Monday, 10 October 2016

Sickness 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,-

  1. Periodical payments to any insured person in case of his sickness certified by a duly appointed medical practitioner or by any other person possessing such qualifications and experience as the Corporation may, by regulations, specify in this behalf (hereinafter referred to as sickness benefit);
Under Section 49, The qualification of a person to claim sickness 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, Subject to the provisions of the Act and the regulations, a person shall be qualified to claim sickness benefit for sickness occurring during any benefit period if the contributions in respect of him were payable for not less than seventy-eight days in the corresponding contribution period and shall be entitled to receive such benefit at the daily standard benefit rate for the period of his sickness.
Provided that in case of a person who becomes an employee within the meaning of the Act for the first time and for whom a shorter contribution period of less than 156 days is available, he shall be qualified to claim sickness benefit if the contribution in respect of him were payable for not less than half the number of days available for working in such contribution period.
Provided that he shall not be entitled to the benefits for the first two days of sickness [except] in the case of a spell of sickness following, at an interval of not more than fifteen days, the spell of sickness for which sickness benefits were last paid.
Provided further that sickness benefits shall not be paid to any person for more than ninety-one days in any two consecutive benefit periods.
The daily rate of sickness benefit in respect of a person during any benefit period shall be seventy per cent. of the standard benefit rate of that person during the corresponding contribution period rounded to the next higher rupee.

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