Monday 10 October 2016

Maternity Benefit Under ESI or Employee State Insurance


Under Section 46, Subject to the provisions of this Act, the insured persons, their dependants or the persons hereinafter mentioned, as the case may be, shall be entitled to the following benefits, namely :-
Periodical payments to an insured woman in case of confinement or miscarriage or sickness arising out of pregnancy, confinement, premature birth of child or miscarriage, such woman being certified to be eligible for such payments by an authority specified in this behalf by the regulations (hereinafter referred to as maternity benefit);


Maternity Benefit Under ESI or Employee State Insurance


Under Section 50, The qualification of an insured woman to claim maternity benefit, the conditions subject to which such benefit may be given, the rates and period thereof shall be such as may be prescribed by the Central Government.

Under Rule 55, An insured woman shall be qualified to claim maternity benefits
Maternity Benefit Under ESI or Employee State Insurance
  1. For a confinement occurring or expected to occur in a benefit period, if the contributions in respect of her were payable for not less than seventy days in the immediately preceding two consecutive contribution periods. Confinement means Labour resulting in issue of a Living Child, or Labour after 26 weeks of pregnancy resulting in issue of a child whether alive or dead.
  2. Subject to the provisions of the Act and the regulations, if any, an insured woman who is qualified to claim maternity benefits in accordance with sub-rule (1) shall be entitled to receive it at the daily rate specified in sub-rule (5) for all days on which she does not work for remuneration during a period of twelve weeks of which not more than six weeks shall precede the expected date of confinement.
  3. Provided that where the insured woman dies during her delivery or during the period immediately following the date of her delivery for which she is entitled to maternity benefits, leaving behind in either case, the child maternity benefits shall be paid for the whole of that period but if the child also dies during the said period, then for the days upto and including the day of the death of the child, to the person nominated by the insured woman, in such manner as may be specified in the regulations, and if there is no such nominee, to her legal representative.
  4. An insured woman who is qualified to claim maternity benefits in accordance with sub-rule (1) shall, in case of miscarriage or medical termination of pregnancy, be entitled, on production of such proof, as may be required under the regulations, to maternity benefits at the rates specified in sub-rule (5), for all days on which she does not work for remuneration during a period of six weeks immediately following the date of her miscarriage or medical termination of pregnancy.
  5. An insured woman who is qualified to claim maternity benefits in accordance with sub-rule (1) in case of sickness arising out of pregnancy, confinement, premature birth of child or miscarriage or medical termination of pregnancy shall, on production of such proof as may be required under the regulations, be entitled, in addition to the maternity benefits payable to her under any other provisions of the Act, for all days on which she does not work for remuneration to maternity benefits at the rates specified in the sub-rule (5) for all days on which she does not work for remuneration during an additional period not exceeding one month.
  6. The daily rate of maternity benefit payable in respect of confinement occurring or expected to occur during any benefit period shall be equal to the standard benefit rate in respect of the insured woman during the corresponding contribution period, rounded to the next higher rupee, or rupees twenty-five, whichever is higher.

Under Rule 56A, An insured woman and an insured person in respect of his wife shall be paid a sum of rupees two thousand five hundred per case as confinement expenses on account of confinement expenses :

Provided that the confinement occurs at a place where necessary medical facilities under the Employees’ State Insurance Scheme are not available :
Provided further that confinement expenses shall be paid for two confinements only.

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