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ESIC is the country's first multi-dimensional social security system for workers in the organized sector, introduced in 1952

ESIC covers a total beneficiary population of more than 355 lakhs today

ESIC has the countrys largest medical infrastructural facility under one umbrella

ESIC is the most affordable social security system with the lowest contribution rate for multiple health insurance benefits.

ESIC is the only health insurance scheme that offers full medical care to workers and their dependants without any ceiling on individual expenditure

ESIC offers a special package of full medical care to retired/disabled insured persons for self and spouse for a nominal contribution of Rs. 120/- per annum

ESIC offers a special package of full medical care to retired/disabled insured persons for self and spouse for a nominal contribution of Rs. 120/- per annum

EMPLOYEES' STATE INSURANCE (CENTRAL) RULES, 1950

I n exercise of the powers conferred by section 95 of the Employees' State Insurance Act, 1948 (XXXIV) of 1948), the Central Government is pleased to make the following rules, :

CHAPTER I I

2A. Election of Members of Parliament to the Corporation

The House of the People (Lok Sabha) and the Council of States (Rajya Sabha) shall elect in such manner as the Speaker of the House of the People or as the case may be, the Chairman of the Council of States may direct, two members of the House of the People (Lok Sabha) and one member of the Council of States (Rajya Sabha) to be members of the Corporation.

3. Election of members of the Standing Committee

(1) The Chairman of the meeting shall, at a meeting of the Corporation at which it is proposed to elect members of the Standing Committee under clause (c) of section 8, invite members to propose names from among members of the Corporation belonging to the group from which election is to be made. The names proposed shall be duly seconded by another member of the Corporation.

(2) If the number proposed from any group for election does not exceed the number of vacancies to be filled from that group, the persons whose names have been so proposed shall be declared elected to the Standing Committee.

(3) If the number proposed for election from a group exceeds the number of vacancies to be filled therefrom, each member of the Corporation present at the meeting shall be give a ballot paper containing the names of all the candidates proposed and he shall be required to vote thereon for as many candidates from group as there are vacancies to be filled up. Not more than one vote shall be given in favour of any candidate. If any member votes for more candidates than there are vacancies in the group or gives more than one vote in favour of any one candidate, all his votes shall be deemed to be invalid.

(4) The persons getting the highest number of votes shall be declared by the Chairman, at the meeting or as soon thereafter as possible, as duly elected to the Standing Committee:

PROVIDED that where an equality of votes is found to exist between any candidates and the addition of one vote will entitle any of the candidates to be declared to be elected, the determination of the person or persons to whom such one additional vote shall be deemed to have been given shall be made by lot to be drawn in the presence of the Chairman and in such manner as he may determine.

(5) If any question shall arise as to the validity of any election it shall be referred to the Central Government whose decision in the matter shall be final.

4. Restoration to membership

(1) A member of the Corporation, the Standing Committee, or the Medical Benefit Council, who ceases to be a member by virtue of section 12, shall be informed of such cessation by a letter sent to him by registered post. The letter shall also indicate that if he desires restoration to membership, he may apply therefor within thirty days from the receipt of the letter.

(2) The application under sub-rule (1) shall indicate the reasons which prevented him from attending three consecutive meetings and shall be addressed to the Chairman concerned.

(3) The application shall be placed before the next meeting of the Corporation, the Standing Committee or the Medical Benefit Council, as the case may be, and if a majority of the members present at such meeting are satisfied that the reasons for failure to attend three consecutive meetings are adequate, he shall be restored to membership immediately after a resolution to that effect is adopted.

(4) The benefit of restoration to membership as provided for in this rule shall be allowed to a member only once during any one term as a member.

5. Fees and allowances of members

(1) Subject to the provisions of sub-rules (2) and (3), every non-official member of the Corporation, Standing Committee or the Medical Benefit Council shall be allowed travelling and daily allowance for attending the meetings of the Corporation or the Standing Committee or the Medical Benefit Council, as the case may be, at the following rates:--

(i) Travelling allowance:

(A) A non-official member residing at the place where a meeting is held shall be allowed the actual expenditure incurred by him on conveyance subject to the maximum of rupees fifty for each day on which he attends one or more meetings;

(B) A non-official member, not residing at the place where a meeting is held, shall be allowed to draw:

(a) actual expenditure incurred by him on air journey by economy (tourist) class; or

(b) actual expenditure incurred by him on journey, by rail, by second class A.C., two-tier sleeper or first class, as the case may be;

(c) actual fare or expenditure incurred on road journey by taxi or own car or auto-rickshaw or bus (other than an air-conditioned bus) but not exceeding the rates notified by the concerned Director of Transport for journey by taxi or auto-rickshaw. When the journey is performed between places connected by railway, mileage would be limited to what would have been admissible to the member under clause (b) of this item.

(ii) Daily allowance:

(A) A non-official member residing at a place where a meeting is held shall not be entitled to any daily allowance;

(B) A non-official member, not residing at a place where a meeting is held shall be paid daily allowance at the rate of Rs. 150 (rupees one hundred and fifty only) per day if the member stays in a hotel and Rs. 100 (rupees one hundred only) per day if the member does not stay in a hotel:

PROVIDED that the daily allowance shall be calculated for the entire absence from the normal place of residence of the non-official member on calendar day basis; i.e., midnight to midnight as under:

For absence not exceeding 6 hours Nil

For absence exceeding 6 hours but not exceeding 12 hours 70%

For absence exceeding 12 hours 100%

(2) A non-official member of the Corporation or Standing Committee or the Medical Benefit Council who is a Member of Parliament or a Member of State Legislature shall be paid travelling allowance and daily allowance in accordance with the provisions of the Salary, Allowances and Pension of Members of Parliament Act, 1954 (30 of 1954), or the respective provisions of the law pertaining to the members of the concerned State Legislature.

(2A) Travelling and daily allowance shall be allowed if a member certifies that he has not drawn any travelling or daily allowance from any other sources in respect of the journey and halt for which the claim is made.

(2B) The daily and travelling allowance shall also be payable in respect of the meetings of any sub-committee set up by the Corporation, the Standing Committee or the Medical Benefit Council.

(3) For attending a meeting of the Corporation, the Standing Committee, Medical Benefit Council or meetings of a Sub-Committee set up by the corporation, Standing Committee or the Medical Benefit Council, an official member of the Central Government shall draw his travelling allowance from his department on a scale admissible to him under the Central Government rules and the amount so drawn shall, on a demand being made therefor by the Central Government, be reimbursed by the Corporation to that Government.

(4) Payments shall not be made to a non-official member earlier than the last date upon which the allowance is claimed. The travelling allowance for both the onward and return journeys will be included in the travelling allowance bill and the payment made thereof treated as final, irrespective of the date of completion of the journey. The Director-General, Employees' State Insurance Corporation will, however, obtain a formal intimation from the non-official member to the effect that the return journey has, in fact, been completed.

6. Minimum number of meetings

(1) The Corporation and the Medical Benefit Council shall meet at least twice each year.

(2) The Standing Committee shall meet at least four times each year.

(3) The Chairman may, whenever he thinks fit, and shall, within fifteen days of the receipt of a requisition in writing from not less than one half of the members of the body concerned, call a meeting thereof.

(4) Any requisition made under this rule shall specify the object of the meeting proposed to be called.

7. Roll of members

(1) The Corporation shall maintain a roll of members separately for the Corporation, the Standing Committee and the Medical Benefit Council. The name and the address of each member shall be stated therein.

(2) If a member changes his address, he shall notify such change to the Corporation for the correction of his address in this roll.

8. Notice of meeting and list of business

(1) The Chairman shall decide the date, time and place of every meeting. A notice of not less than twenty-one days from the date of issue shall ordinarily be given to every member of each meeting of the Corporation, the Standing Committee or the Medical Benefit Council, as the case may be. Such notice may be given to every member by post or in any other suitable manner. A list of business proposed to be transacted shall, after approval by the Chairman, be posted along with the notice. Brief notes on each item of the agenda shall be sent along with the agenda or as soon thereafter as possible. If it is necessary to convene an emergency meeting, a reasonable notice thereof shall be given to every member.

(2) No business other than that for which a meeting is convened shall be considered at that meeting, except with the permission of the Chairman of the meeting.

9. Chairman of the meeting

The Chairman, or in his absence the Vice-Chairman, if any, of the Corporation, the Standing Committee or the Medical Benefit Council, as the case may be, shall preside at the meetings. In the event of the absence of both the Chairman and Vice-Chairman, if any, the members present may elect one from amongst themselves to preside.

10. Quorum

No business shall be transacted at any meeting unless a quorum of fifteen members in the case of the Corporation, five members in the case of the Standing Committee and seven members in the case of the Medical Benefit Council, is present:

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

11. Disposal of business

Any business which requires consideration by the Corporation, the Standing Committee or the Medical Benefit Council shall be considered at a meeting thereof :

PROVIDED that the Chairman may, if he thinks fit, direct that the necessary papers may be referred for opinion to all members :

PROVIDED FURTHER that the decision on any question which is so referred shall be acted upon if supported by not less than a two-thirds majority of the members of the body concerned. In other cases or where the Chairman so decides, the question shall be considered at a duly convened meeting.

12. Proceedings of the meetings

(1) The proceedings of each meeting, showing inter alia the name of the members present thereat, shall be forwarded to each member of the Corporation, the Standing Committee or the Medical Benefit Council, as the case may be, and to the Central Government as soon after the meeting as possible and in any case not later than four weeks after the meeting.

(2) The minutes of each meeting shall be confirmed with such modifications as may be considered necessary at the next meeting.

13. Minutes books

(1) The minutes of a meeting of the Corporation, the Standing Committee and the Medical Benefit Council shall be kept in separate books (hereinafter referred to as minute books) and shall be signed by the Chairman of the meeting at which proceedings are confirmed.

(2) A copy of the minutes so confirmed shall be forwarded to the Central Government within fifteen days from the date of such confirmation.

(3) The minutes books shall be kept open at the principal office of the Corporation during office hours on working days for inspection free of charge by any member of the Corporation.

(4) The minutes book sof the Medical Benefit Council shall be kept open at the principal office of the Corporation during office hours on working days for inspection free of charge by any member of the Medical Benefit Council.

14. Powers and duties of the Medical Benefit Council

The powers and duties of the Medical Benefit Council shall be--

(1) to advise the Corporation in regard to the constitution, setting up duties and powers of the regional and local Medical Benefit Councils;

(2) to make recommendations to the Corporation in regard to--

(i) the scale and nature of medical benefit provided at hospitals, dispensaries, clinics and other institutions and the nature and the extent of the medicines, staff and equipment which shall be maintained at such institutions and the extent to which these fall short of the desired standard;

(ii) the medical formulary for use in connection with the medical benefit provided under the Act;

(iii) medical certification, including the procedure and the forms for such certification, statistical returns, registers and other medical records;

(iv) measures undertaken for the improvement of the health and welfare of insured persons, and the rehabilitation and re-employment of insured persons, disabled or injured.

(3) to advise the Corporation on any matter relating to the professional conduct of any medical practitioner employed for the purpose of providing medical benefit under the Act.

 


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