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Citizen Charter

Citizen Charter
Employees’ State Insurance Corporation (ESIC)

Introduction

The Employees’ State Insurance Scheme (ESI Scheme) of India is an integrated social security scheme designed to provide social protection to workers in the organised sector and their dependants in contingencies such as sickness, maternity, death or disablement due to employment injury or occupational disease. The Scheme provides full medical facilities to insured persons and their dependants, along with cash benefits to compensate for loss of wages or earning capacity under different contingencies.

Applicability of the ESI Act

The ESI Act, 1948 applies to the following categories in implemented areas:

• Non-seasonal factories using power and employing 10 or more persons.
• Non-seasonal factories/establishments not using power and employing 20 or more persons.

The appropriate Government (Central/State) is empowered to extend the provisions of the Act to various classes of industrial, commercial, agricultural or other establishments. Most State Governments have extended the Act to shops, hotels, restaurants, cinemas, transport undertakings, newspaper and advertising establishments, etc., employing 20 or more persons.

Organisation

As provided under the Act, the Scheme is administered by the Employees’ State Insurance Corporation (ESIC). It comprises representatives of the Central and State Governments, employers, employees, Parliament and the medical profession.

• Union Minister of Labour — Chairman
• Director General — Chief Executive (day-to-day administration)

A Standing Committee manages the affairs of the Scheme and monitors implementation of policies. The Medical Benefit Council advises the Corporation on matters related to medical benefits.

Infrastructure

• Central Headquarters: New Delhi
• Regional/Sub-Regional Offices: Across the country (mostly in State capitals)

Medical Services Network:

• 1,427 ESI Dispensaries
• 2,100+ Panel Clinics
• 307 Diagnostic Centres
• 143 ESI Hospitals and 43 Hospital Annexes (27,000+ beds)
• Tie-up arrangements with public and private super-speciality institutions

Cash benefits are disbursed through 800+ Branch/Cash Offices.

Contribution

• Employees’ Contribution: 1.75% of wages
• Employers’ Contribution: 4.75% of wages

Employees earning up to ₹50 per day are exempted from paying their share of contribution.
State Governments bear one-eighth of the expenditure on Medical Benefits up to a ceiling of ₹900 per capita per annum.

Wage Ceiling

Employees drawing wages up to ₹10,000 per month are covered under the ESI Act, 1948.

Social Security Benefits

I. Medical Benefit

• Admissible from day one of entering insurable employment for self and dependants (spouse, parents, children—biological/adopted).
• Super-speciality services on referral basis.
• For superannuated/permanently disabled Insured Persons (IPs): full medical care for self and spouse on payment of ₹120 per annum (lump sum).

II. Sickness Benefit (Cash)

• Eligibility after payment of contribution for 78 days in a contribution period of six months.
• Payable for a maximum of 91 days in a year at a rate not less than 50% of wages.
• Payment within 7 days of certification.

(a) Extended Sickness Benefit (ESB):

• For 34 specified long-term diseases; maximum 2 years.
• Eligibility: 2 years of insurable employment and 156 days contribution in the preceding two years.
• Rate: about 70% of daily wages.

(b) Enhanced Sickness Benefit:

• For sterilisation operations (vasectomy/tubectomy).
• Duration: 14 days (women—tubectomy), 7 days (men—vasectomy).
• Rate: full wages.

III. Maternity Benefit (Cash)

• Eligibility: 70 days of contribution in one year.
• Duration: generally 12–16 weeks.
• Rate: full wages.
• Payment within 14 days.

IV. Disablement Benefit (Cash)

• For employment injury/occupational disease.
• Temporary disablement: 70% of wages (for the certified period).
• Permanent disablement: payable for life based on loss of earning capacity.
• Payment within one month.

V. Dependants’ Benefit (Cash)

• Payable when death occurs due to employment injury/occupational disease.
• Widow: monthly benefit for life or until remarriage.
• Son/Daughter: up to 18 years of age.
• Rate: about 70% of wages, shared in prescribed ratio.

VI. Other Benefits

• Funeral expenses: up to ₹2,500.
• Vocational rehabilitation for insured persons below 45 years with 40%+ disablement.
• Free supply of aids/appliances (crutches, wheelchairs, dentures, spectacles, etc.).
• Preventive healthcare services.
• Confinement Allowance: ₹1,000 if ESI medical facilities are not availed for delivery.

8. Rights and Duties of Employers & Beneficiaries

(a) Duties of Employers

• Registration in Form-01 within 15 days.
• Submission of employee declarations/ID cards; timely deposit of contributions.
• Maintain accident register and report accidents within 24 hours.
• Maintain records and facilitate inspections.
• File half-yearly Return of Contributions (RC) by 12 May / 11 November.
• Pay contributions for contract/casual labour as applicable.
• Inform closure/changes and clear dues.

(b) Rights of Employers

• Exemption from the Workmen’s Compensation Act, 1923 and Maternity Benefit Act, 1961 for covered employees.
• Representation in the Corporation/Councils.
• Right to requisite forms, information, appeals and to seek exemptions where applicable.

9. Safeguards for Insured Employees

• Benefits are non-transferable.
• Cash benefits are not attachable.
• No punitive action during receipt of sickness/maternity benefits.
• Right to register grievances and approach the ESI Court.

10. Role of ESIC in Delivery of Benefits

• Timely, quality service with courteous behaviour.
• Free forms and guidance; timely availability of medicines.
• Complaint box and adherence to notified office hours.

11. Services to Employers

• Guidance, timely responses, protection from harassment.
• Prompt redressal of grievances.

(c) Rights of Patients

• Safe, clean and dignified treatment.
• Protection from abuse/neglect.
• Information about services.
• Privacy and confidentiality.
• Clarification before consent.
• Clear explanation and participation in pain management.
• Right to seek second opinion/change doctor.
• Information on grievance redressal.
• Confidential access to health records.

Responsibilities of Patients

• Provide accurate and complete information.
• Understand risks/benefits of treatment.
• Follow the prescribed treatment plan.
• Accept responsibility for consequences of non-compliance.
• Cooperate and behave respectfully.
• Take care of personal belongings.
• Avoid damage to hospital property.

12. Redressal of Public Grievances

Hospital Level: Through email or OPD drop box.
Grievance Officer: DD (Administration) / Deputy Medical Superintendent
Appellate Authority: Medical Superintendent

13. Vigilance Related Issues

Contact the Regional Director, ESIC, or:
Chief Vigilance Officer / Director (Vigilance), ESIC
Panchdeep Bhawan, Kotla Road, New Delhi–110002
Phone: 011-23239424 / 011-23234092 (Extn. 214/233)

14. General Information

For more details, please visit the website.

 

Last updated / Reviewed : 2026-01-17