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EMPLOYEES STATE INSURANCE GENERAL REGULATIONS, 1950
(1) These regulations may be called the Employees’ State Insurance (General) Regulations, 1950.
(2) They extend to the whole of India including the Union Territory of Pondicherry except the State of Jammu and Kashmir.
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1. Vide Notification No. RS/5/48, dated 17th October, 1950.
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 1[Branch 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;
(1) Where a regulation empowers the Corporation to specify, prescribe, provide, decide or determine anything or to do any other act, such power 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 this regulations shall be made by the Director-General or by such other officers as may be authorised
Where a power is to be exercised by the appropriate Office or appropriate 1[Branch 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.
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1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office” (w.e.f. 1-1-2005).
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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 1st July to 31st December
the year following
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
1[***]
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1. Regulation 5 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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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 the Chairman concerned.
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.
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.
In addition to the matters which are, under any specific provision of the Act or the Central Rules, required to be placed before 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 hospital under section 59;
(f) any proposal to grant exemption under section 91;
1[(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;]
2[(d)(i) the administrative Medical Officer or any other Officer directly incharge of the Employees’ State Insurance Scheme in the
(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 2[***];
(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 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 Governm
The employer in respect of a factory or an establishment shall require every employee in such factory or establishment to furnish and such employees shall on demand furnish to him either before or on the appointed day correct particulars for the purpose of Form I (hereinafter referred to as the Declaration Form). Such employer shall enter the particulars in the Declaration Form including the temporary Identification Certificate, and obtain the signature or the thumb-impression of such employee and also complete the form as indicated thereon.
(1) The employer in respect of a factory or an establishment shall, before taking any person into employment in such factory or establishment after the appointed day, require such person (unless he can produce an Identity Card or other document in lieu thereof issued to him under these regulations) to furnish and such person shall on demand furnish to him correct particulars required for the Declaration Form including the Temporary Identification Certificate. Such employer shall enter the particulars in the Declaration Form including the Temporary Identification Certificate and obtain the signature or the thumb-impression of such person and also complete the form as indicated thereon.
(2) Where an Identity Card is produced under such sub-regulation (1), the employer shall make relevant entries thereon
1[***].
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1. Regulation 13 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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The employer shall send to the appropriate Office by registered post or messenger, all Declaration Forms without detaching the temporary identification certificate prepared under these regulations together with a return in duplicate in Form 3 1[within 10 days of the date] on which the particulars for the Declaration Forms were furnished.
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1. Subs. by Notification No. Genl/Amdt./20, dated 20th January, 1968.
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An insured person shall intimate all changes in the membership of the family as defined under the Act, to the employer within the 15 days of such change having occurred and the employer shall enter such particulars in 2[Form 2] and shall forward it to the appropriate Office within 10 days of the date on which the particulars of the changes were furnished.]
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1. Ins. by the Employees State Insurance (General) (Amendment) Regulations, 1957.
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 1B” (w.e.f. 1-1-2005).
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On the issue of notification under regulation 95A, specifying the date from which the family of an insured person shall also be entitled to medical benefit under the Act, every insured person who has not furnished the particulars of his family at the time of his registration under the Act, shall furnish to the employer correct particulars in respect of his family in Form 1A. The employer shall enter the particulars in the form and obtain the signature or the thumb-impression of such person and complete the form as indicated thereon and send it to the appropriate Office 2[within 10 days of the date] on which the particulars were furnished.]
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1. Ins. by the Employees State Insurance (General) (Amendment) Regulations, 1957.
On receipt of the return required under regulation 14, the appropriate Office shall promptly allot an Insurance Number to each person in respect of whom the Declaration Form has been received unless it finds that the person had already been allotted an Insurance Number. The temporary Identification Certificate with Insurance Numbers marked thereon shall be detached and returned to the employer along with one copy of Form 3. The employer shall deliver the Temporary Identification Certificate to the employee to whom it relates, after obtaining his signature or thumb-impression thereon except in the case of an employee to whom a certificate of employment has been issued under regulation 17A. The Insurance Number allotted by the Regional Office to an employee and indicated in the copy of Form 3 returned to the employer, shall be entered by the employer on the 1[register of employees 2[(Form 7)] and return of contributions].
An employer shall render all necessary assistance which the Corporation may require 1[in connection with the registration of his factory or establishment and] the registration of his employees and specially for photographing such employees and affixing the photographs to the Identity Cards.
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1. Subs. by Notification No. Genl/Amdt./12, dated 20th April, 1961.
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The appropriate Office shall arrange to have an Identity Card prepared in Form 4 for each person in respect of whom an insurance number is allotted and shall include in such card the particulars of the family entitled to medical benefit under regulation 95A and send all such Identity Cards to the employer. Such employer shall if and when the employee has been in his service for 2[three months] obtain the signature or thumb-impression of the employee on the Identity Card and shall after making relevant entries thereon deliver the Identity Card to him. The employer shall obtain a receipt of an employee who has left employment before 2[three months] shall not be given to him, but shall be returned to the appropriate Office as soon as possible. 3[The Identity Card shall not be transferable].
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In areas where the Director-General considers it appropriate, the appropriate Office shall also supply a Permanent Acceptance Card for each employee in such form as the Director-General may specify along with the Identity Card and this shall also be delivered to the employee. Permanent Acceptance Card for the employee who has left employment before 1[three months] shall not be given to him but returned to the appropriate office along with the Identity Card as soon as possible.]
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1. Subs. by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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If an insured person happens to need medical care before the Temporary Identification Certificate is issued to him, the employer shall issue a certificate of employment in such form as may be specified by the Director-General to such person on demand. Such certificate shall also be issued on demand, if an insured person loses his Temporary Identification Certificate before the receipt of the Identity Card.
In case of loss, defacement or destruction of an Identity Card, the insured person shall report the matter to the appropriate 1[Branch Office], and the Corporation may issue a duplicate copy of the Identity Card subject to such conditions and payment of such fees as may be determined by Director-General.
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1. Subs. by Notification No. N-11/3/2/2003-P&D, dated 1st October, 2004, for “Local Office” (w.e.f. 1-5-2005).
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1. Regulation 19 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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1. Regulation 20 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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1. Regulation 21 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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1. Regulation 22 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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1. Regulation 23 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
1[***]
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1. Regulation 24 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
1[***]
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1. Regulation 25 omitted by Notification No. 12/13/19/79-P&D, dated 9th March, 1983 (w.e.f. 26-3-1983).
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(1) Every employer shall send a return of contributions in quadruplicate in 1[Form 5] along with receipted copies of challans for the amounts deposited in the Bank, to the appropriate Office by registered post or messenger, in respect of all employees for whom contributions were payable in a contribution period, so as to reach that office—
2[(a) within 42 days of the termination of the contribution period to which it relates;
(b) within 21 days of the date of permanent closure of the factory or establishment, as the case may be;]
(c) within 7 days of the date of receipt of requisition in that behalf from the appropriate office.
(2) For the purposes of section 77 of the Act, the due date by which the evidence of contributions having been paid
An employer shall, on demand from the appropriate Office, issue certificate of contributions paid or payable in respect of an insured person in such form as may be specified by the Director-General.]
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1. Subs. by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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1[***]
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1. Regulation 28 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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Contribution payable under the Act shall, except when otherwise provided, be paid into a Bank duly authorised by the Corporation.]
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1. Subs. by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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1[***]
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1. Regulation 30 omitted by Notification No. N-12/13/19/79-P&D, dated 9th March, 1983 (w.e.f. 26-3-1983).
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An employer who is liable to pay contributions in respect of any employee shall pay these contributions within 21 days of the last day of the calendar month in which the contributions fall due:]
2[Provided that where a factory/establishment is permanently closed, the employer shall pay contribution on the last day of its closure:]
3[Provided that an employer may opt, in such manner as may be prescribed, by the Director-General for payment of amount in advance towards contribution to be adjusted against contributions payable by him (including employees’ contribution) for a wage period so that the balance of advance amount continues to be more than the contributions due and payable at the end of the concerned wage period. Such an employer shall furnish in the prescribed proforma 4[(Form 5A)], a six monthly statement of contributions pa
If an employer fails to pay contributions within the periods specified under regulation 31, or any other amount payable under the Act, the corporation may recover damages, not exceeding the rates mentioned below, by way of penalty:
Period of delay Maximum rate of damages in per cent.
per annum of the amount due
(i) Less than 2 months 5%
(ii) 2 months and above but less than 4 months 10%
(iii) 4 months and above but less than 6 months 15%
(iv) 6
Any interest payable under regulation 31A may be recovered as an arrear of land revenue or under section 45C to section 45-I of the Act.]
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1. Subs. by Notification No. N-12/13/1/90-P&D, dated 17th May, 1991 (w.e.f. 15-6-1991).
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An employer who fails to pay contribution within the periods specified in regulation 31, shall be liable to pay 2[simple interest at the rate of 3[twelve per cent.] per annum] in respect of each day of default or delay in payment of contribution.]
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1. Subs. by Notification No. N-12/13/19/79-P&D, dated 9th March, 1983 (w.e.f. 26-3-1983).
2. Subs. by Notification No. N-12/13/1/94-P&D, dated 1st November, 1994 (w.e.f. 1-9-1994).
3. Subs. by Notification No. N-12/13/1/2005-P&D, dated 6th July, 2005, for, “fifteen per cent.” (w.e.f. 1-10-2005).
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(1) Every employer shall maintain a register in 2[Form 6] in respect of every employee of his factory or establishment.
3[(1A) Register of employees engaged by immediate employer.—Every immediate employer shall maintain a Register in 1[Form 6] in respect of every employee engaged by him and submit the same to the principal employer before the settlement of any amount payable under sub-section (1) of section 41 of the Act.]
(2) Every employer shall preserve every register maintained under this regulation after it is filled, for a period of five years from the date of last entry therein.
(3) The employer shall give a reasonable opportunity to any of his employees, if he so desires, to see entries in respect of such employee in this register once a month.]
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Subject to the directions of the Standing Committee, the Director-General may, if he thinks fit and subject to such terms and conditions as he may impose, approve of any arrangement, 1[***] whereby contributions are paid at times or in a manner other than those specified in these regulations and such arrangements may include provision for the payment to the Corporation of such fees as may be determined by him to represent the estimated additional expenses to Corporation, and may require such deposit of money by way of security as he may determine.
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1. Omitted by Notification No. N-12/13/19/79-P&D, dated 9th March, 1983 (w.e.f. 26-3-1983).
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1[***]
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1. Regulation 34 omitted by Notification No. N-12/13/19/79-P&D, dated 9th March, 1983 (w.e.f. 26-3-1983).
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1[***]
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1. Regulation 35 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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Where an employee is employed by an employer for part of a wage period, the contributions in respect of such wage period, shall fall due on the last day of the employment by such employer in that wage period.]
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1. Subs. by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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1[***]
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1. Regulation 37 omitted by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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Where an employee is ordinarily employed by two or more employers in a 1[wage period] the employers of such an employee may, if they think fit, submit to the Corporation a scheme for the payment of the contributions in respect of such employee and the Corporation may, if it is satisfied that the scheme is such as will secure the due payment of the contributions, approve such a scheme subject to such terms and conditions as it may think necessary:
Provided that if no such scheme is submitted to or approved by the Corporation, the Corporation may specify that any one of such employers shall be treated as the employer for the purposes of the provisions of the Act and the regulation relating to contributions, and in such a case the contribution for any 1[wage period] shall fall due on the last day of the 1[wage period] on which an employee was employed by the employer so specified.
Where an employee is employed by an employer for only a part of the 1[wage period] or where an employee is employed by two or more employers in a 1[wage period], only the wages payable to him for the days up to and including the day on which the contribution falls due for that 1[wage period] shall be taken into account in reckoning wages for the purposes of determining the average daily wages of the employee for that 1[wage period].
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1. Subs. by Notification No. 12/13/1/84-P&D. Col. II, dated 5th January, 1985 (w.e.f. 27-1-1985).
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(1) Any contribution paid by a person under the erroneous belief that the contributions were payable by that person under that Act may be refunded without interest by the Corporation to the person, if application to that effect is made in writing before the commencement of the benefit period corresponding to the contribution period in which contribution was paid.
(2) Where any contribution has been paid by a person at a rate higher than that at which it was payable the excess of the amount so paid over the amount payable may be refunded without interest by the Corporation to that person, if application to that effect is made before the commencement of the benefit period corresponding to the contribution period in which such contribution was paid.
(3) In calculating the amount of any refund to be made under this regulation there may
1[***]
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1. Regulation 41 omitted by Notification No. 12/13/19/79-P&D, dated 9th March, 1983 (w.e.f. 26-3-1983).
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1. Regulation 42 omitted by Notification No. 12/13/19/79-P&D, dated 9th March, 1983 (w.e.f. 26-3-1983).
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1. Regulation 43 omitted by Notification No. 12/13/19/79-P&D, dated 9th March, 1983 (w.e.f. 26-3-1983).
Every claim for a benefit payable under the Act shall be made in writing, in accordance with these regulations, to the appropriate 1[Brnach Office] on the form appropriate for the purpose of the benefit for which the claim is made or in such other manner as the appropriate office may, subject to its being in writing, accept as sufficient in the circumstances of any particular case of class of cases. Assistance for filling in the form of claim in case of insured persons who cannot do so themselves shall be provided at the 1[Branch Office] of the Corporation.
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1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office” (w.e.f. 1-1-2005).
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A claim for any benefit under the Act shall for the purposes of section 77 of the Act, becomes due on the following days—
(a) for sickness benefit or for disablement benefit for temporary disablement for any period, on the date of the issue of the medical certificate in respect of such periods: provided that in cases where a person is not entitled to sickness benefit for the first two days of sickness, the due date shall be deferred by such days.
(b) for maternity benefit—
(i) in case of confinement, on the date of issue, in accordance with these regulations, of certificate of expected confinement or on the day six weeks preceding the expected date of confinement so certified whichever is later or, if no such certificate is issued, on the date of confinement; and
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Claim forms shall be available to intending claimants from such persons and such offices of the Corporation as it may appoint or authorise for that purpose and shall be supplied free of charge.
Where a claim for any benefit has been made on an approved form other than the form appropriate to the benefit claimed, the Corporation may treat the claim as if it was made on the appropriate form: provided that the Corporation may in any such case require the claimant to complete the appropriate form.
Every person who makes a claim for any benefit shall, in addition to the medical certificate and other forms specifically required under these regulations, furnish such other information and evidence for the purpose of determining the claim as may be required by the appropriate office, and, if reasonably so required, shall for that purpose attend at such office or place as the appropriate office may direct.
If, in the absence of due signature or of due certification, a claim is defective on the date of its receipt by an office of the Corporation, the office of the Corporation may in its discretion refer the claim to the claimant and if the form is returned duly signed and/or certified within three months from the date on which it was so referred, the office may treat the claim as if it had been duly made in the first instance.
Where it appears that a person who has made a claim for any benefit payable under the Act, may be entitled to a benefit other than that which he has claimed, any such claim may be treated as a claim in the alternative for that other benefit.
The authority which is to certify the eligibility of claimants shall be the appropriate 1[Branch Office] in respect of maternity, sickness, temporary disablement benefit 2[benefits and funeral expenses and the appropriate Regional Office, in respect of permanent disablement and dependant’s benefits].
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1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office” (w.e.f. 1-1-2005).
2. Subs. by Notification No. N-12/13/2/99-P&D, dated 13th May, 2002 (w.e.f. 29-6-2002).
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1[(1) Any benefit payable under the Act shall be paid—
(a) in the case of sickness benefit not later than 7 days;
2[(b) in the case of funeral expenses not later than 15 days;]
(c) in the case of the first payment in respect of maternity benefit not later than 14 days;
(d) in the case of the first payment in respect of Temporary Disablement
Benefit, not later than one month;
(e) in the case of the first payment in respect of Permanent Disablement
Benefit, not later than one month;
(f) in the case of first payment of Dependants’ Benefits, not later than 3 mont
2[(1)] Every employer shall furnish to the appropriate Office such information and particulars in respect of the abstention of an insured person for work for which sickness benefit 3[***] or disablement benefit for temporary disablement, as provided under the Act have been claimed or paid, in 4[Form 10] and within such time as the said office may in writing require in the said Form.]
5[(2) Every employer shall furnish to the appropriate office such information and particulars in respect of the abstention of an insured woman from work for which maternity benefit as provided under the Act has been claimed or paid in 4[Form 10] and within such time as the said office may in writing require in the said Form.]
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1. I
Every insured person claiming sickness benefit or disablement benefit for temporary disablement shall furnish evidence of sickness or temporary disablement in respect of the days of his sickness of temporary disablement by means of a medical certificate given by an Insurance Medical Officer in accordance with these regulations in the form appropriate to the circumstances of the case:
1[Provided that in areas where arrangements for medical benefit under the Employees’ State Insurance Act have not been made or otherwise if in its opinion the circumstances of a particular case so justify, the Corporation may accept any other evidence of sickness of temporary disablement in the form of a certificate issued by the medical officer of the State Government, local body or other medical institution, or a certificate issued by any registered medical practitioner containing such particulars a
No medical certificate under these regulations shall be issued except by the Insurance Medical Officer to whom an insured person has been allotted or by an Insurance Medical Officer attached to a dispensary, hospital, clinic or other Institution to which an insured person is allotted and such Insurance Medical Officer shall examine and if in his opinion the condition of the insured person so justifies, issue to such insured person free of charge, any medical certificates reasonably required by such insured person under or for the purposes of the Act or any other enactment or these regulations:
Provided that an Insurance Medical Officer may issue a medical certificate under these regulations to an insured person who is not allotted to him or to the dispensary, hospital, clinic or other institution to which he is attached, if such officer is satisfied that in the circumstances of a
The appropriate form of a medical certificate shall be filled in ink or otherwise as may be specified by the Director-General by the Insurance Medical Officer in his own handwriting and shall contain a concise statement of the disease or disablement which in the opinion of the Insurance Medical Officer necessitates abstention from work on medical grounds or renders the person temporarily incapable of work. The statement of the disease or disablement in the medical certificate shall specify the nature thereof as precisely as the Insurance Medical Officer’s knowledge of the condition of the insured person at the time of the examination permits.
(a) An Insurance Medical Officer shall give the medical certificate to an insured person at the time of the examination to which it relates; where he is prevented from so doing he shall send the certificate to the insured person within twenty-four hours thereafter.
(b) No further medical certificate relating to the same examination shall be issued, except where a duplicate of such certificate is required, in which case it shall be issued free of charge and clearly marked “Duplicate.”
When the examination is the first examination in respect of spell of sickness or a spell of temporary disablement, the medical certificate shall be in the form of a first certificate 2[(Form 7)] and shall be only in respect of the date of examination:]
3[Provided that where the insured person who needs abstention from work on the day of examination, states that he has been actually sick or temporarily disabled on a day earlier than the date of his first examination, the Insurance Medical Officer may, if he is satisfied as to the truth of the statement that the insured person was unable to present himself for medical examination earlier for reasons beyond his control, certify incapacity for work on the date preceding the date of examination:
Provided further, that where in the opinion of the Insurance Medical Officer, the insured person
If at the date of the examination to which a medical certificate other than a first certificate relates, the insured person in the opinion of the Insurance Medical Officer is, or will become on a date not later than the third day after that date, fit to resume work, that certificate shall be in the form of a final certificate 1[(Form 7)].
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1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 9” (w.e.f. 1-1-2005).
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If the final certificate is not issued within seven days of the date of the first certificate, an insured person shall, except where the case is covered by regulation 61, submit certificates in the form of intermediate certificates 1[(Form 7)] at intervals of not more than seven days each, commencing from the date of the first certificate.
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1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 10” (w.e.f. 1-1-2005).
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Every insured person shall obtain a medical certificate in the form of a final certificate before he takes up any work for wages.
When temporary disablement or sickness has continued for not less than twenty-eight days and the Insurance Medical Officer is satisfied that such disablement or sickness is likely to continue for a long period and that, owing to the nature of the disablement or sickness examination and treatment at intervals of more than one week will be sufficient, the insured person may, unless otherwise directed by the appropriate office, furnish medical certificates in the form of special intermediate certificate 1[(Form 8)] at intervals of such longer periods not exceeding four weeks as may be specified by the Insurance Medical Officer.
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1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 11” (w.e.f. 1-1-2005).
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1. Regulation 62 omitted by Noification No. Genl/Amdt./20, dated 20th January, 1968.
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An insured person intending to claim sickness benefit or disablement benefit for temporary disablement shall submit to the appropriate 1[Branch Office] by post or otherwise, a claim for benefit in 2[Form 9], appropriate to the circumstances of the case together with the appropriate medical certificates:
3[Provided that where only one claim in 4[Form 9] is submitted in respect of more than one certificates, such 5[Form 9] shall be deemed to be appropriate to all such certificates.]
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1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office” (w.e.f. 1-1-2005).
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for
If a person who intends to claim sickness benefit or disablement benefit for temporary disablement fails to submit to the appropriate 1[Branch Office] by post or otherwise the first medical certificate or any subsequent medical certificate within a period of three days from the date of issue of such certificate he shall not be eligible for that benefit in respect of any period—
(i) in the case of a first certificate, more than three days before the date on which the certificate is submitted to the appropriate 2[Branch Office];
(ii) in the case of a subsequent certificate, more than fourteen days before the date on which such subsequent certificate is submitted to the appropriate 1[Branch Office]:
3[Provided that the appropriate Regional Office or other office as authorised by Director-Gen
(i) Every insured person who sustains personal injury caused by accident arising out of and in the course of his employment in a factory or establishment shall give notice of such injury either in writing or orally, as soon as practicable after the happening of the accident:
Provided that any such notice require to be given by an insured person may be given by some other person acting on his behalf.
1[Explanation.—No such notice shall be required to be given by an insured person if an employment injury is caused by any occupational disease specified in 2[Schedule III to the Workmen’s Compensation Act, 1923].
(ii) Every such notice shall be given to the employer or to a foreman or to other official under whose supervision the insured person is employed at the time of the accident or any othe
Every employer shall,—
(i) keep a book readily accessible (hereinafter called ‘the Accident Book’) in 1[Form 11], in which the appropriate particulars of any accident causing personal injury to an insured person may be entered;
(ii) preserve every such book when it is completed for a period of five years from the date of the last entry thereon:
2[Provided that it shall not be necessary to enter in the said Accident Book particulars of any employment injury caused by an occupational disease specified in 3[Schedule III to the Workmen’s Compensation Act, 1923]]:
4[Provided further that an employer shall be deemed to have complied with this regulation sufficiently if in any register maintained by him, the appropriate particulars are also shown.]
If notice of an employment injury under regulation 65 is given otherwise than by an entry in the Accident Book it shall be the duty of the employer or any other person to whom such notice is given under that regulation to make an appropriate entry in the book in respect of the accident to which the notice relates immediately after such notice is received, and where the notice is received otherwise than in writing, read over the particulars to the person who gives the notice and obtains his signature or thumb-impression on the Accident Book.
Every employer shall send a report in 1[Form 12] to the nearest 2[Branch Office] and to the nearest Insurance Medical Officer—
(i) immediately if the injury is serious, i.e., it is likely to cause death or permanent disablement or loss of a member; and
(ii) in any other case within 24 hours after the receipt of the notice under regulation 65 or of the time when the accident came to the notice of the employer or of a foreman or other official under whose supervision the insured person was employed at the time of the accident or any other person designated for the purpose by the employer:
Provided that in case of a serious injury, and particularly when the injury results in death at the place of employment, the report to the Insurance Medical Officer and the 2[Branch Office] shall be sent
Every employer shall arrange for such first aid and medical care and transport for obtaining such aid and care as the circumstances of the accident may require till the injured person is seen by the Insurance Medical Officer and such employer entitled to reimbursement in respect of expenses thereby incurred by him but not exceeding such scale of expenses as may be specified by the Corporation from time to time:
Provided that if the employer is required to provide such medical aid free of charge under any other enactment, he shall not be entitled to any reimbursement of expenses.
Every employer shall furnish to the appropriate office such further information and particulars of an accident and within such time as the said office may, in writing, require.
Every claimant for and every beneficiary in receipt of disablement benefit shall comply with every direction given to him by the appropriate Regional Office which requires him either—
(i) to submit himself to a medical examination by such medical authority as may be appointed by that office for the purpose of determining the effect of the relevant employment injury or the treatment appropriate to the relevant injury or loss of faculty, or
(ii) to attend any vocational training courses or industrial rehabilitation courses provided by any institution maintained by any Government, local authority or any public or private body, recognised for the purpose by the Corporation and considered appropriate by it in his case.
A reference to the Medical Board may be made—
1[(a) at any time not later than twelve months, in cases where claim for temporary disablement benefit is made for an employment injury, from the date of the final certificate issued in respect of the spell of temporary disablement commencing on or immediately after the day of the occurrence of that injury, or from the date of the occurrence of an employment injury in cases where temporary disablement benefit not having been claimed, for permanent disablements is made on the basis thereof by the appropriate Regional Office, at the instance of the disabled person or the employer or any recognised employees’ union:
Provided that such reference may be made by the appropriate Regional Office after the expiry of the period prescribed as aforesaid if it is satisfied that the applicant was preve
The Medical Board shall after examining the disabled person send its decision on such form as may be specified by the Director-General, to the appropriate Regional Office. The disabled person shall be informed in writing of the Medical Board and the benefit, if any, to which the disabled person shall be entitled.]
-------------------------------
1. Subs. by Notification No. Genl/Amdt./20, dated 20th January, 1968.
-------------------------------
Any question whether an employment injury is caused by an occupational disease specified in the Third Schedule to the Act shall be determined by a Special Medical Board which shall examine the disabled person and send a report in such form as may be prescribed by the Director-General in this behalf to the appropriate Regional Office stating:—
(a) whether the disabled person is suffering from one or more of the diseases specified in the said Schedule;
(b) whether the relevant disease has resulted in permanent disablement;
(c) whether the extent of loss of earning capacity can be assessed provisionally or finally;
(d) the assessment of the proportion of loss of earning capacity and in case of provisional assessment, the period for which suc
Medical Boards for the purposes of the Act and Special Medical Boards for the purposes of regulation 74 shall be constituted by the Corporation and where it so desires it may approach the State Government for setting up the same and shall consist of such persons, have such jurisdiction and follow such procedure as the Director-General may from time to time decide.]
-------------------------------
1. Subs. by Notification No. Genl./Amdt./33, dated 27th April, 1978.
-------------------------------
(1) An insured person whose permanent disablement has been assessed as final and who has been awarded permanent disablement benefit at a rate not exceeding 3[Rs. 5.00] per day may apply for commutation or permanent disablement benefit into a lump sum:
Provided that the insured person whose permanent disablement has been assessed as final and the benefit rate exceeds 3[Rs. 5.00] per day may also apply for commutation of the permanent disablement benefit into lump sum subject to the condition that the total commuted value of the lump sum permanent disablement benefit does not exceed 4[Rs. 30,000] at the time of commencement of final award of his permanent disability:
Provided further that cases falling under clause (3) of this regulation where commutation has been refused because the insured person did not have average expectation of life,
An insured person who has been declared to be permanently disabled by a Medical Board or by a Medical Appeal Tribunal or an Employees’ Insurance Court shall submit, by post or otherwise, to the appropriate 3[Branch Office] a claim, covering, except in the case of a first payment, a period of one or more complete calendar months in 4[Form 14] for claiming permanent disablement benefit.]
-------------------------------
1. Ins. by the Employees State Insurance (General) (Amendment) Regulations, 1957.
2. Subs. by Notification No. N-12/13/1/90-P&D, dated 17th May, 1991 (w.e.f. 15-6-1991).
3. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office” (w.e.f. 1-1-20
For the purposes of regulation 74, an Appeal Tribunal shall be constituted by the State Government and shall consist of a Judicial officer of the State Government being a person other than the Judge of an Employees’ Insurance Court, who shall be assisted by the following persons to be selected by him as assessors—
(a) one or more medical experts.
(b) one or more officials of or members of Trade Union or Unions.]
-------------------------------
1. Subs. by Notification No. Genl./Amdt./14, dated 3rd October, 1962.
-------------------------------
In case of death of an insured person as a result of an employment injury—
(a) if the death occurs at the place of employment the employer shall, and
(b) if the death occurs at any other place, a dependant intending to claim dependants’ benefit shall, or
(c) any other person present at the time of death may,
immediately report the death to the nearest 1[Branch Office] and to the nearest dispensary, hospital, clinic or other institution where medical benefit under the Act is available.
---------------------------------
1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Off
Where an insured person dies as a result of an employment injury sustained as an employee under the Act, the body of the insured person shall not be disposed of until the body has been examined by an Insurance Medical Officer, who will also arrange a post mortem examination, if considered necessary in co-operation with any other existing agency:
Provided that if an Insurance Medical Officer is unable to arrive for the examination within 12 hours of such death, the body may be disposed of after obtaining a certificate from such Medical Officer or practitioner as may be available:
Provided further that nothing contained in this regulation shall be in derogation of any power conferred on a Coroner under any law for the time being in force or on the officer-in-charge of a police station or some police officer under 1[section 174 of the Code
An Insurance Medical Officer attending the disabled person at the time of his death or the Insurance Medical Officer who examines the body after the death or the Medical Officer who attended the insured person in a hospital or other institution where such disabled person dies, shall issue free of charge a death certificate in 1[Form 13] to the dependants of the deceased and shall send a report to the appropriate Regional Office.
----------------------------
1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 17” (w.e.f. 1-1-2005).
(1) A claim for dependants’ benefit shall be submitted to the appropriate 1[Branch Office] by post or otherwise in 2[Form 15] by the dependant or dependants concerned or by their legal representative or, in case of a minor, by his guardian, and such claim shall be supported by documents proving—
(i) that the death is due to an employment injury;
3[(ii) that the person claiming is a dependant entitled to claim as provided in rule 58 of the Employees’ State Insurance (Central) Rules, 1950;]
(iii) the age of the claimant;
(iv) the infirmity of the dependant claiming to be infirm within the purview of 3[rule 58 of the Employees’ State Insurance (Central) Rules, 1950] by a certificate of such medical or other authority as the Director-General m
On receipt of a claim or claims for dependents’ benefit in respect of the death of an insured person and, after making such inquiries as may be necessary about the circumstances and cause of death and about all persons, who may be entitled to dependants’ benefit, the appropriate Regional Office shall issue by registered post to such other persons, if any, as appear on enquiry to be entitled to dependants’ benefit, and who have not yet submitted a claim for such benefit a notice for submission of claims for dependants’ benefit within a period of thirty days from the date of such notice. The notice shall indicate inter alia the relevant provisions of the Act and regulations and the procedure for submission of a claim for dependant’s benefit.
As soon as possible after the expiry of the period during which claims can be submitted in terms of the notice issued under regulation 81, the appropriate Regional Office shall intimate by registered post the decision of the Corporation in regard to the claim of each of the dependants in writing to the dependants concerned or to his legal representative, or, in the case of a minor, to his guardian.
The dependant’s benefit shall accrue from the date of the death in respect of which the benefit is payable, 1[or, where disablement benefit was payable or where wages were payable] for that date from the date following the date of death.
-----------------------
1. Ins. by Notification No. Genl/Amdt./20, dated 20th January, 1968.
-----------------------
Each dependant whose claim for dependants’ benefit is admitted under regulation 82, shall submit to the appropriate 2[Branch Office], by post or otherwise, a claim covering, except in the case of first or a final payment, a period of one or more complete calendar months in 3[Form 16]. Such claim may be made by the legal representative of a beneficiary or in the case of a minor by his guardian.]
-----------------------
1. Ins. by the Employees State Insurance (General) (Amendment) Regulations, 1957.
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office” (w.e.f. 1-1-2005).
3. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form
(1) The amounts payable as dependant’s benefit in respect of the death of any insured person may be reviewed by the appropriate Regional Office at its own initiative, and shall be so reviewed if an application is made to that effect, under any of the following circumstances—
(a) if any of the beneficiaries ceases to be entitled to the dependant’s benefit by reason of marriage, re-marriage, death, age or otherwise, or
(b) if a fresh dependant is admitted to the claim for dependant’s benefit by the birth of a posthumous child, or
(c) if, after the previous decision as to the distribution of the dependant’s benefit was taken, some facts materially affecting such distribution come to light.
(2) Any review under this regulation shall be made after
1[***]
-------------------------
1. Regulation 85 omitted by Notification No. Genl./Amdt./4, dated 11th December, 1977.
-------------------------
If at any time the appropriate Regional Office is satisfied that a child who is in receipt of dependent’s benefit is being neglected by his guardian, not being a guardian appointed under the Guardian and Wards Act, 1890; and the child’s share of the dependent’s benefit is not being properly spent on his or her maintenance, the appropriate Regional Office may direct that such share may be paid subject to such conditions as it may specify to such other person as it deems fit and as in its opinion would utilise it for the care and maintenance of the child.
An insured woman, who decides to give notice of pregnancy before confinement, shall give such notice in 1[Form 17] to the appropriate 2[Branch Office] by post or otherwise and shall submit, together with such notice, a certificate of pregnancy in 3[Form 17] given in accordance with these regulations on a date not earlier than seven days before the date on which such notice is given.
-------------------------
1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 19” (w.e.f. 1-1-2005).
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office” (w.e.f. 1-1-2005).
3. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October,
Every insured woman claiming maternity benefit before confinement shall submit to the appropriate 1[Branch Office] by post or otherwise—
(i) a certificate of expected confinement in 2[Form 18] given in accordance with these regulations, not earlier than fifteen days before the date of confinement;
(ii) a claim for maternity benefit in 3[Form 19] stating therein the date on which she ceased or will cease to work for remuneration; and
(iii) within thirty days of the date on which her confinement takes place, a certificate of confinement in 4[Form 18] given in accordance with these regulations.
-------------------------
1. Subs. by Notification No. N-11
Every insured woman claiming maternity benefit for miscarriage shall within 30 days of the date of the miscarriage, and every insured woman claiming maternity benefit after confinement, shall submit to the appropriate office by post or otherwise a claim for maternity benefit in 2[Form 19] together with a certificate of confinement of miscarriage in 3[Form 18] given in accordance with these regulations.]
-------------------------
1. Subs. by Notification No. Genl/Amdt./20, dated 20th January, 1968.
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 22” (w.e.f. 1-1-2005).
3. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 23”
(1) Every insured woman claiming maternity benefit in case of sickness arising out of pregnancy, confinement, premature birth of child or miscarriage, shall submit to the appropriate office by post or otherwise a claim for benefit in one of the Forms 2[Form 9] appropriate to the circumstances of the case together with the appropriate medical certificate in 3[Form 7 or 8], as the case may be, given in accordance with these regulations.
(2) The provisions of regulations 55 to 61 and 64 shall, so far as may be, apply in relation to a claim submitted and a certificate given in accordance with this regulation as they apply to certification and claims under those regulations.]
---------------------------
1. Ins. by Notification No. Genl/Amdt./20, d
For the purposes of the proviso to sub-section (2) of section 50 of the Act, the person nominated by the deceased insured woman on Form 1 or on such other Form as may be specified by the Director-General in this behalf and if there is no such nominee, the legal representative, shall submit to the appropriate office by post or otherwise a claim for maternity benefit, as may be due, in 2[Form 20] within 30 days of the death of the insured woman together with a death certificate in 3[Form 21] given in accordance with these regulations.]
---------------------------
1. Ins. by Notification No. Genl/Amdt./20, dated 20th January, 1968.
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 24A” (w.e.f. 1-1-2005).
The Corporation may accept any other evidence in lieu of a certificate of pregnancy, expected confinement, confinement death during maternity, miscarriage or sickness arising out of pregnancy, confinement, premature birth of child or miscarriage by an Insurance Medical Officer, if in its opinion, the circumstances of any particular case so justify.
1[Except as provided in regulation 89B] every insured woman who has claimed maternity benefit shall give notice in 2[Form 19] if she does work for remuneration on any day during the period for which maternity benefit would be payable to her but for her working for remuneration.
---------------------------
1. Subs. by Notification No. Genl/Amdt./20, dated 20th January, 1968.
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 24” (w.e.f. 1-1-2005).
Maternity benefit shall be payable from the date from which it is claimed provided that such date does not precede the expected date of confinement by more than forty-two days and that no work is undertaken by the insured woman for remuneration.
An insured woman may be disqualified from receiving maternity benefit if she fails without good cause to attend for or to submit herself to medical examination when so required; and such disqualification shall be for such number of days as may be decided by the authority authorised by the Corporation in this behalf:
Provided that a woman may refuse to be examined by other than a female doctor or midwife.
No certificate required under any of the regulations 78 to 79B shall be issued except by the Insurance Medical Officer to whom the insured woman has or had been allotted or by an Insurance Medical Officer attached to dispensary, hospital, clinic or other institution to which the insured woman is or was allotted and such Insurance Medical Officer shall examine and if in his opinion if the condition of the woman so justifies or in case of death of the insured woman or the death of the child, if satisfied about such death issue to such insured woman or in case of her death to her nominee or legal representative, as the case may be, free of charge any such certificate when reasonably required by such insured woman or her nominee or legal representative, as the case may be, under or for the purpose of the Act or any other enactment or these regulations:
Provided that such Officer may
Nothing in these regulations shall relieve an Insurance Medical Officer to whom an insured woman has been allotted, or an Insurance Medical Officer attached to the dispensary, hospital, clinic or other institution to which an insured woman is allotted of the obligation to examine and if in her opinion the condition of the woman so justifies, issue free of charge a certificate of pregnancy, of expected confinement or confinement or miscarriage or sickness arising out of pregnancy, confinement, premature birth of a child or miscarriage during any period in which such insured woman is obtaining treatment or attendance from any other person or from any other hospital or institution.
(1) A claim to 1[funeral expenses] shall be submitted to the appropriate 2[Branch Office] by post or otherwise in 3[Form 22] by the claimant entitled under the Act and in case of a minor, by his guardian, and such claim shall be supported by documents proving,—
(i) the death of the deceased person,
(ii) that the person claiming is the eldest surviving member of the family of the deceased insured person and incurred the expenditure necessary for the funeral of the deceased, or
(iii) in case the claimant is other than the eldest surviving member of the family—
(a) that the deceased insured person did not have a family or that the deceased insured person was not living with his family at the time of his death; and
&n
The Corporation may accept any other evidence in lieu of a death certificate by Insurance Medical Officer if in its opinion, the circumstances of any particular case so justify.
An Insurance Medical Officer attending the insured person at the time of death or the Insurance Medical Officer who examines the body after the death or the Medical Officer who attended the insured person in a hospital or other institution where such insured person died, shall issue free of charge a death certificate in 1[Form 13] to the person entitled and intending to claim 2[funeral expenses].
---------------------------
1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 17” (w.e.f. 1-1-2005).
2. Subs. by Notification No. Genl/Amdt./20, dated 20th January, 1968.
---------------------------
In case of death of insured person—
(a) if the death occurs at the place of employment, the employer shall, and
(b) if the death occurs at any other place, the person entitled and intending to claim 1[funeral expenses] shall, or
(c) any other person present at the time of death may,
immediately report the death to the 2[Branch Office] of the deceased insured person.
---------------------------
1. Subs. by Notification No. Genl/Amdt./20, dated 20th January, 1968.
2. Subs. by Notification No. N-11/13/2/2003-P&D,
(1) Medical benefit may be extended to the families of insured persons from such date as the Corporation may, in consultation with State Government, notify.
(2) The family of an insured person shall become entitled to medical benefit 2[from the day the insured person himself] becomes entitled to medical benefit and shall continue to be so entitled so long as the insured person is entitled to receive medical benefit for himself, or in the case of death of the insured person till such date up to which the insured person would have remained entitled to medical care had he survived.
(3) The nature and scale of medical benefit to which the family of an insured person shall be entitled shall be such as may be specified by the State Government in consultation with the Corporation from time to time.
&nb
The authority for determining for purposes of sub-section (2) of section 70 of the Act, the value of benefits other than cash payment shall be the Medical Commissioner of the Corporation.
Claims for reimbursement of expenses incurred in respect of medical treatment of insured person and (where such medical benefit is extended to his family) his family may be accepted in circumstances and subject to such conditions as the Corporation may by general or special order specify.]
-----------------------
1. Ins. by S.R.O. A-499 of 1965, dated 17th April, 1965.
-----------------------
An employer may discontinue or reduce benefits payable to his employees under conditions of their service which are similar to the benefits conferred by the Act to the extent specified below, namely—
(a) from the date of the commencement of the first benefit period following the appointed day for his factory or establishment—
(i) sick leave on half pay to the full extent;
(ii) such proportion of any combined general purposes and sick leave on half pay as may be assigned as sick leave but in any case not exceeding 50 per cent of such combined leave:
(b) any maternity benefits granted to women employees the extent to which such women employees may become entitled to the maternity benefit under the Act:
&
If the conditions of service of any employee so allow, an employer may discharge or reduce on due notice an employee,—
(i) who has been in receipt of disablement benefit for temporary disablement, after he has been in receipt of such benefit for a continuous period of six months or more;
(ii) who has been under medical treatment for sickness other than tuberculosis, leprosy, mental or malignant diseases or has been absent from work as a result of illness 1[***] duly certified in accordance with these regulations to arise out of the pregnancy or confinement rendering the employee unfit for work, after the employee has been under such treatment or has been absent from work for a continuous period of six months or more;
2[(iii) who has been under medical treatment for any of the following
Sickness benefit or disablement benefit or temporary disablement may be suspended, if a person who is in receipt of such benefit fails to comply with any of the requirements of section 64 of the Act, and such suspension shall be for such number of days as may be decided by the authority authorised by the Director-General in this behalf.
No person shall be entitled to sickness benefit or disablement benefit for temporary disablement on any day on which he remains on strike except in the following circumstances:—
(i) if a person is receiving medical treatment and attendance as an indoor patient in any Employees’ State Insurance Hospital or a hospital recognised by the Employees’ State Insurance Corporation for such treatment; or
(ii) if a person is entitled to receive extended sickness benefit for any of the diseases for which such benefit is admissible; or
(iii) if a person is in receipt of sickness benefit or disablement benefit for temporary disablement immediately preceding the date of commencement of notice of the strike given by the Employees’ Union(s) to the management of the factory/establishment;]
&nbs
The Director-General may by special or general order relax any regulation under such circumstances and subject to such conditions, as he may deem fit.
1[***]
--------------------------
1. Regulation 101 omitted by Notification No. Genl/Amdt./20, dated 20th January, 1968.
--------------------------
The Director-General, the Insurance Commissioner, the Joint Insurance Commissioner, a Deputy Insurance Commissioner, a Regional Director, a Deputy Regional Director, an Assistant Insurance Commissioner and Assistant Regional Director and a 1[Branch Manager] shall have all the powers of an Inspector specified in sub-section (2) of section 45 of the Act. In addition to the officers mentioned above, the Director-General may, by a written order, confer upon any employee of the Corporation or any Government officer the powers of an Inspector for such period or periods as he may think fit.
--------------------------
1. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office Manager” (w.e.f. 1-1-2005).
------------
(i) Every principal employer shall maintain a bound inspection book and shall be responsible for its production, on demand by an Inspector or any other officer of the Corporation duly authorised to exercise the powers of an Inspector irrespective of the fact whether the principal employer is present in the factory or establishment or not during the Inspection.
(ii) A note of all irregularities and illegalities discovered at the time of inspection indicating therein the action, if any, proposed to be taken against the principal employer together with the orders for their remedy or removal passed by an Inspector or any other officer of the Corporation duly authorised to exercise the powers of an Inspector, shall be sent to the principal employer who shall enter the note and orders in the inspection book.
(iii) Every principal employer
A person who is in receipt of disablement benefit shall be entitled to medical benefit while he is in receipt of such benefit:
Provided that after the disablement has been declared as a permanent disablement, the person shall not be entitled to medical benefit, if he is not otherwise entitled to such benefit, except in respect of any medical treatment which may be rendered necessary on account of the employment injury from which the disablement resulted.
(1) An insured person who ceases to be in insurable employment on account of permanent disablement caused due to employment injury shall continue to receive medical benefit for himself and his/her spouse till the date on which he would have vacated the employment on attaining the age of superannuation had he not sustained such permanent disablement, if produces a certificate from the employer/a declaration in the form which may be specified by the Director-General for the purpose.
(2) Medical benefit to retired insured persons.—An insured person who has attained the age of superannuation shall be eligible to receive medical benefit for himself and his/her spouse, if he produces a certificate from the employer in the form which may be specified by the Director-General for the purpose.
(3) An employer shall, on demand, issue the certi
(1) A person on becoming an insured person for the first time shall be entitled to medical benefit for a period of 5[three months] provided that where such a person continues for 2[three months] or more to be an employee of a factory or establishment to which the Act applies, he shall be entitled to medical benefit till the beginning of the corresponding benefit period.
3[(2) the person in respect of whom contributions have been paid in a contribution period for not less than seventy-eight days in the said contribution period shall be entitled to medical benefit till the end of the corresponding benefit period:
Provided that in case of a person who becomes an employee within the meaning of the Act, for the first time, and for whom a shorter contribution period of less than 156 days is available, he shall be entitled to medical benefit ti
A person intending to claim medical benefit, and who is otherwise entitled to such benefit, shall produce his Identity Card or such other document as may have been issued in lieu thereof at the time of claiming such benefit if demanded by the Insurance Medical Officer and if he fails to do so, medical benefit may be refused to him.
Where any question arises as to the correctness of any certificate by virtue of which an insured person claims, or is entitled to, any benefit under the Act, he shall, 1[on being so required in writing or otherwise] by the appropriate Office submit himself, with a view to obtaining a further certificate, to medical examination by such medical authority as the Corporation may appoint in this behalf. 2[If the further certificate specifies the date on which the insured person is or will be fit to resume work, any certificate which is or has been issued by the Insurance Medical Officer for the same spell of incapacity shall, to the extent to which it relates to any period after and including the said date on the further certificate, be deemed not to have been issued in accordance with these regulations and such further certificate shall notwithstanding anything contained in these regulations, be deemed to be a final certifica
Every person to whom any benefit is payable under the Act shall, as soon as may be practicable, notify the appropriate Office of any change of circumstances which he may be expected to know and which might affect the continuance of his right to receipt of such benefit.
Every person whose claim for any permanent disablement benefit has been admitted shall submit at six-monthly intervals, with the claim for December and June every year, a certificate in 2[Form 23] affected by such authority or persons and in such manner as may be specified by the Director-General.]
-----------------------------------
1. Subs. by the Employees State Insurance (General) (Amendment) Regulations, 1959.
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 26” (w.e.f. 1-1-2005).
In the case of claimant for permanent disablement benefit or dependents’ benefit, the appropriate 2[Branch Manager] may require personal attendance and due identification of any claimant, other than a person incapacitated by bodily illness or infirmity or a purdanashin lady at the appropriate 2[Branch Office] or at any other office of the Corporation provided that such appearance shall not be required more frequently than once in every six months.]
-----------------------------------
1. Ins. by the Employees State Insurance (General) (Amendment) Regulations, 1959.
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Local Office Manager” (w.e.f. 1-1-2005).
----------
Every person whose claim for any dependants benefit has been admitted shall submit at six-monthly intervals, with the claim for December and June every year, a declaration and a certificate in 2[Form 24] attested by such authority or persons and in such manner as may be specified by the Director-General.]
-----------------------------------
1. Ins. by the Employees State Insurance (General) (Amendment) Regulations, 1959.
2. Subs. by Notification No. N-11/13/2/2003-P&D, dated 1st October, 2004, for “Form 27” (w.e.f. 1-1-2005).
--------------------------------
1[***]
-----------------------------------
1. Regulation 108 omitted by Notification No. N-12/13/1/90-P&D, dated 17th May, 1991 (w.e.f. 15-6-1991).
--------------------------------
The employer or insured person, as the case may be, shall, on demand from the appropriate Office, submit information in such form as may be specified by the Director-General.]
-----------------------------------
1. Added by Notification No. N-12/13/2/92-P&D, dated 22nd April, 1994 (w.e.f. 1-4-1994).
--------------------------------
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