. This urge has assumed a several forms, according to the needs of people and their level of social consciousness, the advance of technology and the pace of economic development. These measures have introduced an element of stability and protection in the midst of stress and strains of life. It is a major aspect of public policy and the extent of its prevalence is a measure of the progress made by a country towards the ideal of a welfare state[3]. There are nine components[4]of the social security which configure its scope[5]. It envisages that the members of a community shall be protected by a collective action against social risks causing undue hardships and privation to individuals whose prime resources can seldom be adequate to meet them. It covers through an appropriate organisations, certain risks are such than an individual of small means cannot effectively provide for them by his own ability or foresight alone or even in private combination with his colleagues[6]. The crux of the labour problem is the mutual conflict between the employer and the employee over the question of adequacy of which the collective bargaining and the industrial conflict are two main aspects[7].

·I.L.O and social security:
·The primary object of the international labour organisation is promoting social justice[8]and improving the living and working conditions of workers throughout the world. It emphasized the importance of comprehensive social security measures in the preamble to its constitution, in which it promised, “protection of employment injury and disease and workers against stress, the protection of children, young person and women, provision for old age and injury.

·Indian constitution and social security:
·The directive principles of our constitution reflect the concern of the state to protect and promote the interests of weaker sections of our population. The constitution of India was enshrined with the provisions in a way to ensure social security to the human beings, in particular the workmen. The constitution guarantees the promotion of welfare of the people[9]and eradication of the inequalities[10]and it provides forthe state to direct its policy towards securing livelihood, common hood[11]etc., By the constitution the operation of a legal system shall be secured[12]and effective provisions[13]were made by the statefor the participation of workers in undertakings[14]and for securing just and humane conditions of work[15]and a decent standard of life[16].

·The provision of the constitution was incorporated as a remedial measure to deal with the inconsistency between laws made by the parliament and legislatures of the state[17]. The matters relating to the labour class are enumerated in the concurrent list[18]. If any provisions were made inconsistent with that list, it will be void[19]. The state legislatures has full power to legislate regarding these subjects, subject to the provisions of article 254(2)[20], that is, provided the provisions of state act do not conflict with those of any contract act on the subject.The constitution also prohibits trafficking[21]and child labour[22].

Social security system in India:
·In ancient India there were economic groups living together in the form of modern guilds, specialising in different branches of the economy. Dr.R.C. Majumdar gives a list of about thirty such groups[23]. The ancient jurists like Vishnu, yagnavalkya, Brihaspati etc., had frame extensive laws regarding wages and conditions of work and technical and vocational training, women and child labour, regulation of industrial relations etc., these scripts bear testimony to the fact that social structure in those days was so involved and codes so designed as to provide security to the people in general and the workers in particular[24]. Kautilya[25]has mentioned a number of pension schemes in his work, such as, educational pension, public poor relief[26].In the eighth century, sukracharya makes special provisions for social security particularly regarding sickness benefits, pensions and the old age benefits, family pensions and maintenance allowance. He made it clear that when a servant was ill and couldn’t work temporarily, the master should make no deduction from his salary[27].

·In modern India, it was only during the present century that the ancient rulers tried to look into the problem of social security that too was mainly restricted to the factoryworkers and the like. The different sessions of the international labour conference, the recognition of social security as a responsibility of the state of different states in Europe and America and advances made in these countries inspired the government of India to study the problems. A number of study teams and committees[28]were appointed and they gave suggestions and unanimously agreed that the social security measures for the workers in India were not adequate. However it was mainly after the independence that India could take up the problem of social security at par with all advanced countries of the world in a planned and co-ordinatedmanner[29]. Free India adopted the thoughts of the leader’s pt. Jawaharlal Nehru[30], sardarvallabhai Patel[31],[32]and others.

Establishment of Employees State Insurance Corporation

Pursuant to the power granted to the central government under section 3 of the Act, the central government established the corporation on 1. 10.1948 by the issue of notification in the official gazette. The corporation is a body corporate having perpetual succession and a common seal and shall sue and sued[33].

Constitution of The Corporation
The corporation consists of the members representing the governments at the centre and the states, parliament, medical council, employers and employees. The chairman and vice chairman of the corporation are nominated by the central government. The director general of the corporation will be an ex officio member. He is vested with the powers to manage the affairs of the corporation.
The other members of the corporation are chosen as follows:
(i) Not more than five members nominated by the central government;
(ii) One person nominated by the state government of each state in which the act is in force;
(iii) One person nominated by the central government to represent the union territories;
(iv) Five persons representing the employers to be nominated by the central government in consultation with the employers organization;
(v) Five persons representing the employees nominated by the central government in consultation with the employees organization;
(vi) Two persons representing medical profession to e nominated by the central government after consulting the organizations of medical practioners;
(vii) Three members of parliament of whom two shall be from the lok sabha and one from the rajya sabha who are elected by the concerned houses[34].
The chairman, vice chairman, representatives of the central government, state governments and union territories hold office during the pleasure of the government concerned whereas the representatives of the employers medical professions and parliament are to hold office even after the expiry of their tenure until the nomination of their successors is notified.

Powers of The Employees State Insurance Corporation
The corporation is empowered to take steps for the benefit of the insured persons. They are:
(i) To promote the measures for the improvement of health and welfare of insured personnel;
(ii) To promote the measures for the rehabilitation and re-employment of insured persons who are disabled or injured;
(iii) To incur expenses in respect of such measures from its fundup to a limit prescribed by the central government[35].

Constitution of Standing Committee
The standing committee is constituted from among the members of the corporation as follows:
(i) A chairman nominated by the central government;
(ii) Three members of the corporation representing three state governments as nominated by the central government;
(iii) Three members of the corporation nominated by the central government;
(iv) Eight members elected by the corporation from among its members;
(v) Three representing employers, three representing employees;
(vi) One representing medical profession;
(vii) One representing the parliament[36].
The chairman and representatives of the central and state governments hold office during the pleasure of the central government. The other members of the committee elected by the corporation hold office for two years from the date on which election is notified[37].

Powers of The Standing Committee
The standing committee is constituted to administer the affairs of the corporation. It is to function in accordance with the regulations framed by the corporation. Its activities are controlled and supervised by the corporation under the general provision ad matters as specified in the regulations for the corporations consideration and decision[38].

Constitution of Medical Benefit Council
The medical benefit council set up by the central government to advise the corporation on medical questions consists of the director general of health serviced as its official chairman, deputy director general, medical commissioner of the corporation, three members representing the employers nominated by the central government, three members representing the medical profession nominated by the central government and one representative from every state nominated by the state government. The deputy director general holds office during the pleasure of the central government. Similarly, representatives of the state governments pleasure. The representatives of the employers, employees and medical profession hold the office for four years from their nomination[39].

The Powers And Duties of Medical Benefit Council
The council is to advise the corporation and the standing committee regarding the matters relating to the administration of medical benefits certification for the purposes of the grant of benefit and other concerned matters. The council enjoys such powers and performs such duties as may be prescribed in relation to the administration of medical benefits, in connection with the medical treatment and assistance as specified in the regulations[40]

Central Governments Power To Supersede The Corporation And Standing Committee
The central government is empowered to supersede the corporation or standing committee on the following grounds:
(i) If in the opinion of the central government, the corporation or the standing committee persistently makes default in performing the duties imposed on it by or under the act; or
(ii) If in the opinion of the central government, the corporation or standing committee abuses the powers invested on it[41].
Such supersession is possible only in consultation with the corporation. The central government shall give a reasonable opportunity to the corporation or the standing committee to slow causes why it should not be superseded. When a notification superseding the corporation, or standing committee is published by the central government, all the members of these bodies shall be deemed to have vacated their office from the date of publication of notification.

A person is disqualified to be chosen or to continue as a member of the corporation, standing committee or medical benefit council if:
(a) He is declared to be of unsound mind by a competent court; or
(b) He is an undischarged insolvent; or
(c) He has directly or indirectly by means or by his partner any interest in a subsisting contract with any work being done for the corporation except as a medical practioner or a shareholder of a company; or
(d) He is convicted of an offence involving the moral turpitude whether before or after this act came in to force[42].

Role of ESIC To Secure Social Security Through Benefits Available Under Employees State Insurance Act, 1948
The various benefits under this clearly shows that this is for social security legislation. It provides for six types of benefits to which the insured persons, their dependants and certain other entitled persons.
The benefits are as follows:
1.Sickness benefit
2.Maternity benefit
3.Disablement benefit
4.Dependants benefit
5.Medical benefit
6.Funeral benefit

Sickness Benefit
An insured person is entitled to claim sickness benefit if he had paid contribution for a period of not less than 13 weeks. For sickness occurring during the first benefit period, he can claim sickness benefit if he had paid for half the number of weeks of the contribution period ending in that period[43]( for e,g. more than 26 weeks in the one year)

A duly appointed medical practioner must certify that the insured person is suffering from sickness. The daily rate of sickness benefit is calculated by a ratio between his average daily wages and the contribution period.
But if sickness recurs within 15 days he can get the benefits. Sickness benefit is not payable for more than 56 days in any two consecutive benefit periods. The daily rate at which the benefit is payable to a person for the period of sickness is the standard benefit rate corresponding to the daily average wages during the corresponding contribution period.

The following conditions are to be complied with to entitle to sickness benefit:
(i) The person must be under medical treatment at the dispensary hospital or institution provided under the act and must carry out the instructions given by the medical officer.
(ii) While under treatment, he must not do anything which might reduce his chances of recovery.
(iii) He should not leave the area without the permission of the medical officer.
(iv) He must allow himself to be examined by any duly appointed officer authorized by corporation.

Waiting Period In Sickness Benefit Under ESI Act, 1948
Sickness benefit is not payable for the first two days of a spell of sickness except in case of a spell commencing within 15 days of closure of earlier spell for which sickness benefit was last paid. This period of two days is called ‘waiting period’.

Maternity Benefit
An insured woman can get maternity benefit in cases of miscarriage, confinement, sickness due to pregnancy and for premature birth of a child. The grounds of eligibility of an insured woman to such payments must be certified by an insurance medical officer as provided by the regulations under the act. However, she should have paid weekly contributions for not less than 13 weeks. All the other rules are similar to the rules in sickness benefit except that her standard benefit will be doubled. The maternity benefit is not available for maternity benefit is not available for more than six weeks during her confinement. If the insured women dies leaving behind a child, the maternity benefit is paid for the whole period. If the child also dies, the maternity benefit is given to the woman workers nominee. If there is no nominee it is paid to her legal representatives[44].
In the year 1921, ILO adopted a recommendation to the effect that each member should take measures to ensure to woman wage-earner employed in agricultural undertakings protection before and after child birth, similar to that provided by the maternity protection convention, 1919.

The Employees state Insurance Scheme provides benefits against maternity, insecurity of danger to life and death to life and death of the mother and child arising out of miscarriage, confinement, still and premature birth and sickness or disease due to pregnancy.

The justification for maternity benefit is two fold:
(1)To protect the health of mother and her child; and
(2)To alleviate part of the financial hardship caused by the birth of a child[45].

Statutory definition of maternity benefit: periodical payments to an insured woman in case of confinement or miscarriage or sickness arising out of pregnancy, confinement, premature birth of a child or miscarriage, such women being certified to be eligible for such payments by an authority specified in this behalf by the regulations is hereinafter referred to as maternity benefit[46].

However, it may be noted that section 50 which contained all these provisions has been substituted in 1989. Section 50 as it now stands provides that the qualification of an insured woman to claim maternity benefit, the conditions subject to which such benefit may begiven, the rates and period thereof shall be such as may be prescribed by the central government.

Contingencies under which it is payable:As indicated above, the maternity benefit is payable for (a) confinement, (b) miscarriage, (c) sickness arising arising out of pregnancy confinement, premature birth of child, or miscarriage, and (d) death.

(a) Confinement: the term confinement has been defined under section 2(3) of this act. According to it, 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. This definition clearly indicates that labour resulting in the issue of child is covered under confinement and labour resulting in the issue of child- whether alive or dead is covered under confinement only when such delivery takes place after 26 weeks of pregnancy.

(b) Miscarriage: according to section 2 (14-B) of ESI Act, miscarriage means the expulsion of the contents of a pregnant uterus at any period prior to or during the 26 th week of pregnancy but does not include any miscarriage, the causing of which is punishable under the indian penal code. If the definitions of miscarriage and confinement, are read together it becomes clear that if expulsion of contents of the uterus takes place after 26 weeks, labour resulting therein is known as confinement and if it occurs at any period prior to or during the 26 th week of pregnancy it is known as miscarriage. An insured woman who is qualified to claim maternity benefit in accordance with section 50 shall in case of miscarriage be entitled to maternity benefit at the rates and for such duration and subject to such conditions as may be specified by the central government in this behalf. Really speaking the incidence of miscarriage or abortion is higher for woman employed in industries than other woman. Such occasions, besides causing economic loss and physical sufferings, like that of normal confinement also upset the woman emotionally. In most of the countries the contingency of maternity, besides pregnancy and confinement also includes their probable consequences[47].

It would be worth mentioning that no woman can claim maternity benefit for miscarriage causing of which is punishable under indian penal code because an intentional miscarriage amounts to an offence punishable under the provisions of the Indian penal code[48].

(c) Sickness arising out of pregnancy, confinement, premature birth of child or miscarriage: ESI scheme provides special protection to working women in industrial establishments to which the provisions of this act apply for maintenance of their health and newly-born child. The sickness arising out of pregnancy, confinement, premature birth of child or miscarriage entitles to an insured woman, in addition to maternity benefit payable to her under any provisions of this Act, for all days on which she does not work for remuneration to maternity benefit at the rates specified.

As a matter of fact, confinement as defined by the provisions of this act covers contingencies of premature birth as well. If a child is born alive after full period of pregnancy it is mature birth, and if the child is born after 26 weeks of pregnancy it is premature birth-whether alive or dead and an insured woman is entitled to claim maternity benefit in all such contingencies.

(d) Death: sometimes it so happens that an insured woman dies during her delivery or during the period immediately following the date of her delivery for which she is entitled to maternity benefit. It may happen that she may expire leaving behind the surviving child and sometimes the unfortunate event of death of both child and mother may occur. In all such contingencies an insured woman is entitled to maternity benefit. The maternity benefit shall be paid for the whole of that period then maternity benefit shall be paid for the days upto and including the day of the death of the child. It means that if the mother dies on the date of the delivery of the child and the child of child death. In such an event maternity benefit shall be paid by the authorities concerned to the person nominated by the insured woman in such a manner as may be specified in the regulations and if there is no such such nominee such benefits are paid to her legal representative[49].

In 1996 ESI (Central) Rules,1950 have been amended and now rule 56-A has been inserted which provides that medical bonus to an insured woman and an insured person in respect of his wife shall be paid sum of rs.2500/- per case as medical bonus on account of confinement expenses: provided that the confinement occurs at a place where necessary medical facilities under the ESI scheme are not available. Provided further that confinement expenses shall be paid for two confinements only.

Disqualifications for maternity benefit-An insured wpman may be disqualified from receiving maternity benefit if (1) she fails without good cause to attend for; or (2) to submit herself to medical examination when so required and such disqualification shall be for such number of days as may be decided by the authority authorized by the corporation in this behalf. However, she may refuse to be examined by other than a female doctor or midwife[50].

Disablement Benefit
An accident is an unfortunate occurrence resulting in cessation of work by worker or a group of workers. More often than not, every accident also inflicts on worker.[51]The ESI Scheme provides for benefits to be paid to workers who sustain employment injury as defined under the provisions of this act and discussed earlier, are entitled to claim benefits. Periodical payment to an insured person suffering from disablement as a result of an employment injury sustained as an employee under this act, certified to be eligible for such payments by an authority specified in this behalf by regulations, is referred to as the disablement benefit.

Section 51 of ESI Act provides for disablement benefit in case of temporary and permanent disablement. The disablement benefit shall be payable to an insured person. The amended section 51 makes provisions for the disablement benefit in tow contingencies:
(1) Where a person sustains temporary disablement for not less than three days excluding the day of accident;
(2) Where a person sustains permanent disablement, whether total or partial.

The rate and the conditions of eligibility were governed by first schedule before amendment made in 1989 but now the first schedule and some provisions of old section 51 have been omitted. In place of these provisions now the central government has been empowered to prescribe rates, periods and conditions subject to which such benefit shall be payable.

Temporary Disablement Benefit, is a condition caused by an employment injury which necessitates medical attendance and renders the employee temporarily incapable of doing the work which he was doing prior to the happening of the accident, resulted in such an employment injury. Temporary disablement is paid as leave salary, in case of an employment injury. The rate of leave salary is 90% of the average daily wage earned by the employee in the contribution period corresponding to the benefit in which the accident happened. It is available from the date of joining the insurable employment.

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 the date following the date of termination of temporary disablement at rate of benefit[52].

Dependants Benefit
The individualistic character of the family and the want of income yielding property or family occupation causes economic insecurity for the members of a workers family in case he dies a premature death. With human life there is an asset value; the life of bread-winner is the biggest asset often the only asset of the average family of the industrial workers. The death of its bread-winner is the greatest calamity that can befall. The family at once sinks below the poverty line and hence flows a train of evils. It is this that is largely responsible for putting women in factories when they should have been in homes and the children on the streets when they should have been at school[53].

Dependants benefit is a monthly pension payable to the eligible dependants of an insured person who dies as a result of an employment injury or occupational disease. The benefit cane 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 the bank account of beneficiary.

Review of Dependent's Benefit-Any decision awarding dependents benefit may be reviewed at any time by the Corporation if it is satisfied by fresh evidence that the decision given in non-disclosure or misrepresentation by the claimant or other person of a material fact whether the or misrepresentation was not or was fraudulent or that the decision is no longer in accordance with this due to any other or due to the marriage, remarriage or cesser of infirmity of or attainment the age of 25 years by, claimant subject to the provisions of ESl. Act, the Corporation may, such direct that the dependents' benefit be continued, increased, reduced or discontinued[54]. The Corporation has been empowered to review the decisions taken earlier for award of dependent's benefit in order to provide relief in cases where decision has been taken in consequence of non-disclosure of material fact or misrepresentation of material fact, secondly, if the circumstances have changed due to birth or death or marriage or re marriage or cesser of infirmity or attainment of prescribed age.

Medical Benefit
The first need of a sick or injured person is the alleviation of his physical care. He must be cured of his ailment and restored to his suffering by per medical normal health as rapidly as possible. Health is the most precious asset individual and the only asset of the wage earner. No amount of cash payment can adequately compensate for its loss. Ill-health is a permanent drain on the meagre earnings of an individual; medical benefit, therefore, forms an integral part of insurance benefit and more than the cash payment made to compensate the loss of earnings. In fact is more important the pecuniary compensation which aims at shielding the patient from the most material cases only subsists as a factor side by side with medical assistance[55]. The supplementary maintenance of a healthy and vigorous labour supply is of capital importance not only for the workers themselves, but also for communities which desire to develop their productive the workers the capacity[56].

The medical care recommendation of ILO. provides that a medical care service should meet the need of the individual for care by the members of the medical and allied professions and for such other facilities as are provided at medical institutions.

(A) With a view to restoring the individual's health, preventing the further development of diseases and alleviating suffering when he is afflicted by ill health (curative care);
(B) With a view to protecting and improving his health (preventive care)[57].

The Universal Declaration of Human Rights adopted in 1948 by United Nations General Assembly proclaimed the right of everyone to medical care and so it recognised medical care principles contained in ILO. recommendations The provision for medical benefit has been made under ES.I Act, 194s in accordance the above ILO. Medical recommendations. The responsibility to provide medical benefit to the insured person is placed on the State Governments which have to make arrangements for medical assistance etc. in consultation with the ESI. Corporation and according to the standards laid down by it. The State Governments are not to bear the le cost of medical care since the Corporation reimburses each State for a part of the expenditure incurred in providing medical care to the insured person under the act. Medical treatment for an attendance on insured persons is hereinafter referred to as medical benefit[58].

Conditions for Medical Benefit-Following are the conditions for application of section 56 of the ES.I. Act:
(1) The claimant must be an insured person
(2) The claimant must be in such a condition which requires medical treatment and attendance.
(3) The claimant must have paid his contribution for the period for which he requires medical benefit then and then only he shall be entitled to medical benefit during such a period or he is qualified to claim sickness benefit or he is entitled to claim maternity benefit or he is in receipt of such disablement benefit as does not disentitle him to medical benefit under the regulations.
(4) Medical benefit is given to the insured person and to his family, where it has been extended to cover family of an insured person.

If an insured person or any member of his family requires medical treatment, then medical benefit is given. It may be given either in the form of out patient treatment or as inpatient in the hospital. The insured person is entitled to medical benefit during any week in which contributions are payable. The state government also arranges for medical treatment and provides rules for the kind and scale of medical benefit. The corporation may establish and maintain hospitals, dispensaries and surgical services with the approval of the state government, for the benefit of insured persons and their families. The corporation may undertake responsibility of providing medical benefit to insured persons in consultation with the state government[59].

Funeral Expenses
Besides benefits indicated earlier, ESI scheme provides for funeral expenses also under certain circumstances. Section 46 (f) provides that payment to the eldest surviving member of the family of an insured person who has died, towards the expenditure on the funeral of the deceased insured person, or, where the insured person did not have a family or was not living with his family at the time of his death, to the person who actually incurred expenditure on the funeral of the deceased insured person to be known as funeral expenses shall be one thousand rupees.

For the application of section 46 (f), the following conditions must be fulfilled-
(1) The insured person must have died;
(2) The claimant must have incurred expenditure on the funeral of the deceased insured person;
(3) The claim for such payment shall be made within three months of the death of the insured person.

However, the period may be extended by the corporation or any officer or authority authorized by it in this behalf. The rules regarding funeral expenses have been substituted with effect from 15-6-1991; which provide in respect of issue of death certificate, submission of claims for funeral expenses, etc.,

Other Benefits
Besides the above, other benefits being provided to the beneficiaries are confinement expenses, funeral expenses, unemployment allowance and skill up gradation training under RGSKY, vocational rehabilitation facilities for permanently disabled persons, aids to insured persons and his family members etc., and role in providing a complete social security to a major work force.

Case Laws:
In Whirpool of India Ltd. v. ESI Corpn[60]. the Supreme Court again held that the ESI is a social legislation to provide benefits to employees. Broadly this The main source of which the action has been established under Section3 of the Act. the Corporation contributions paid to the Corporation. The Employees' State Insurance Fund is the others are as in Chapter v. in benefits to be provided to insured persons and used but not defined in the Act particular, 46 The words and expressions have meanings respectively defined in the Industrial Disputes Act, 1947, an assigned to them in Disputes Act, 1947. Undoubtedly as would be interpretations may be possible would deserve such construction beneficial working class but, at the same time, we cannot go by to the plain language of a provision.

In damodar mangal ji and Co. v. Director, ESI[61]where appellant company was engaged in mining industries. The company challenged the notification issued to mining industry is beyond the scope of the notification Government means, in respect of reason that the Government, or railway the establishment under the control of Central government, and in administration a oil the all other cases, the State Government. The appellant contended expression 'mine in Section of Act to be with the expressions such as in respect of read so, would mean not only the area where extraction of ores takes but also the other office and that the enactment itself intends to make a distinction. It has so been made as is clear from Section which defines expression factory", and mine which is subject to the operation of the Mines Act, 1952 is excluded from the purview of the Act and placed heavy reliance on the decision of the Court.

In Ballarpur Collieries C. v. State Industrial[62]Court on behalf of the respondent. strong reliance is placed upon the decision in Serajuddin and Co. v. Workmen , where the specific question what is the appropriate Government has been considered and held that the expression mine used in Section 2 (a) (i) of the Mines Act, 1952 to confine only to those cases where it really concerns a mine where extraction of ores actually takes place as defined under Mines Act and not other parts of establishment The supreme Court considered both the cases and observed that in Ballarpur Collieries Co, case the Court was concerned with a notification which stated that the Act would come into force on 21-11-1974 "in all industries except the following and then went on to name four industries, the third one being "mines". The Supreme Court held that after the "following" the word "industries" and thus read the notification in effect said the Act would come into effect on the given date in all industries except the industries above mentioned. Therefore, it was held that it is not only mines but the mining industry itself that was exempted from the operation of the Act Application of the Act The Law regarding extension of the Act was fully discussed by the C Mootham of the Allahabad High Court.

In Anand Kumar v. Employees' State Insurance Corporation[63]is lt was observed that the Central Government have been given wide discretion in extending the provisions of the Act to any part of India. But the Act cannot be brought fully into force until the Central Government is satisfied that the contributions amount have been collected to enable the Corporation to fulfil its obligation under this Act. This power been given to the Central Government to enforce different provisions o this Act.

In paul abrao and sons v. Esi corpn, and p.k.mohd v. Esi corpn[64]the supreme court discussing legality of notification extending operation of the act to shops, hotels, restaurants and other specified establishments in specified areas observed that the appellant is rendering service to cater to the needs of exporters and importers and others who want to carry the goods further. Therefore , it is shop carrying on a systematic economic or commercial activity. This would be enough to bring in the appellant without specifically enumerating the specific activities carried on by the appellant. Merely because other establishments which are akin to shops are enumerated, it does not, , in any manner, oblige the court to give a narrow meaning to the word shop nor does it in any way dilute the meaning of shop.

In esi corpn. V. R.k. swamy and others[65]the supreme court observed that essentially, the advertising agency sells its expert services to a client to launch an effective advertising campaign for his product. Without straining the language, the premises of an advertising agency can, therefore, reasonably be said to be a shop. Further , the act is a beneficient legislation and therefore advertising agencies must be brought within its purview. A shipping company is also a shop, regardless of the fact that the steamship company is not carrying on stevedoring operations.

Inregional director, esi corpn v. Kerala state drugs and pharmaceuticals ltd[66]where certain employees were engaged through contractor. After the construction of the plant, the contractor and his employees were no longer connected with the respondents. Thereafter corporation made a demand for contribution in respect of such employees towards insurance, the contributions was refused. The supreme court observed that both the insurance court and high court misconceived both the object of the act and the purpose of the insurance scheme under it. The contribution which is levied on the employer in respect of the employees engaged by him directly or through another agency is for the benefit of all workmen in general who are covered by the act. The contribution is irrespective of the fact whether the employees get or do not get the said benefit. There is thus no quad pro quo between the persons insured and the benefit available under the act. As regards the finding that the workmen were unidentifiable, what is forgotten is that under the act, once an establishment comes to be covered by the act, the employer becomes liable to pay the contribution in respect of employees in his employment directly or indirectly. The contribution which has become payable for the relevant period has to be paid even if the employees concerned are no longer in employment or unidentifiable on the relevant date.

ESIC has played a significant role in providing social security millions of workers in the organized sector. It is only social security organization in the country which provides insurance coverage for exi9gencies related to health, maternity, disablement, death and employment. The corporation thus extends complete social security cover to the workers and their family members. However, the working of ESI is not up to the expected level of the insured person from three sectors.

Findings of The Study:
·All ESI hospitals are not multidisciplinary hospitals and the employees are not much satisfied with their services.
·Reimbursement of medical bill is a complex and time consuming process and the employed are not getting the refund of full amount spent by them.
·Some ESI hospitals are facing the problem of lack of proper diagonising facilities which forces the employees to depend private or clinics.
·Working time of ESI hospitals does not match with working time of employees.
·In terms of services provided, private hospitals are better compared to government hospitals.

Based on the findings of the study, following suggestions are offered to improve the performance of ESI.
More number of ESI hospitals and dispensaries may be started to satisfy the requirements of employees. The authorities of ESI hospitals should concentrate more attention to provide better quality services to beneficiaries especially in the areas of basic diagnostic services, nursing, laboratory and sanitary services,. It is found that in certain areas of ESI dispensaries are functioning only up to noon. It causes inconvenience to employees as they are forced to avail leave from their workplace. Hence the working to the convenience of the employees. Similarly, the procedures and formalities in connection with the reimbursement should be simplifies to the extent possible.

[1]Article 22 and 25 of universal declarartion of human rihts, 1948.
[2]Articles 38, 39, 41, 42, 47 of the constitution of india.
[3]Report of the national commission on labour(1969), p.162.
[4]Medical care, old age benefit, unemployment benefit, family benefit, sickness benefit, invalidity benefit, maternity benefit, survivors benefit and employment injury benefit.
[5]Social security (minimum standards) convention (No:102)adopted by ILO in 1952.
[6]Report of the national commission on labour, 1969.
[7]Supra., p.p.162-163
[8]Justice in terms of the distribution of wealth, opportunities, and privileges within a society. “The way in which the human rights are manifested in the everyday lives of people at every level of society”.
[9]Article 38: the state shall strive to promote the welfare of the people by securing and protecting as effectively as it may, a social order in which justice, social, economic and political shall inform all the institutions of the national life.
[10]Article 38(2): the state shall in particular, strive to minimise the inequalities in income facilities and opportunities, not only amongst individuals but also amongst groups of people residing in different areas or engaged in different avocations
[11]Article 39: a) that the citizens, men and women equally, have the right to an adequate means of livelihood.
b) That the ownership and control of the material resources of the community also distributed as best to sub serve the common good.
c) That the operation of the economic system does not result in the concentration of wealth and means of production in the common detriment.
d) That there is equal pay for equal work for both men and women.
e) That the health and strength of workers, men and women, and tender age of children are not forced by economic necessity to enter avocations unsuited to their age or strength.
f) That childhood and youth are protected against exploitation and against moral and material abandonment.
[12]Article 39-A: The operation of a legal system shall be secured by the state which promotes justice, on a basis of equal opportunity and shall in particular, provide free legal aid, by suitable legislation or schemes or in any other way, to ensure that opportunities for securing justice are denied to any citizen by reason of economic or other disabilities
[13]Article 41: shall make effective provisions for securing the right to work, to education and to public assistance in case of employment, old age, sickness ad disablement and in other cases of undeserved want, within the limits of its economic capacity and development
[14]Article 43-A: The state shall take steps, by suitable legislation or in any other way, to secure the participation of workers in the management of undertakings, establishments or other organisations engaged in any industry
[15]Article 42: the state shall make provisions for securing just and humane conditions of work and for maternity relief.
[16]Article 43: The state shall endeavour to secure, by suitable legislation or economic organization or in any other way to all workers, agricultural, industrial or otherwise, work, a living wage, conditions of work ensuring a decent standard of life and full enjoyment of leisure and social opportunities and in particular, the state shall endeavour to promote cottage industries on an individual or co-operative basis in rural areas
[17]Article 254 of the constitution of India.
[18]Entry 22:- trade unions; industrial and labour disputes; Entry 23:-social security and social insurance; employment and unemployment; Entry 24:-welfare of labour including conditions of work, provident funds employer’s liability, workmen’s’ compensation, invalidity and old age pensions and maternity benefits.
[19]Article 254(1): It was provided that, if any provision of law made by parliament which is competent to enact or to any provision of an existing law with respect to one of the matters enumerated in the concurrent list, then subject to the provisions of clause (2), the law made by parliament, whether passed before or after the law made by the legislature of such state, or, as the case may be, the existing law, shall prevail and the law made by the legislature of the state shall, to the extent of the repugnancy, be void
[20]Article 254(2): Where the law made by the legislature of the state with respect to one of the matters enumerated in the concurrent list contains any provision repugnant to the provisions of an earlier law made by parliament or an existing law with respect to that matter, then the law so made by the legislature of the state shall, if it has been reserved for the consideration of the president and has received his assent, prevail in that state.
[21]Article 23: prohibition of traffic in human beings and forced labour.
[22]Article 24: prohibition of employment of children in factories, mine or any other hazardous employment.
[23]Cooperative life in ancient India. Dr.V.R. Bhattacharya, Loc. Cit, pp. 1-2.
[24]M.chandrasekar, loc. Cit, p.19.
[25]He says the “state itself should provide support to poor, pregnant women, to their new born offspring, to orphans, to the aged, the infirm, the affected and the helpless.
[26]N.C.Bandhopadhyaya, Kautilya, p.173.
[27]M.chandrasekar Loc. Cit, chapter II.
[28]Royal commission on labour in 1931, the Kanpur labour enquiry committee in 1938, the Bihar labour enquiry committee in 1940 and adarkar committee in 1943.
[29]Dr.V.R. Bhattacharya, Loc. Cit. pp.13-19.
[30]He says, “I think every employer should realise the terrible time labourer has had for generations, how they were crushed”. Pt. Jawaharlal Nehru’s speeches, Vol.3, pp.65-66.
[31]He says, “like gandhiji I want to make the capitalists also understand which way their true duty lies”.
[32]Speeches of sardarvallabhai Patel: “for a United India”, pp. 94-95.
[33]Section 3(2) of ESI Act,1948.
[34]Section 4 of ESI Act, 1948.
[35]Section 19 of ESI Act, 1948.
[36]Section 8 of ESI Act, 1948.
[37]Section 9 of ESI Act, 1948.
[38]Section 18 of ESI Act, 1948.
[39]Section 10 of ESI Act, 1948
[40]Section 22 of ESI Act, 1948.
[41]Section 21 of ESI Act, 1948.
[42]Section 13 of ESI Act, 1948.
[43]Section 29 of ESI Act, 1948.
[44]Section 50 of ESI Act, 1948.
[46]Section 46(b) of ESI Act, 1948.
[47]ILO: minimum standards of social security, p.23.
[48]Section 2 (14-B) of ESI Act, 1948.
[49]ESI (Central) Rules,1950, proviso to rule 50(2).
[50]ESI General Regulations, 1950, Regulation 93.
[52]Section 51 of ESI Act, 1948.
[53]Dr. p.c. Srivastava,loc.cit.p.238.
[54]ILO Sickness insurance,p.72; dr.P.C. srivastava, loc.cit,p.252.
[55]ILO Sickness insurance,p.72; dr.p.c. srivastava,loc.cit,p.252.
[56]Int. labour conference, conventions and recommendations. 1909-1949,p.133.
[57]I.L. Code,1951, vol.i, pp.653-655.
[58]Section 46(e) of ESI Act, 1948.
[59]Section 52 of ESI Act, 1948.
[60]2000 SCC (l&S) 326.
[61]2001 SCC (l & S) 582.
[62]AIR 1996 SC 925 distinguished.
[63]AIR 1996 SC 921 followed.
[64]Air 1993 sc 252.
[65]1994 1 llj 636 sc.
[66]1995 scc (l&s) 1116

Law Article in India

Ask A Lawyers

You May Like

Legal Question & Answers

Lawyers in India - Search By City

Copyright Filing
Online Copyright Registration


Section 482 CrPc - Quashing Of FIR: Guid...


The Inherent power under Section 482 in The Code Of Criminal Procedure, 1973 (37th Chapter of th...

Whether Caveat Application is legally pe...


Whether in a criminal proceeding a Caveat Application is legally permissible to be filed as pro...

How To File For Mutual Divorce In Delhi


How To File For Mutual Divorce In Delhi Mutual Consent Divorce is the Simplest Way to Obtain a D...

Copyright: An important element of Intel...


The Intellectual Property Rights (IPR) has its own economic value when it puts into any market ...

The Factories Act,1948


There has been rise of large scale factory/ industry in India in the later half of nineteenth ce...

Law of Writs In Indian Constitution


Origin of Writ In common law, Writ is a formal written order issued by a body with administrati...

Lawyers Registration
Lawyers Membership - Get Clients Online

File caveat In Supreme Court Instantly