ESIC Benefits | Only for the Private Use for the Staff of SandMartin Group of Companies & should not be treated as professional opinion/recommendations.

1. Employment State
Insurance
Disclaimer: The purpose of the presentation is to spread awareness amongst employees and the information provided in the
presentation is to best of our knowledge, but we would suggest you to contact the HR/ESIC Department/Website for further
instructions at the time of predicament and follow the procedure as instructed by ESI officials which may change from time to time. We
are not responsible should any information/procedure change in due course.

2. Contents
➢ Sickenss Benefit
➢ Disablement Benefit
➢ Dependant Benefit
➢ Maternity benefit
➢ Other Benefits
➢ Hospitals covered in Delhi/NCR under ESI
➢ Dispenseires covered in DELHI/NCR under ESI
➢ Hospitals covered in Maharashtra under ESI
➢ Dispenseires covered in Mumbai under ESI
For more information on Employment State Insurance,
please visit www.esi.nic.in
2
- How ESI will help you?
- Registration Process
- Benefits
- Coverage
- Reimbursement
- Public Grievances

3. Employees’ State Insurance Scheme of
India is a multidimensional social security
system tailored to provide socio-economic
protection to worker population and their
dependents covered under the scheme.
Besides full medical care for self and
dependents.
3

4. How will ESI help you??
The scheme provides full medical care to the employee registered
under the ESI Act, 1948 during the period of his incapacity,
restoration of his health and working capacity. It provides financial
assistance to compensate the loss of his/ her wages during the
period of his abstention from work due to sickness, maternity and
employment injury. The scheme provides medical care to his/her
family members also.
4

5. Registration
In case, the employee is already having an insurance number, the employer
has to enter that number and proceed with updating the details of the
employee, as the insurance number is unique for each employee and is valid
throughout the life of the employee, irrespective of his changing jobs.
Once the registration process is completed, the employee will be allotted an
insurance number, which is unique and will be valid throughout the life of the
employee, even if the employee changes job.
5

6. What Employee needs to do? 6
Personal
and Family
details
Family
photo
Online
Registration
Issuance of
TIC

7. How can Employee avail ESI Benefits
(Temporary Identity Card) (Permanent Identity Card)
7
TIC
Linking
of
Aadhar
PIC

8. Temporary Identity Card & Permanent Identity Card
»With PIC the IP and his family members can avail benefits under the ESI Scheme,
without any hitch.
»If Aadhar number of IP/family is not available, then employer will ensure to affix the IP
photo along with the family members on TIC duly authenticated with his stamp &
signature. This TIC will be valid for a period of one month only.
»As soon as possible but not later than a month, the insured person along with his entire
family should link their Aadhar number using the web site www.esic.in for availing
medical benefit at dispensary/ hospital and availing cash benefits at the ESI branch
Office.
»Any changes in his residence/ dispensary/ employment can be carried out by the
employer in the ESIC Portal as and when arises.
8

9. What if Employee exceeds INR 21,000 per month?
If the wages of an employee (excluding remuneration for overtime
work) exceeds the wage limit prescribed by the Central Government
after start of contribution period, he continues to be an employee till
the end of that Contribution Period [(1st Apr – 30th Sep) or (1st Oct –
31st Mar)] and the contribution is to be deducted and paid on the
total wages earned by him.
9

10. Benefits of ESI

11. Sickness
Benefits
Eligibility: Payment
of contribution for 78
days in
corresponding
Contribution Period.
Duration & scale of
benefits: Up to 91
days in two
consecutive Benefit
Periods.
Rate: 70% of the
average daily wages
11
Enhanced
Sickness
Benefit
Eligibility: Payment
of contribution for 78
days in
corresponding
Contribution Period.
Duration & scale of
benefits: 14 days for
Tubectomy & 7 days
for Vasectomy,
extendable on
medical advice.
Rate: 100% of the
average daily wages.
Extended
Sickness
Benefit
Eligibility: For 34 specified long term
diseases, continuous insurable
employment for two years with
minimum 156 days' contribution in four
consecutive Contribution Periods.
Duration & scale of benefits: 124
days during a period of two years. This
may be extended up to two years on
medical advice.
Rate: 80% of the average
daily wages.

12. Disablement Benefit
Temporary
Disablement
Benefit
Eligibility: From day one of entering
insurable employment for
disablement due to employment
injury.
Duration & scale of benefits:
As long as temporary
disablement lasts.
Rate: 90% of the average
daily wages approx
Permanent
Distilment Benefit
Eligibility: From day one of entering
insurable employment for disablement
due to employment injury.
Duration & scale of
benefits: For whole life.
Rate: For permanent total disablement - 90% of the
average daily wages. For permanent partial
disablement - Proportionate to the loss of earning
capacity as determined by medical board.
12

13. Dependants and Maternity Benefit
Dependants’
Benefit
Eligibility: From day one of
entering insurable employment in
case of death due to employment
injury.
Duration & scale of benefits: For life to the
widow or until her re-marriage. To dependant
children till the age of 25 years. To dependant
parents etc. subject to conditions.
Rate: 90% of the average daily wages
shareable in fixed proportion among all
dependants.
Maternity
Benefit
Eligibility: Payment of
contribution of 70 days in two
preceding Contribution Periods.
Duration & scale of benefits: Up to 12 weeks in case of
confinement. Up to 6 weeks in case of miscarriage.
Extendable by 1 Month on medical advice in case of
Sickness arising out of Pregnancy, Confinement,
Miscarriage.
Rate: 100% of the average daily
wages.
13

14. Medical Benefit
Eligibility: Reasonable medical care for self and family from day one of entering
insurable employment.
Duration & scale of benefits: Reasonable medical care till he/she remains in
insurable employment. Medical Benefit under the ESI Scheme has now been
extended to the widow/spouses of deceased/retired/superannuated Insured Persons
as well as to the widow/spouses of Insured Persons who ceases to be in an insurable
employment on account of Permanent Disablement, and also to widows of Insured
Persons who are in receipt of Dependants’ Benefit.
14

15. Other Benefits
Confinement
Expenses
Eligibility: An Insured Woman or an I.P.
in respect of his wife is eligible if
confinement occurs at a place where
necessary medical facilities under ESI
Scheme are not available.
Duration & scale of benefits: Up
to two confinements only.
Rate: 5000/- per case.
Funeral
Expenses
Eligibility: From day one of
entering insurable
employment.
Duration & scale of
benefits: For defraying
expenses on the funeral of an
Insured Person.
Rate: Actual expenses
subject to a maximum of `
10000/- .
Vocational
Training
Eligibility: In case of physical
disablement due to
employment injury.
Duration & scale of
benefits: As long as
vocational training lasts.
Rate: Actual fee charged or
`123/- a day, whichever is
higher.
15

16. Other Benefits
Physical
Rehabilitation
Eligibility: In case of physical
disablement due to employment
injury.
Duration & scale of benefits: As long as
a person is admitted in an artificial limb
centre.
Rate: 100% of the average
daily wages.
Unemployment
Allowance
(RGSKY)
Eligibility: In case of involuntarily loss of employment due
to closure of factory, retrenchment or permanent invalidity
due to non-employment injury and the contribution in
respect of him have been paid/payable for a minimum of
three years prior to the loss of employment.
Duration & scale of benefits: Maximum twelve
months during life time.
Rate: 50% of the average daily wages.
16

17. Other Benefits
Skill Up gradation Training under RGSKY
Eligibility: In case of involuntarily loss of employment due to closure of
factory, retrenchment or permanent invalidity due to non-employment injury
and the contribution in respect of him have been paid/ payable for a minimum
of three years prior to the loss of employment.
Duration & scale of benefits: For a duration of maximum 6
months.
17

18. Reimbursement

19. Claims for reimbursement of expenses incurred in respect of medical
treatment of IP and his family may be accepted in circumstances
Claims for
reimbursement
of expenses
incurred in
respect of
medical
treatment of IP
and his family
may be
accepted in
circumstances
• Full authority is vested with the
State Government concerned to
reimburse expenditure in
respect of medical treatment of
IP and his family.
• It may be left to the discretion of
the State Government to decide
the Authority within their
machinery who will approve the
expenditure in question;
• Time limit for submission of the
claims for reimbursement is one
year
19

20. The State Government has to keep in view the following points while
considering the cases of reimbursement of expenditure on Medical Care
Whether such facilities for
which reimbursement is
recommended are not
available with the State.
Whether the hospital
where the IP was sent or
proposed to be sent
was/is the nearest
hospital having required
facilities/services.
20
➢Under the circumstances where ESI Hospitals are unable to provide right treatment, ESI shall offer to pay the
expenses incurred in the hospital referred by ESI

21. 21Sl. No. Place / Address Tel. No.
1.
BASAIDARAPUR
Medical Superintendent, ESI Hospital, Ring Road, New Delhi-110 015
http://esih-basai.org
25100664
2.
JHILMIL
Medical Superintendent, ESI Hospital, Jhilmil, Delhi
22151329
3.
NOIDA
Medical Superintendent, ESI Hospital, Sector-24, Noida.
91-4527872
4.
OKHLA
Medical Superintendent ESI Hospital, Phase-II Okhla
26814161
5.
ROHINI
Medical Supdt. ESI Hospital Rohini, Sec – 15 New Delhi.
27861033
Hospitals in Delhi/NCR

22. S No. Place/Address Telephone/Fax VOIP No.s'/Email Address
1
AZADPUR
011-27242791
60011058/59/60
Medical Officer Incharge, ESI Dispensary, C-2/35, Model Town-III, disp-azadpur[dot]dl[at]esic[dot]in
Azadpur, DELHI
2
DWARKA
011-25088415
60011073/74/75
Medical Officer Incharge ESI Dispensary Opp. Shruti Apartment, Plot No. 22 Behind Vardhman Plaza Near Ramphal Chowk,
Sector-7 Dwarka, NEW DELHI-110075
disp-dwarka[dot]dl[at]esic[dot]in
3
FACTORY ROAD
011-24671333
60011088/89/90
Medical Officer Incharge, ESI Dispensary, Factory road, Opp. D.T.C. Depot, Sarojini Nagar, DELHI disp-factoryroad[dot]dl[at]esic[dot]in
4
INDERLOK
011-23657807
60011064/65/66 d
Medical Officer Incharge ESI Dispensary New Masjid, isp-inderlok[dot]dl[at]esic[dot]in
Inderlok, NEW DELHI
5
JAHANGIRPURI
011-27633503
6011037/38/39
(BADLI EXTENSION) A-79, Badli Extension, Outer Ring Road, DELHI disp-jahangirpuri[dot]dl[at]esic[dot]in
6
JAWALA PURI
011-25267204
60011096/97/98
Medical Officer Incharge ESI Dispensary Resettlement Colony, disp-jawalapuri[dot]dl[at]esic[dot]in
Phase-4, Jawala Puri, DELHI
Dispensaries in Delhi/NCR

23. Dispensaries in Delhi/NCR
S No. Place/Address Telephone/Fax VOIP No.s'/Email Address
7
JANGPURA
011-24312832
60011028/29/30
Medical Officer Incharge ESI Dispensary, Opp. Railway Crossing, disp-jangpura[dot]dl[at]esic[dot]in
(Near Eros Cinema) Jangpura, NEW DELHI
8
KALKAJI
011-26430583
60011049/50/51
Medical Officer Incharge ESI Dispensary G-Block, disp-kalkaji[dot]dl[at]esic[dot]in
Opp. CGHS Dispensary, Kalkaji, NEW DELHI
9
KARAMPURA
011-25101314
60011034/35/36
Medical Officer Incharge ESI Dispensary I-Block, Karampura, DELHI disp-l-block[dot]dl[at]esic[dot]in
10
MADIPUR
011-25213796
60011040/41/42
Medical Officer Incharge ESI Dispensary Pocket-3, Paschim Puri, disp-madipur[dot]dl[at]esic[dot]in
MADIPUR, NEW DELHI
11
MANGOLPURI
011-27923274
60011076/77/78
Medical Officer Incharge SI Dispensary O-Block, Mangolpuri, disp-mangolpuri[dot]dl[at]esic[dot]in
DELHI-83
12
MAYA PURI PHASE-I
011-28114516
60011061/62/63
Medical Officer Incharge ESI Dispensary B-309, Industrial Area disp-mayapuri1[dot]dl[at]esic[dot]in
Mayapuri, NEW DELHI

24. Dispensaries in Delhi/NCR
S No. Place/Address Telephone/Fax VOIP No.s'/Email Address
13
MAYAPURI-PHASE-II
011-28112417
60011031/32/33
Medical Officer Incharge ESI Dispensary 22, Facility area, Near Punjab & Sindh Bank, MAYAPURI,
Phase-II DELHI
disp-mayapuri2[dot]dl[at]esic[dot]in
14
MAYUR VIHAR
011-22751272
60011043/44/45
Medical Officer Incharge ESI Dispensary MIG Flats, 183A, B, 184A,B Mayur Vihar, disp-mayurvihar[dot]dl[at]esic[dot]in
DELHI
15
MEHRAULI
011-26643190
60011067/68/69
Medical Officer Incharge ESI Dispensary 33-B-7/9, Kishan Garh, Vasant Kunj, New Delhi disp-mehrauli[dot]dl[at]esic[dot]in
16
MORI GATE
011-23974744
60011010/11/12
Medical Officer Incharge ESI Dispensary Near Tis Hazari, Opp. Mori Gate, disp-morigate[dot]dl[at]esic[dot]in
DELHI-110006
17
NAJAFGARH
011-25012143
60011085/86/87
Medical Officer Incharge ESI Dispensary 1625-C/2, Thana Road, Najafgarh, New Delhi disp-najafgarh[dot]dl[at]esic[dot]in
18
NAND NAGRI
011-22591935
60011079/80/81
Medical Officer Incharge ESI Dispensary Nand Nagri, Near DTC Depot, NEW DELHI-110093 disp-nandnagri[dot]dl[at]esic[dot]in

25. Dispensaries in Delhi/NCR
S No. Place/Address Telephone/Fax VOIP No.s'/Email Address
19
NARELA
011-27285840
60011091/92/93
Medical Officer Incharge ESI Dispensary U-103, Vijay Nagar, Narela, NEW DELHI disp-narela[dot]dl[at]esic[dot]in
20
NIA
011-25102949
60011025/26/27
Medical Officer Incharge disp-nia[dot]dl[at]esic[dot]in
ESI Dispensary Near Moti Nagar Police Station, Naraina Industrial Area, NEW DELHI
21
OKHLA (Modi Mill)
011-26929048
600110022/23/24
Medical Officer Incharge ESI Dispensary Okhla Industrial Area, Modi Mills, Okhla NEW DELHI disp-okhla[dot]dl[at]esic[dot]in
22
OKHLA PHASE-I
011-26813134
60011004/5/6
Medical Officer Incharge ESI Dispensary Staff Quarters, ESI Hospital, Shri Maa Anandmayee Marg, disp-okhlaphase1[dot]dl[at]esic[dot]in
Okhla, Delhi-110020
23
PAHARGANJ
011-23580679
60011052/53/54
Medical Officer Incharge ESI Dispensary Gurudwara Street, Chuna Mandi, Pahar Ganj, NEW DELHI disp-paharganj[dot]dl[at]esic[dot]in
24
RAGHUBIR NAGAR,
011-25438441
60011007/8/9
Medical Officer Incharge ESI Dispensary Tagore Garden Extn. Near Holy Child School, NEW DELHI
disp-
raghubirnagar[dot]dl[at]esic[dot]in

26. Dispensaries in Delhi/NCR
S No. Place/Address Telephone/Fax VOIP No.s'/Email Address
25
ROHINI-V
011-27042878
60011013/14/15
Medical Officer Incharge ESI Dispensary Pocket B-9, Sector-V disp-rohini[dot]dl[at]esic[dot]in
Rohini DELHI
26
SEELAMPUR
011-22826829
60011055/56/57
Medical Officer Incharge ESI Dispensary Phase-4, Welcome Colony, Seelampur, DELHI disp-seelampur[dot]dl[at]esic[dot]in
27
SHASTRI NAGAR
011-23640492
60011046/47/48
Medical Officer Incharge ESI Dispensary Near Vivekand Puri,Near Shastri Nagar Metro Station, DELHI-
110032
disp-shastrinagar[dot]dl[at]esic[dot]in
28
SUBZI MANDI
011-23845932
6001101/2/3
Medical Officer Incharge ESI Dispensary Behind Birla Cotton & General Mills, Shakti Nagar, Subji Mandi
DELHI
disp-subzimandi[dot]dl[at]esic[dot]in
29
TIGRI
011-26059721
60011070/71/72
Medical Officer Incharge ESI Dispensary Ambedkar Nagar, disp-tigri[dot]dl[at]esic[dot]in
Behind State Bank of India, Tigri, NEW DELHI
30
TILAK VIHAR
011-28331925
60011019/20/21
Medical Officer Incharge ESI Dispensary Near Works Deptt., disp-tilakvihar[dot]dl[at]esic[dot]in
Opp. Police Station, Tilak Vihar, NEW DELHI

27. 27
Hospitals in Mumbai
S.
No.
Place / Address Tel. No.
1. ANDHERI
Medical Supdt
ESI Hospital, Central Road, MIDC,
Andheri (E), MUMBAI-93.
28367203
28320752
2. KANDIVALI
Medical Supdt
ESI Hospital, Akruli Road, Kandivalli(E)
MUMBAI - 400 101.
28877764-65

28. Dispensaries in Mumbai 28
S. No. Place / Address Tel. No.
1
ANDHERIA
28367203
Medical Officer Incharge, ESI Dispensary, ESI Hospital Andheri, Central Road, Andheri, MUMBAI-400 093
2
CHEMBUR
25583906Medical Officer Incharge, ESI Dispensary, M. Joshi hospital Bldg, Plot No. 70,Dayanand Saraswati Road, Opp. Ambedkar Udyan,
Chembur, MUMBAI 71
3
J.J. HOSPITAL COMPOUND
23716450
Medical Officer Incharge, ESI Dispensary, J.J. Hospital Compound, byculla, MUMBAI 08
4
KANDIVALI (W)
28877764/65
Medical Officer Incharge, ESI Dispensary, ESIS Hospital Charkop, Industrial Estate, Charkop, KANDIVALI (W), MUMBAI
5
MAHINDRA INDUSTRAIL
24074873
Medical Officer Incharge, ESI Dispensary, 109, Mahindra Industrial Estate, Road No. 29, Opp. Nehru Garden, SION, MUMBAI 22`

29. Dispensaries in Mumbai
S. No. Place / Address Tel. No.
6
MULUND (WEST)
25645520-24
Medical Officer Incharge, ESI Dispensary, ESI Hospital, LBS Marg, Mulund (w), MUMBAI 80
7
MALAD (EAST)
26894381
Medical Officer Incharge,ESI Dispensary, S.K. Patil Arogyadham, Daftari Road, malad (East), MUMBAI 64
8
PAREL
24132575
Medical Officer Incharge, ESI Dispensary, M.G.M Hospital, PAREL, MUMBAI- 12
9
VILE PARLE (WEST)
26126593Medical Officer Incharge, ESI Dispensary, S.V. Road, B/h Nanawati Hospital,
Sarojini Naidu Road, Vile Parle (West) MUMBAI
10
WORLI 24933142/3
Medical Officer Incharge,ESI Dispensary,ESI Hospital, Worli,Dr. Annie Besant Road, 24932390
Worli, MUMBAI 18 24932428
11
KANDIVALI (EAST)
28877501Medical Officer Incharge,ESI Dispensary,ESIS Hospital,Akurli Road, Kandivali (E),
MUMBAI 01

30. Public Grievances
• The ESI Corporation
has set up the Public
Grievances Redressal
System at all levels i.e.
Hqrs. Office /Regional/
Sub-Regional/
Divisional/ Branch
Offices/ESI
Dispensaries/ESI
Hospitals.
Offices
• An online portal has
been provided to lodge
and monitor
www.esic.in/ web/ esic/
lodge – a - grievance
Online
Portal
• A Toll Free Helpline No.
1800-11-2526 activated
at Hqrs. office.
Telephone
30