How can we claim ESIC medical insurance?

1 Answer

Employee state Insurance Corporation provides medical benefits to employees as per ESIC act 1948,  under the ministry of labor employment.

  • Medical Benefits (ESIC provides reasonable Medical Care for self and family from day one of entering into insurable employment.).
  • Sickness Benefits (ESIC provides 70% of average daily wages during medical leaves, up to 91 days in two consecutive benefits periods).
  • Maternity Benefits (ESIC provides 100% of average daily wages up to 12 weeks in confinement and 6 weeks in case of miscarriage. Maternity leaves are proposed to be increased to 26 weeks).
  • Disablement Benefits (ESIC provides a monthly payment for partial and full disablement).
  • Dependent benefits ( ESIC provide monthly pension shareable to the fixed proportion in case of death of employee).

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To claim the above ESIC benefits, employees should have TIC (Temporary Identification card) with him. TIC will be provided by the employer at the time of joining the organization. Employees get benefits once the contribution to ESIC is started by the employer.

An employee can only get the benefits in a government hospital and recommended hospital by ESIC. The employee has to carry TIC card along with him at the time of visiting any government hospital for medical treatment. An employee, along with dependents also can avail the benefits of ESIC free of cost (without any limit) at any government hospital or recommend hospital by ESIC panel.

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