The Employees' State Insurance Scheme of India is a multi-faceted Social Security Scheme designed to provide socio-economic cover to 'employees' in the organized sector against disability, pregnancy, disablement, and death as a result of a work-related injury, as well as to provide medical treatment to them.
The ESI platform is a self-funding method. Employer and employee contributions are mainly used to finance the ESI accounts, which are charged annually at a fixed percentage of wages paid. State governments are also responsible for 1/8th of the cost of Medical Benefits.
In the event that the insured person or his family members become infected with COVID-19, they will receive free medical treatment at any ESIC/ ESIS hospital that has been designated as a COVID-19 dedicated hospital.
In addition to the above, each ESIC hospital has been instructed to use at least 20% of its bed capacity as dedicated Covid beds for ESI IPs, beneficiaries, employees, and pensioners.
In accordance with their entitlement, ESI beneficiaries can obtain emergency/non-emergency medical care from a tie-up hospital without a referral letter.
The repayment of expenses may be sought if the IP or a family member infected with COVID-19 seeks care in a private institution.
If the Insured Person is infected with COVID-19 and is unable to work, he is entitled to Sickness Insurance for the period he was unable to work. Sickness benefits are paid at 70% of average daily earnings for a period of 91 days.
ESIC has developed the blueprint and deployed a Dashboard so as to help the needy citizen's search for a bed in its hospitals. Here is the 'COVID-19 Facility Dashboard for ESIC Hospitals'.— ESIC #StayHome #StaySafe (@esichq) April 28, 2021
For more information, visit - https://t.co/uCp83bKW1u#Unite2FightCorona pic.twitter.com/vSKiIu49ql
If an insured person loses his or her job, he or she may be eligible for relief under the Atal BeemitVyaktiKalyanYojana(ABVKY) for up to 90 days at 50% of average daily earnings. The Insured Person may apply for this relief by submitting a claim online at www.esic.in.
If an insured person becomes unemployed as a result of retrenchment or the closing of a factory or establishment as specified by the ID Act of 1947, he is entitled to unemployment benefits for a period of two years, subject to RGSKY qualifying conditions.
Funeral expenses of Rs.15000/- are charged to the eldest surviving member of any Insured Person's family in the event of his unfortunate death.
ESIC has created a roadmap and implemented a Dashboard to assist vulnerable citizens in finding a bed in its hospitals.