Hello All, I’m working in a manufacturing company in Chennai. Now my company wants to convert ESI policy to MEDICLAIM. Shall it be possible? plz. help me. S. SARKAR
From India, Calcutta
11From India, Calcutta
If your establishment is a covered establishment and if you want to get exempted from the operation of ESI Act, you will have to prove to the satisfaction of the ESI Authorities that you provide facilities in the form of medical and other benefits to your employees and their family members better than that are being provided by the ESI Corporation. That means you have to show that you have own hospitals where you can give super speciality treatments to your employees and their family members, leave and cash benefits to the members, pension to family members of the employees who dies after employment injury and similar other benefits. Mere taking a mediclaim policy which does not guarantee many of the above may not be sufficient for you to get exemption from ESI.
Regards,
Madhu.T.K
From India, Kannur
Regards,
Madhu.T.K
From India, Kannur
Dear Mr.Syam
As per Mr.Madhu, if we are able to show that company can provide better services then we can take expemtion but your mail clearly says not possible. Can you plz help us in clarifying whether it is possible or not possible..?
Warm Regards
Sita Prakash
Human Resources
From India, Bangalore
As per Mr.Madhu, if we are able to show that company can provide better services then we can take expemtion but your mail clearly says not possible. Can you plz help us in clarifying whether it is possible or not possible..?
Warm Regards
Sita Prakash
Human Resources
From India, Bangalore
In ESI Act, there are certain provisions for exemption from ESI Act in the following cases:
i) Exemption for certain class of factories/esttt., ii) Exemption for certain class of employees & iii) Exemption for certain provisions fo the ESI.....
The first point that ESI Exemption committee will see at is : Whether the Employer is providing at par or superior benefits than ESI....but no company will give equal or more benefit than ESI, only for regular employees that too public sector only provides the benefits at par or superior benefits to ESI..... Since some of the main benefits given by the ESI are:
i) Sickness Benefit...Insured person is entitled for 91 days leave in one year with approximately 60% of his wages, besides the medical/hospital benefit;
ii) Enhanced Sickness Benefit:... Incase of Family planning, i.e. Tubectomy/vasectomy the concerned insured person/women are entitled for cash benefit more than or equal to their wages besides medical/hosptal facility;
iii) Extended Sickness Benefit:.. in case of certain long diseases like TB/Heart diseases...etc... even the medical benefit will be extended to 3 years irrespective of his employment position ...& cash benefit will be extended upto 2 years, in case if he is having 2 years of insurable employement..
iv) Disablement Benefit: If a person met with an injury/accident at work place or on the way to work place or return from workplace to home, he is entitled for Temporary disablement benefit, which nearly 80% of his wages, for which there is no limit, i.e. the leave may be extended beyond 91 days... If it results in loss his earling capacity due to loss of early part of body,ex. a part of finger, or a fracture to leg, etc..... he will be paid life long pension on the basis of the recommendations of the Medical Board, irrespective of the fact that whether he continues that employment or not; In case if dies due to that employment injury the pension will be paid to the dependants...ie. wife till life time or remarriage, children upto 21 years, widowed mother....
v) Maternity Benefit: If an I.W. completed 9 months service under ESI coverage and works for wages for 70 days in the concered contribution period she will be paid 84 days maternity benefit @ rate of more than her wages, besides medical/hospital facility;
Besides all these things Insured Persons/women are entitled for funeral expenses, superspeciality treatment, In cases of loss of job due to retrenchment he will be paid Unemployment allowances with certain terms and conditions...etc., What more........
Main salient feature in ESI is that there is no restriction of predisease condition as in Mediclaims...
Since ESI is providing handful of benefits......No company afford these things... Hence getting exemption is said to be highly difficult.......
Hope I clarified ur doubts....
From India, Hyderabad
i) Exemption for certain class of factories/esttt., ii) Exemption for certain class of employees & iii) Exemption for certain provisions fo the ESI.....
The first point that ESI Exemption committee will see at is : Whether the Employer is providing at par or superior benefits than ESI....but no company will give equal or more benefit than ESI, only for regular employees that too public sector only provides the benefits at par or superior benefits to ESI..... Since some of the main benefits given by the ESI are:
i) Sickness Benefit...Insured person is entitled for 91 days leave in one year with approximately 60% of his wages, besides the medical/hospital benefit;
ii) Enhanced Sickness Benefit:... Incase of Family planning, i.e. Tubectomy/vasectomy the concerned insured person/women are entitled for cash benefit more than or equal to their wages besides medical/hosptal facility;
iii) Extended Sickness Benefit:.. in case of certain long diseases like TB/Heart diseases...etc... even the medical benefit will be extended to 3 years irrespective of his employment position ...& cash benefit will be extended upto 2 years, in case if he is having 2 years of insurable employement..
iv) Disablement Benefit: If a person met with an injury/accident at work place or on the way to work place or return from workplace to home, he is entitled for Temporary disablement benefit, which nearly 80% of his wages, for which there is no limit, i.e. the leave may be extended beyond 91 days... If it results in loss his earling capacity due to loss of early part of body,ex. a part of finger, or a fracture to leg, etc..... he will be paid life long pension on the basis of the recommendations of the Medical Board, irrespective of the fact that whether he continues that employment or not; In case if dies due to that employment injury the pension will be paid to the dependants...ie. wife till life time or remarriage, children upto 21 years, widowed mother....
v) Maternity Benefit: If an I.W. completed 9 months service under ESI coverage and works for wages for 70 days in the concered contribution period she will be paid 84 days maternity benefit @ rate of more than her wages, besides medical/hospital facility;
Besides all these things Insured Persons/women are entitled for funeral expenses, superspeciality treatment, In cases of loss of job due to retrenchment he will be paid Unemployment allowances with certain terms and conditions...etc., What more........
Main salient feature in ESI is that there is no restriction of predisease condition as in Mediclaims...
Since ESI is providing handful of benefits......No company afford these things... Hence getting exemption is said to be highly difficult.......
Hope I clarified ur doubts....
From India, Hyderabad
That is companies burden, but only rule is that any period for which company has paid any amount during that period cash benefit will not be provided by ESI.....
From India, Hyderabad
From India, Hyderabad
Hello every body,
I am an ex-serviceman and employed in a private concern. I am getting a salary of Rs. 25,000/- P.M. at present in cash voucher and also getting my pension. I have requested to my company that not to deduct any EPF/ESI and TDS etc. Because I am a member of Ex-serviceman Contributary Health Scheem(compulsary for all Exsm) and receiving my pension/family pension. Can any body help me to justify whether this practice is correct or not ? If it correct then please help me out to prepare a salary sheet to prevent tax deduction.
Basic-
HRA-
Medical Allow-
Childeren Edu. Allow-
Conveyance-
Telephone_
Etc......
lxrath
From India, Bhubaneswar
I am an ex-serviceman and employed in a private concern. I am getting a salary of Rs. 25,000/- P.M. at present in cash voucher and also getting my pension. I have requested to my company that not to deduct any EPF/ESI and TDS etc. Because I am a member of Ex-serviceman Contributary Health Scheem(compulsary for all Exsm) and receiving my pension/family pension. Can any body help me to justify whether this practice is correct or not ? If it correct then please help me out to prepare a salary sheet to prevent tax deduction.
Basic-
HRA-
Medical Allow-
Childeren Edu. Allow-
Conveyance-
Telephone_
Etc......
lxrath
From India, Bhubaneswar
Dear all
I would like to add a corollary what Mr. Prasad has already deliberated.
Under mediclaim, NO OUT-PATIENT TREATMENT IS ALLOWED BY ALMOST ALL OF THE COMPANIES.
THE CLAIM AMOUNT IS RESTRICTED TO THE VALUE OF THE SUM-INSURED (EG. A PERSON HAS TAKEN A POLICY OF 1 LAKH, SUPPOSE HE UNDERGOES A HEART BYE-PASS SURGERY, WHICH COSTS AROUND 2.5 LAKH. THEN MEDICLAIM ALLOWS YOU AROUND 90,000 OR IN A IDEAL CASE 1 LAKH. NOT MORE THAN THAT.
BUT ESI HAS NO UPPER LIMIT ON THE CLAIM. IN CASES SUCH AS RENAL TRANSPLANTS THE BILL MAY SHOOT UPTO 20 LAKHS EVEN THEN THE AMOUNT IS RELEASED.)
The most important highlight of the ESI scheme is that " THE ABOVE SAID BENEFIT IS NOT RESTRICTED TO THE EMPLOYEE ALONE. BUT THE SAME BENEFIT IS PAYABLE TO HIS SPOUSE, CHILDREN AND DEPENDENT FATHER & MOTHER WITHOUT ANY SUB-LIMIT.
Whether it is possible for a private/commercial player to give such benefits. Then how can the benefits be superior to ESI at the same costs to company. Hence the question of getting exemption would probably not arise.
Best wishes
Ramesh
From India, Madras
I would like to add a corollary what Mr. Prasad has already deliberated.
Under mediclaim, NO OUT-PATIENT TREATMENT IS ALLOWED BY ALMOST ALL OF THE COMPANIES.
THE CLAIM AMOUNT IS RESTRICTED TO THE VALUE OF THE SUM-INSURED (EG. A PERSON HAS TAKEN A POLICY OF 1 LAKH, SUPPOSE HE UNDERGOES A HEART BYE-PASS SURGERY, WHICH COSTS AROUND 2.5 LAKH. THEN MEDICLAIM ALLOWS YOU AROUND 90,000 OR IN A IDEAL CASE 1 LAKH. NOT MORE THAN THAT.
BUT ESI HAS NO UPPER LIMIT ON THE CLAIM. IN CASES SUCH AS RENAL TRANSPLANTS THE BILL MAY SHOOT UPTO 20 LAKHS EVEN THEN THE AMOUNT IS RELEASED.)
The most important highlight of the ESI scheme is that " THE ABOVE SAID BENEFIT IS NOT RESTRICTED TO THE EMPLOYEE ALONE. BUT THE SAME BENEFIT IS PAYABLE TO HIS SPOUSE, CHILDREN AND DEPENDENT FATHER & MOTHER WITHOUT ANY SUB-LIMIT.
Whether it is possible for a private/commercial player to give such benefits. Then how can the benefits be superior to ESI at the same costs to company. Hence the question of getting exemption would probably not arise.
Best wishes
Ramesh
From India, Madras
Its approximately 60% of his daily wages, the reason behind is that: In branch office the cash benefit will be paid based on a chart which contains the daily cash benefit to be paid for an employee whose daily wages is between one SLAB, which contains lower and upper limit.. Naturally the person who draws at the beginning of that SLAB slot will get less than the person whose daily wages is nearer to end of that particular SLAB.
I hope ur clarified ur doubt... in case of any querry don't hesitate to call me on 09443434313 or mail to
From India, Hyderabad
I hope ur clarified ur doubt... in case of any querry don't hesitate to call me on 09443434313 or mail to
From India, Hyderabad
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