Employee State Insuarance Act

The following extract from http://www.esic.nic.in/benefits.php. As stated in class Section 46

details the benefits but leaves it to Central Government to specify which comes out in ESI
Central Rules. As mentioned in class dispensing these benefits is the responsibility of the
ESIC and not HR in the organization.

Benefits
The section 46 of the Act envisages following six social security benefits :(a) Medical Benefit : Full medical care is provided to an Insured person and
his family members from the day he enters insurable employment. There is no
ceiling on expenditure on the treatment of an Insured Person or his family
member. Medical care is also provided to retired and permanently disabled
insured persons and their spouses on payment of a token annual premium of
Rs.120/- .
1.

System of Treatment

2.

Scale of Medical Benefit

3.

Benefits to Retired IPs

4.

Administration of Medical Benefit in a State

5.

Domiciliary treatment

6.

Specialist consultation

7.

In-Patient treatment

8.

Imaging Services

9.

Artificial Limbs & Aids

10.

Special Provisions

11.

Reimbursement

(b) Sickness Benefit(SB) : Sickness Benefit in the form of cash compensation

at the rate of 70 per cent of wages is payable to insured workers during the
periods of certified sickness for a maximum of 91 days in a year. In order to
qualify for sickness benefit the insured worker is required to contribute for 78
days in a contribution period of 6 months.
1.

Extended Sickness Benefit(ESB) : SB extendable upto two years in the

case of 34 malignant and long-term diseases at an enhanced rate of 80 per
cent of wages.

2.

Enhanced Sickness Benefit : Enhanced Sickness Benefit equal to full

wage is payable to insured persons undergoing sterilization for 7 days/14
days for male and female workers respectively.

(c) Maternity Benefit (MB) : Maternity Benefit for confinement/pregnancy is

payable for three months, which is extendable by further one month on

medical advice at the rate of full wage subject to contribution for 70 days in
the preceding year.
(d) Disablement Benefit
1.

Temporary disablement benefit (TDB) : From day one of entering

insurable employment & irrespective of having paid any contribution in
case of employment injury. Temporary Disablement Benefit at the rate of
90% of wage is payable so long as disability continues.

2.

Permanent disablement benefit (PDB) : The benefit is paid at the rate of

90% of wage in the form of monthly payment depending upon the extent of
loss of earning capacity as certified by a Medical Board

(e) Dependants' Benefit(DB) : DB paid at the rate of 90% of wage in the form of
monthly payment to the dependants of a deceased Insured person in cases
where death occurs due to employment injury or occupational hazards.
(f) Other Benefits :
Funeral Expenses : An amount of Rs.10,000/- is payable to the dependents or
to the person who performs last rites from day one of entering insurable
employment.
Confinement Expenses : An Insured Women or an I.P.in respect of his wife in
case confinement occurs at a place where necessary medical facilities under
ESI Scheme are not available.
In addition, the scheme also provides some other need based benefits to
insured workers.

Vocational Rehabilitation :To permanently disabled Insured Person

for undergoing VR Training at VRS.

Physical Rehabilitation : In case of physical disablement due to

employment injury.

Old Age Medical Care :For Insured Person retiring on attaining the
age of superannuation or under VRS/ERS and person having to leave service
due to permanent disability insured person & spouse on payment of Rs. 120/per annum.

Rajiv Gandhi Shramik Kalyan Yojana : This scheme of

Unemployment allowance was introduced w.e.f. 01-04-2005. An Insured
Person who become unemployed after being insured three or more years, due

to closure of factory/establishment, retrenchment or permanent invalidity are

entitled to : Unemployment Allowance equal to 50% of wage for a maximum period

of upto one year.

Medical care for self and family from ESI Hospitals/Dispensaries during

the period IP receives unemployment allowance.

Vocational Training provided for upgrading skills - Expenditure on
fee/travelling allowance borne by ESIC.

Incentive to employers in the Private Sector for

providing regular employment to the persons with
disability :

Minimum wage limit for Physically Disabled Persons for availing ESIC

Benefits is 25,000/-.
Employerss' contribution is paid by the Central Government for 3
years.

Benefits & Contributory Conditions :

An interesting feature of the ESI Scheme is that the contributions are related
to the paying capacity as a fixed percentage of the workers wages, whereas,
they are provided social security benefits according to individual needs
without distinction.
Cash Benefits are disbursed by the Corporation through its Branch Offices
(BOs) / Pay Offices (POs), subject to certain contributory conditions.

The following section has been inserted in the ESI Act after the DCosta judgment. I could not
locate it in your textbook in the morning. Maybe I missed it. But this has been inserted w.e.f
2010.

[51-E. Accidents happening while commuting to the place of work

and vice versa. An accident occuring to an employee while
commuting from his residence to the place of employment for duty
or from the place of employment to his residence after performing
duty, shall be deemed to have arisen out of and in the course of
employment if nexus between the circumstances, time and place in
which the accident occured and the employment is established.]
2

therefore for accidents to and fro you should be able to answer that a) wherever esi is
applicable sec 51 e and thus esic will pay and b) and where esi is not applicable then eca
provided the employee falls within the schedule two and the three situations discussed in
class earlier.

Offer and Acceptance quiz.. How it can be?

Consider the following contracts involving the same parties. Advice Rajesh
in the two
situations.
a) Contract I: Sabarwal had a car which had done 1, 50,000 kms. He
represented to Rajesh that the car had done only 20,000 kms. Sabarwal
had repainted the car and tampered with the meter. Rajesh accepted the
offer to buy the new looking car for Rs. Two lakhs. He paid an advance
of Rs.40, 000. Later he learnt from reliable sources that the car was
actually older than was represented to him. Rajesh wants his money
back. Sabarwal insists that he should pay the balance and take the car.
b) Contract II: Sabarwal had a car which had done 1, 50,000 kms. He
represented to Rajesh that the car had done only 20,000 kms. Sabarwal
had repainted the car and tampered with the meter. Rajesh accepted the
offer to buy the new looking car for Rs. Two lakhs. He paid an advance
of Rs.40, 000. Later, he learnt from reliable sources that the car was
actually old. However in this while the government had imposed some
taxes, which made cars a lot more expensive. Now Sabarwal wants to
return the Rs.40, 000 to Rajesh and not give him the car. However
Rajesh is insistent on paying the balance amount and taking the car
away.
Answers expected on these lines
a) Here Sabaharwal has made false representations deliberately while selling his car to
Rajesh. Rajeshs consent is based on fraud and the consent of Rajesh is not free and genuine
and the contract is voidable. In other words Rajesh does not have to pay the balance money or
take the car and can claim his advance paid. ( BOLD LETTERS ESTABLISH LINK BETWEEN
FACTS- LAW- REASONING-CONCLUSION) leading to conclusion/answer.
b) In this situation too Sabharwal has made false representations while selling his car to
Rajesh. Thus Rajeshs consent is based on fraud and the consent of Rajesh is not free and
genuine and hence the contract is voidable. The option to make the contract voidable is with
the person whose consent is not free and not the person who commits the fraud. Hence
Rajesh can claim his car and Sabharwal will have to sell it.
Shweta vs Shamim
When in office pr at work legal questions will come up in which case your reply will have to be
more elaborate. As an example I am replying to the Shweta vs Shamim case for your
reference. A lawyer would add case law judgments to it.

In this case Shamim has sent his acceptance to an offer which has been revoked by
the offerror viz Shweta and the revocation is in his mailbox at the time of his
sending his acceptance.
Now Indian Contract Act as per Section 5 states
5. Revocation of proposals and acceptances
A proposal may be revoked at any time before the communication of its acceptance is
complete as against the proposer, but not afterwards.

Two points emerge a) offer can be revoked

b) at any time before communication of acceptance is complete as
against proposer
The next question is when is communication of acceptance complete as against
proposer? The answer to this lies in Section 4 second line which is reproduced below
The communication of an acceptance is completeas against the proposer, when it is put in a course of transmission to him so at to be out
of the power of the acceptor;
So when Shamim posted his acceptance that is out of his power the revocation was
already in his mailbox.
Thus the revocation is valid.
Lastly the question of when revocation is complete the answer lies in the third part of
section 4 which is reproduced below :
The communication of a revocation is completeas against the person who makes it, when it is put into a course of transmission to the
person to whom it is made, so as to be out of the power of the person who makes it;
as against the person to whom it is made, when it comes to his knowledge.
Here again as far as Shweta is concerned the revocation is complete. And once it is in his
mailbox the communication has reached him / his mailbox.

Finally as mentioned under IT Act once something reaches your mailbox it is considered
communicated.
Hence revocation is valid and communicated.

Section 27
Section 27 of Indian Contract Act is important in that restrictive covenants( clauses) is viewed
as against public policy and yet employers find themselves harmed when :
a) trade secrets are divulged ( non disclosure agreement )
b) when employees join rivals ( non compete clauses) and
c) non solicitation of clients
We need to balance the contrary positions of Sec 27 and the need to protect the employer
from harmful consequences as outlined in a) , b) and c). So the clauses in the agreement if
crafted to protect employer would be well received by the courts rather than clauses seen as
restricting the employee.