CHAPTER I - SHORT TITLE AND EXTENT & DEFINITIONS



EMPLOYEES' STATE INSURANCE (GENERAL) REGULATIONS, 1950

An exercise of the powers conferred by section 97 of the Employees' State Insurance Act, 1948 (34 of 1948), the Employees' State Insurance Corporation is pleased to make the following regulations, the same having been previously published as required by sub-section (1) of the said section, namely: --

CHAPTER I 

1. Short title and extent

(1) These regulations may be called the Employees' State Insurance (General) Regulations, 1950.
(2) They extend to the whole of India.

2. Definitions

In these regulations, unless the context otherwise requires--

(a) "Act" means the Employees' State Insurance Act, 1948 (34 of 1948);

(b) "appointed day" means with reference to any area, factory or establishment, the day from which the whole of Chapters IV and V of the Act apply to such area, factory or establishment, as the case may be;

(c) "appropriate office", "appropriate local office" or "appropriate regional office", shall mean with reference to any action taken under these regulations, such office of the Corporation as may be specified for that purpose under a general or special order of the Corporation;

(d) "Central rules" means the rules made by the Central Government under section 95 of the Act;

(e) [* * *]
(f) [* * *]

(g) "employer" means the principal employer as defined in the Act;

(h) "employer's code number" means the registration number allotted by the appropriate regional office to a factory or establishment for the purposes of the Act, the rules and these regulations;

(i) "factory or establishment" means a factory or an establishment to which the Act applies;

(j) "form" means a form appended to these regulations;

(k) "identity card" means a permanent identity card issued by the appropriate office to an insured person for identification for the purposes of the Act, the rules and these regulations;

(kk) "family identity card" means a card issued by the appropriate office to an insured person for identification of his family for the purposes of the Act, the rules and these regulations;

(l) "inspector" means a person appointed as such by the Corporation under section 45 of the Act;

(m) "instructions" means instructions or orders issued by the Corporation or by such officer or officers of the Corporation as may be authorised by the Corporation in this behalf;

(n) "insurance medical officer" means a medical practitioner appointed as such to provide medical benefit and to perform such other functions as may be assigned to him and shall be deemed to be a duly appointed medical practitioner for the purposes of Chapter V of the Act;

(o) "insurance number" means a number allotted by the appropriate office to an employee for the purposes of the Act, the rules and these regulations;

(p) "local office" and "regional office" shall mean, according to the context, such subordinate office of the Corporation, set up at such place and with such jurisdiction and functions as the Corporation may, from time to time determine;

(q) "local office manager" means a person appointed by the Corporation as such or the office-in-charge of a local office;

(r) "state rules" means the rules made by a State Government under section 96 of the Act;

(s) "regional director" means a person appointed by the Corporation as such for a specified region;

(t) "registered midwife" means a person who is registered as a midwife under any law in force in any State providing for registration of nurses and midwives;

(u) "rules" means rules made by the Central or a State Government under the Act;

(v) "specified" means specified by instructions issued from time to time by the Corporation or any authorised officer;

(w) "Year" means a calendar year except when specifically stated otherwise;

(x) All other words and expressions have the meanings respectively assigned to them in the Act or the rules, as the case may be.


3. The manner in which the Corporation may exercise its powers

(1) Where a regulation empowers the Corporation to specify, prescribe, provide, decide or determine anything or to do any other act, such powers may be exercised by a resolution of the Corporation or subject to the provisions of section 18 of the Act by a resolution of the Standing Committee :

PROVIDED that the Corporation or the Standing Committee may delegate any of the powers under these regulations to a sub-committee or to such officers of the Corporation as it may specify in that behalf:

PROVIDED FURTHER that no power shall be delegated under this regulation which under the Act is required to be exercised by the Corporation only.

(2) Any appointment to be made by the Corporation under these regulations shall be made by the Director General or by such other officers as may be authorised in this behalf by the Standing Committee.


3A. Exercise of powers by an office

Where a power is to be exercised by the appropriate office or appropriate local office or appropriate regional office it shall be exercised by the officer for the time being in charge thereof or by such other officer as may be authorised for the purpose under general or special orders of the Director-General.


4. Contribution and benefit periods

Contribution periods and the corresponding benefit periods shall be as under :
  
Contribution period                                                     Corresponding benefit period

1st April to 30th September                                           1st January of the year following to 30th June
1st October to 31st March of the year following             1st July to 31st December.

PROVIDED that in the case of a person who becomes an employee within the meaning of the Act for the first time, the contribution period shall commence from the date of such employment in the contribution period current on that day and the corresponding benefit period for him shall commence on the expiry of the period of nine months from the date of such employment.

5. [* * *]


6. Meetings of the Corporation, the Standing Committee and the Medical Benefit Council

The meetings of the Corporation, the Standing Committee and the Medical Benefit Council shall be held in accordance with the Central Rules at such time and place as may be fixed by Chairman concerned.


7. Decision by majority

Every matter coming up for decision before a meeting of the Corporation, the Standing Committee or the Medical Benefit Council shall be decided by a majority of persons present and voting at the time of the meeting and in case of equality of votes the Chairman of the meeting shall have an additional casting vote.


8. Mode of exercising vote

The votes shall be taken by show of hands and the names of persons voting in favour and against any proposition shall be recorded only if any member present requests the Chairman to do so.


9. Matters to be brought before the Corporation

In addition to the matters which are, under any specific provision of the Act or the Central Rules, required to be placed before the Corporation, the following matters shall be referred to the Corporation for its decision :

(a) regulations under section 97 and amendments thereto before final publication;

(b) any measures proposed under section 19 of the Act;

(c) any proposal to extend medical benefit to families under sub-section (2) of section 46;

(d) any dispute proposed to be referred to arbitration under sub-section (4) of section 58;

(e) any proposal to set up hospitals under section 59;

(f) any proposal to grant exemption under section 91;

(g) any proposal to enhance benefits under section 99;

(h) any other matter which the Corporation or its Chairman may direct the Standing Committee or the Director-General to place before the Corporation.


10. Regional Boards

(1) A Regional Board may be set up for each State or Union Territory by the Chairman of the Corporation and shall consist of the following members, namely :--

(a) a Chairman to be nominated by the Chairman of the Corporation in consultation with the State Government or the administration of the Union Territory;

(b) a Vice-Chairman to be nominated by the Chairman of the Corporation in consultation with the State Government or the Administration of the Union Territory.

(c) one representative of the State or the Union Territory to be nominated by the State Government or the Administration of the Union Territory;

(d) (i) the Administrative Medical Officer or any other Officer directly in charge of the Employee's State Insurance Scheme in the State or the Union Territory, ex officio;

(ii) the Regional Deputy Medical Commissioner of the Corporation, ex officio;

(e) one representative each of the employers and employees from the State or the Union Territory to be nominated by the Chairman of the Corporation in consultation with such organisation of the employers and the employees as may be recommended for the purpose by the State Government or the Union Territory;

(f) members of the Corporation other than the Chairman and the Vice-Chairman and officials, if any, amongst those nominated by the Central Government under clause (c) of section 4 of the Act, residing in the State or the Union Territory, ex officio;

(g) members of the Medical Benefit Council nominated by the Central Government under clauses (e), (f) and 
(g) of section 10 of the Act residing in the State or the Union Territory, ex officio :

PROVIDED that where the Chairman of the Corporation so considers it to be expedient he may nominate such additional representatives of employers, and employees, not exceeding three from each side, with a view to providing for the adequate representation of important organisations and included in the nominations of the State Governments, or the Union Territory and to maintain parity between the number of representatives of such employers and employeesÿ:

PROVIDED FURTHER that the Chairman of the Corporation shall nominate such additional representatives of employers and employees not exceeding three from each side where the number of representatives of employers and employees including the ex officio members, is less than three each.

(2) A Regional Board may, if it considers it desirable, co-opt the officer-in-charge of a sub-regional officer set up within its boundaries and/or a member of the medical profession in the region and the person(s) so co-opted shall continue to be member(s) during the pleasure of the regional board.

(3) The regional director or officer-in-charge of the regional office shall be the member secretary of the Board.

(4) (i) Save as expressly provided in this regulation, the term of office of the members of the regional board referred to in clause (e) of and the proviso to sub-regulation (1), shall be three years commencing from the date on which their nomination is notified, provided that the members of the regional board, shall, notwithstanding the expiry of the said period, continue to hold office until the nomination of their successors is notified.

(ii) Save as expressly provided in this regulation, the members of the regional board referred to in clause (c) of sub-section (1) shall hold office during the pleasure of the State Government nominating them.

(iii) A member of the regional board referred to in clause (f) of sub-regulation (1) shall cease to hold office when he ceases to be a member of the Corporation or ceases to reside in that area.

(iv) Any member referred to in clause (i) of this sub-regulation nominated to fill a casual vacancy shall hold office for the remainder of the term of office of the member in whose place he is nominated.

(v) An outgoing member shall be eligible for renomination.

(5) A member of the regional board referred to in clause (e) of and the proviso to sub-regulation (1) above, may resign his office by notice in writing to the Chairman of the Corporation, through the Chairman, Regional Board, and his seat shall fall vacant on the acceptance of the resignation.

(6) (i) A member of the regional board referred to in clause (e) of and the proviso to sub-regulation (1) shall cease to be a member of the Board if he fails to attend three consecutive meetings thereof provided that his membership may be restored by the Chairman of the Corporation on his being satisfied as to the unavoidable nature of the circumstances which led to his non-attendance.

(ii) When any person nominated to represent an employer's or employee's organisation on the Regional Board has ceased to represent such organisation, the Chairman of the Corporation may, by notification in the Gazette of India, declare that such person shall cease to be a member thereof with effect from such date as may be specified therein.

(7) The members of the Regional Board shall receive such fees and allowances as may be prescribed by the Central Government for members of the Corporation.

(8) A member shall be disqualified for being nominated or for being a member of the Regional Board--

(i) if he is declared to be of unsound mind by a competent court; or

(ii) if he is an undischarged insolvent; or

(iii) if before or after the commencement of the regulations he has been convicted of an offence involving moral turpitude.

(9) The Secretary shall, with the approval of the Chairman, fix the date, time and place of, and also draw up the agenda for, every meeting. Notice of not less than ten days from the date of posting shall ordinarily be given to every member for each meeting, provided that if it is necessary to convene an emergency meeting, a reasonable notice thereof shall be given to every member. No matter other than that included in the agenda shall be considered except with the permission of the Chairman.

(10) No business shall be transacted at any meeting unless there is a quorum of not less than one-third of the number of the members on the Board:

PROVIDED that if at any meeting, sufficient number of members are not present to form a quorum, the Chairman may adjourn the meeting to a date not later than seven days from the date of original meeting and it shall thereupon be lawful to dispose of the business at such adjourned meeting irrespective of the number of members present.

(11) All matters shall be decided by a majority of persons present and voting and in case of equality of votes, the Chairman shall have a casting vote or a second vote.

(12) The Chairman or in his absence the Vice-Chairman of the Regional Board shall preside at the meetings. In the event of the absence of both the Chairman and the Vice-Chairman the members present may elect one from amongst themselves to preside.

(13) (i) The minutes of each meeting showing inter alia the names of the members present thereat shall be forwarded to all members of the Regional Board as soon after the meeting as possible and in any case not later than fifteen days from the date of the meeting.

(ii) The records of the minutes of each meeting shall be signed by the Chairman after confirmation with such modifications as may be considered necessary at the meeting, at which the minutes are confirmed.

(14) A Regional Board shall perform the following functions in respect of the Region for which it is set up :

(a) Such administrative and/or executive functions as may, from time to time, be entrusted or delegated to it by a resolution, by the Corporation or the Standing Committee.

(b) To make recommendations from time to time in regard to changes which may in its opinion be advisable in the Act, Rules and Regulations and forms and procedures to be followed in the running of the scheme.

(c) To decide within the broad framework of the general decisions and programme of priorities of the Corporation, the following matters, provided that where the specific approval of the Corporation or the appropriate government is required, such approval shall be taken :

(i) Extension of the scheme to other categories of establishments in accordance with the order of priorities laid down by the Corporation;

(ii) extension of scheme to new areas and extension of medical care to families;

(iii) adoption of special measures to meet peculiar conditions in the area;

(iv) improvement in benefits;

(v) provision of indoor medical treatment;

(vi) measures and arrangements for the rehabilitation of insured persons in the area, who are permanently disabled;

(vii) securing compliance by employers with the various provisions of the Employees' State Insurance Act, the Regulations and other rules and instructions;

(d) To review from time to time the working of the Scheme in the State both on the medical side as well as cash benefit side and to advise the Corporation and State Government on measures to improve the working of the Scheme both in regard to payment of cash benefits and administration of medical benefit and in particular to promote preventive health measures, safety and personal hygiene and to review and check lax certification and other abuses of the scheme.

(e) To look into general grievances, complaints and difficulties of insured persons, employers, etc. as it may consider necessary;

(f) To advise the Corporation on such matters as may be referred to it for advice by the Standing Committee or the Director General.

The Regional Board may set up suitable sub-committees for carrying out any of its functions and may seek the assistance or advice of local committees where necessary.

(15) (i) If in the opinion of the Corporation, the Regional Board persistently makes default in performing the duties imposed on it by or under this regulation or abuses its powers, the Corporation may by notification in the Gazette of India supersede the Regional Board.

(ii) Upon the publication of a notification under clsuse (i) above superseding the Regional Board, all the members of the Regional Board shall from the date of such publication be deemed to have vacated their offices.

(iii) When the Regional Board has been superseded the Corporation may--

(a) immediately constitute a new Regional Board in accordance with this regulation; or

(b) appoint such agency for such period as it may think fit to exercise the powers and perform the functions of the Regional Board and such agency shall be competent to exercise all powers and perform all the functions of the Regional Board.


10A. Local committees

(1) A local committee may be set up for such area as may be considered appropriate by the Regional Board and shall consist of the following members, namely--

(a) a Chairman to be nominated by the Chairman, Regional Board,

(b) an official of the State to be nominated by the State Government;

(c) the Administrative Medical Officer-in-charge of the scheme in the area concerned, ex officio, or any other medical officer nominated by him;

(d) such number, not being less than two and not or more than four of representative of employers in the area as may be considered appropriate by the Chairman, Regional Board, to be nominated by him, in consultation with such employers' organisations as may be recommended for the purpose by the State Government;

(e) an equal number of representatives of employees in the area to be nominated by the Chairman, Regional Board, in consultation with such organisations of employees as may be recommended for the purpose by the State Government;

(f) an official of the Corporation to be nominated by the Director-General, who shall also act as Secretary to the Committee :

PROVIDED that where the Chairman, Regional Board, so considers it to be expedient, he may nominate such additional representatives of employers and employees, not exceeding two from each side, with a view to providing for the adequate representation of important organisations not included in the nominations of the State Government and to maintaining the parity between the number of representatives of such employers and employees :

PROVIDED FURTHER that in any area in which medical care is provided through a panel system, a local committee may co-opt a member representing the local insurance medical practitioners.

(2) (i) The term of office of the members of a local committee nominated under clauses (d) and (e) of sub-regulation (1) shall be three years, commencing from the date on which their nomination is notified, provided that such members shall, notwithstanding the expiry of the said period, continue to hold office until the nomination of their successor is notified.

(ii) The members of a local committee nominated under clauses (b), (c) and (f) of sub-regulation (1) shall hold office during the pleasure of the authority nominating them.

(3) A member of a local committee may resign his office by notice in writing to the Chairman, Regional Board, and his seat shall fall vacant on the acceptance of the resignation.

(4) (i) A member of a local committee shall cease to be a member of the committee if he fails to attend three consecutive meetings thereof provided that his membership may be restored by the Chairman, Regional Board, on being satisfied as to the unavoidable nature of the circumstances which led to his non-attendance.

(ii) Where in the opinion of the State Government any person nominated to represent employers or employees on a local committee has ceased to represent such employers or employees, the Chairman, Regional Board, may declare that such person shall cease to be a member thereof with effect from such date as may be specified by him.

(5) The members of the committee shall receive such fees and allowances as may be specified by the Central Government.

(6) The Secretary, shall, in consultation with the Chairman, fix the date, time and place, of, and also draw up the agenda for every meeting. Notice of not less than seven days shall ordinarily be given to every member for such meeting. No matter other than that included in the agenda shall be considered except with the permission of the Chairman.

(7) No business shall be transacted at any meeting of a committee unless there is a quorum of not less than one-third of the number of the members of the committee.

(8) All matters at a meeting of a local committee shall be decided by a majority of persons present at the meeting and voting, and in case of equality of votes, the Chairman shall have a casting vote or a second vote.

(9) A local committee shall perform the following functions in respect of the area for which it is set up, namely--

(a) to discuss local problems in regard to the Employees' State Insurance Scheme so as to secure its efficient working with the full co-operation of all parties concerned and to make recommendations;

(b) to refer such complaints as it may consider necessary to the Regional Director concerned, or in the case of complaints concerning medical benefit, to the State Government or such authority as that government may nominate for the purpose; and

(c) to advise the Corporation or the Regional Board concerned on such matters as may be referred to it for advice.





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APPLICABILITY OF THE ACT & SCHEME:

 Is extended in area-wise to factories using power and employing 10 or more persons and to non-power using manufacturing units and establish-ments employing 20 or more person upto Rs.15,000/- per month w.e.f. 01.04.10. It has also been extend-ed upon shops, hotels, restaurants, roads motor transport undertakings, equip-ment maintenance staff in the hospitals.

COVERAGE OF EMPLOYEES:

 Drawing wages Upto Rs.15,000/- per month Engaged either directly or thru’ contractor

RATE OF CONTRIBUTION OF THE WAGES:

 Employers’ 4.75%

 Employees’ 1.75%

MANNER AND TIME LIMIT FOR MAKING PAYMENT OF CONTRIBUTION:

 The total amount of contribution (employee’s share and employer’s share) is to be deposited with the authorized bank through a challan in the prescribed form in quadruplicate on ore before 21st of month following the calendar month in which the wages fall due.

BENEFITS TO THE EMPLOYEES UNDER THE ACT:

 Medical Benefit
 Sickness Benefit(SB)
 Maternity Benefit(MB)
 Disablement Benefit
 Dependants’ Benefit(DB)
 Funeral Expenses

 In addition, the scheme also provides some other need based benefits to insured workers.

WAGES FOR ESI CONTRIBUTIONS:

 Registers/files to be maintained by the employers

CONTRIBUTION PERIOD:

 If the person joined insurance employment for the first time, say on 5th January, his first contribution period will be from 5th January to 31st March and his corresponding first benefit will be from 5th October to 31st December.

TO BE DEEMED AS WAGES:

• Basic pay
• Dearness allowance
• House rent allowance
• City compensatory allowance
• Overtime wages (but not to be taken into account for determining the coverage of an employee)
• Payment for day of rest
• Production incentive
• Bonus other than statutory bonus
• Night shift allowance
• Heat, Gas & Dust allowance
• Payment for unsubstituted holidays
• Meal/food allowance
• Suspension allowance
• Lay off compensation
• Children education allowance (not being reimbursement for actual tuition fee)

NOT TO BE DEEMED AS WAGES:

• Contribution paid by kthe employer to any pension/provident fund or under ESI Act.
• Sum paid to defray special expenses entailed by the nature of employment – Daily allowance paid for the period spent on tour.
• Gratuity payable on discharge.
• Pay in lieu of notice of retrenchment compensation
• Benefits paid under the ESI Scheme.
• Encashment of leave
• Payment of Inam which does not form part of the terms of employment.
• Washing allowance for livery
• Conveyance Amount towards reimbursement for duty related journey

PENALTIES :

 Different punishment have been prescribed for different types of offences in terms of Section 85: (I) (six months imprisonment and fine Rs.5000), (ii) (one year imprisonment and fine), and 85-A: (five years imprisonment and not less to 2 years) and 85-C (2) of the ESI Act, which are self explanatory. Besides these provisions, action also can be taken under section 406 of the IPC in cases where an employer deducts contributions from the wages of his employees but does not pay the same to the corporation which amounts to criminal breach of trust.

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