The promulgation of Employees’ State Insurance Act, 1948 envisaged an integrated need based social insurance scheme that would protect the interest of workers in contingencies such as sickness, maternity, employment injury causing temporary or permanent physical disablement, resulting in loss of wages or earning capacity, or causing death due to employment injury. The Act also guarantees reasonably good medical care to workers and their immediate dependants. Later on other benefits such as funeral expenses physical and vocational Rehabilitation in case of permanent disablement beyond such limit as decided by the Corporation was added.

Following the promulgation of the ESI Act the Central Govt. set up the ESI Corporation to administer the Scheme. The Scheme was first implemented at Kanpur and Delhi on 24^th February 1952. The Act further absolved the employers of their obligations under the Maternity Benefit Act, 1961 and Workmen’s Compensation Act 1923. The benefit provided to the employees under the Act are also largely in conformity with ILO conventions.

Employees’ State Insurance Scheme is an integrated social security scheme tailored to provide protection to workers and their dependants, in the organised sector, in contingencies, such as, sickness, maternity and death or disablement due to employment injury or occupational hazard.

The ESI Act, (1948) applies to following categories of factories and establishments in the implemented areas:-

Non-seasonal factories using power and employing ten (10) or more persons

Non-seasonal and non power using factories and establishments employing twenty (20) or more persons.

The ESI Scheme is mainly financed by contributions raised from employees covered under the scheme and their employers, as a fixed percentage of wages. Employees of covered units and establishments drawing wages upto Rs.7500/- per month come under the purview of the scheme for social security benefits. However, employees’ earning upto Rs.50/- a day as wages are exempted from payment of their part of contribution. However, they shall remain entitled to all benefits as usual as per their wage group. The State Govts. bear one-eighth share of expenditure on Medical Benefit within the per capita ceiling of Rs.900/- per annum additional expenditure beyond the ceiling.

Employees covered under the scheme are entitled to medical facilities for self and dependants. They are also entitled to cash benefits in the event of specified contingencies resulting in loss of wages or earning capacity. The insured women are entitled to maternity benefit for confinement. Where death of an insured employee occurs due to employment injury, the dependants are entitled to family pension.

A Standing Committee constituted from among the members of the Corporation acts as the Executive Body for the administration of the Scheme.

There is also a Medical Benefit Council to advise the Corporation on matters connected with the provision of Medical Benefit.

The Director General who is the Chief Executive of the Corporation is also ex-officio member of the Corporation and of its Standing Committee.

Besides the Hqrs. Office in New Delhi, the Corporation has 23 Regional Offices and 8 Sub-Regional Offices at Pune, Nagpur, Coimbatore, Madurai, Hubli, Noida, Surat, Baroda, Vijaywada, Varanasi (U.P.), Salem and Divisional Offices at Ambala, Gurgaon in Haryana, Rohini, Nand Nagari & Okhla in Delhi, Barrackpur in West Bengal and 628 Branch Offices and Pay Offices (116) all over the country for the administration of the Scheme.

The Medical care under the Scheme is administered by State Governments, who have the statutory responsibility in this regard, except in Delhi State and Noida area of U.P. Besides, the ESI Hospital, K.K. Nagar at Chennai, ESI Hospital, Thakurpukur at Calcutta and ESI Hospital at Nagda are also being run directly by the Corporation and eleven hospitals in various regions as ESI Model Hospital.

The Employees’ State Insurance Scheme is administered by a corporate body called the ESI Corporation.

The Corporation is the highest policy making and decision taking authority under the ESI Act and oversees the functioning of the Scheme. The Corporation is to meet at least twice in a year, to conduct business as may be required to regulate the functioning of the Scheme.

A body Corporate consisting of: -

The Standing Committee is the statutory executive organ of the Corporation. The members are drawn from the main body of the Corporation by nomination and election. The nominated members include three members each of the Central Govt. and State Governments. Further, three members each representing employers and employees and one each representing Parliament and the medical profession are elected from amongst the members of the Corporation through a voice vote. Secretary, Ministry of Labour, Govt. of India functions as the Chairman of the Standing Committee. Director General, ESI Corporation is also an ex-officio member of the Standing Committee. The Committee holds its quarterly meetings.

The Standing Committee is vested with powers to administer the affairs of the Corporation, exercise any of the powers and perform any functions of the Corporation subject to the overall control and superintendence of the Corporation. Standing Committee is also empowered to constitute any non-statutory sub-committees for specific purposes as the need be.

Medical Benefit Council is an advisory body on matters related to the administration of medical benefit under the ESI Scheme. The council is constituted by the Central Govt. for a specific term and consists of :-

Director General, Central Health Services(ex-officio Chairman)

Deputy Director General/Addl. Director General, Central Health Services.

One member each representing respective State Govts.

Three members each representing employees, employers and the medical profession.

Medical Commissioner, ESI Corporation(ex-officio member)

The ESI Act empowers the Medical Benefit Council to advise the Corporation on matters related to developments and improvements in the medical service delivery system.

The constitution of the Corporation, Standing Committee and the Medical Benefit Council are dealt with in Section 4, 8 and 10 of the ESI Act, 1948 respectively. Powers of the Standing Committee and duties of the MBC are given under Section 18 and 22 respectively.

The Scheme is mainly financed mainly by contributions from employers and employees. The employers’ contribution is equal to four and three fourth per cent of the wages payable to employees. The employees’ contribution is at the rate of one and three-fourth per cent of the wages payable to an employee. The State Governments share expenditure on the provision of medical care.

E.S.I. Scheme being contributory in nature, all the employees in the factories or establishments to which the Act applies shall be insured in a manner provided by the Act. The contribution payable to  the Corporation in respect of an employee shall comprise of employer’s contribution and employee’s contribution at a specified rate. The rates are revised from time to time. Currently, the employee’s contribution rate (w.e.f. 1.1.97) is 1.75% of the wages and that of employer’s is 4.75% of the wages paid/payable in respect of the employees in every wage period. Employees in receipt of a daily average wage upto Rs.50/- are exempted from payment of contribution. Employers will however contribute their own share in respect of these employees.

An employer is liable to pay his contribution in respect of every employee and deduct employees contribution from wages bill and shall pay these contributions at the above specified rates to the Corporation within 21 days of the last day of the Calendar month in which the contributions fall due. The Corporation has authorized designated branches of the State Bank of India and some other banks to receive the payments on its behalf.

There are two contribution periods each of six months duration and two corresponding benefit periods also of six months duration as under.

Contribution period       Corresponding Cash Benefit period

1^st April to 30^th Sept.         1^st January of the following year to 30^th June.

1^st Oct. to 31^st March        1^st July to 31^st December of the year following

The Act was originally applicable to non-seasonal factories using power and employing 20 or more persons; but it is now applicable to non-seasonal power using factories employing 10 or more persons and non-power using factories employing 20 or more persons.

Under Section 1(5) of the Act, the Scheme has been extended to shops, hotels, restaurants, cinemas including preview theatre, road motor transport undertakings and newspaper establishment employing 20 or more persons.

The existing wage-limit for coverage under the Act, is Rs.7500/- per month (with effect from 1.4.2004).

The Act in the first instance applies to all non-seasonal factories, using power and employing 10 or more persons, and to non-power using factories employing 20 or more persons for wages on any day in implemented areas. There is an enabling provision in the Act under Section 1(5) to extend to other classes of establishment – industrial, commercial, agricultural or otherwise. Most of the State Govts. have extended the provision of the Act to the following class of establishments, i.e., shops, hotels, restaurants, cinemas including preview theatres, road-motor transport agencies, newspaper establishments employing 20 or more persons.

A factory once covered remains covered even if the number of employees at any later stage falls short of the stipulated number of 10 or 20 or the manufacturing process therein ceases to be carried on with the aid of power. The Act does not apply to workers engaged in mining operations, railway running sheds, certain seasonal factories operating for less than 7 months in a year. Factories or establishments run by the State Govts./ Central Govt. whose employees are in receipt of social security benefits substantially similar or superior to those provided under the Act can be exempted from coverage.

AREAS COVERED

The ESI Scheme is being implemented center-wise by stages. The Scheme has already been implemented in different areas in the following States/Union Territories

STATES

All the States except Nagaland, Manipur, Tripura, Sikkim, Arunachal Pradesh and Mizoram.

UNION TERRITORIES 

Delhi, Chandigarh, Pondicherry, Daman and Div

A monthly wage limit is prescribed by the Central Govt. for the purpose of coverage of employees/workers of the aforesaid factories or establishments. An employee has been defined under Section 2(9) of the Act and means any person employed for wages in or in connection with the work of a factory or establishment to which this Act applies. The wage ceiling is enhanced from time to time. The existing ceiling effective from 1.4.2004 is Rs.7,500/- per month.

Employees of covered factories and establishments drawing wages upto Rs.7500/- per month w.e.f. 01.04.2004 come under the purview of the ESI Act, 1948 for multi-dimensional social security benefits.

The section 46 of the Act envisages following six social security benefits :-

Sickness Benefit (SB)
           Extended sickness Benefit (ESB)
           Enhanced Sickness Benefit

Disablement Benefit

Funeral Expenses

An interesting feature of the ESI Scheme is that the contributions are related to the paying capacity as a fixed percentage of the workers wages, whereas, they are provided medical benefits according to individual needs without distinction.

Cash Benefits are disbursed by the Corporation through its Branch Offices, / pay offices, subject to certain contributory conditions.

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

These includes: -

Rehabilitation allowance

Vocational Rehabilitation

They are also entitled to cash benefits in the event of specified contingencies resulting in loss of wages or earning capacity. The insured women are entitled to maternity benefit for confinement. Where death of an insured person occurs due to employment injury or occupational disease the dependants are entitled to family pension – the dependants benefit.

Various benefits that the insured employees and their dependants are entitled to, the duration of benefits and contributory conditions therefore, are as under:-

(I)  Medical Benefit:

Full medical facilities for self and dependants are admissible from day-one of entering insurable employment. Whereas, the primary, secondary and specialised services are provided through a network of Panel clinics, ESI dispensaries and hospitals, super speciality services are provided through a large number of advanced empanelled medical institutions on referral basis.

The Employees’ State Insurance Scheme provides full medical care in the form of medical attendance, treatment, drugs and injections, specialist consultation and hospitalization to insured persons and also to members of their families where the facility for Specialist consultation, hospitalization has been extended to the families.

For the families, this benefit has been divided into two categories as under:-

This consists of hospitalization facilities and includes specialist services, drugs and dressings and diets as required for in-patients.

This consists of consultation with the specialists and supply of special medicines and drugs as may be prescribed by them in addition to the out-patient care. This also includes facilities for special laboratory tests and X-Ray examinations.

Apart from the curative services provided through hospitals and dispensaries, the Corporation also provides the following facilities including family welfare services.

The Corporation has embarked upon a massive programme of immunization of young children of insured persons. Under this programme, preventive inoculation and vaccines are given against diseases like diphtheria, pertusis, polio, tetanus, measles, mumps, rubella, tuberculosis etc.

Along with the immunization programme, the Corporation has been undertaking provision of family Welfare Services to the beneficiaries of the Scheme. The Corporation has organized these services in 180 centers besides reserving 330 beds in hospitals for undertaking tubectomy operations. So far, 828976 sterilization operation viz. 176197 vasectomies and 652779 tubectomies have been performed upto 31.3.1999. The ESI Corporation has also extended additional cash incentive to insured persons to promote acceptance of sterilization method by providing sickness cash benefit equal to full wage for a period of 7 days for vasectomy and 14 days for tubectomy. The period for which cash benefit is admissible is extended beyond the above limits in the event of any complications after Family Planning operations.

Insured persons and members of their families are provided artificial limbs, hearing aids, and artificial appliances like spinal supports, cervical collars, walking calipers, crutches, wheel chairs and cardiac pace makers as a part of medical care under the Scheme.

To ensure that there are proper secondary care facilities for the beneficiaries, the E.S.I.C has decided to set up one Model Hospital in each State. The proposed Model Hospitals are being identified out of the existing Hospitals to provide all modern infrastructure facilities, staff and equipments as per E.S.I. norms and to act as referral hospitals for the entire State to provide state of art secondary care services.

The Model Hospital will have all general specialties along with support services of Radiology, Laboratory, Store and Pharmacy, Operation Theatres, Medical Records, Dietary services, Laundry, CSSD, Engineering services, Ambulance services, Telephone, house keeping, horticultural development works, waste management systems, facility for training, Library etc. To facilitate community services, staff accommodation, cafeteria, parking areas, recreation facilities etc., shall also be provided. To start with, staff to manage these hospitals will be made available on deputation from the State Government for an initial period of 3 years.

Sickness Benefit is payable to an insured person in cash, in the event of sickness resulting in absence from work and duly certified by an authorised insurance medical officer/practitioner.

Sickness Benefit represents periodical cash payments made to an IP during the period of certified sickness occurring in a benefit period when IP requires medical treatment and attendance with abstention from work on medical grounds. Prescribed certificates are; Forms 8,9,10,11 & ESIC-Med.13. Sickness benefit is roughly 50% of the average daily wages and is payable for 91 days during 2 consecutive benefit periods.

(i)To become eligible to Sickness Benefit, an IP should have paid contribution for not less than 78 days during the corresponding contribution period.

(ii)A person who has entered into insurable employment for the first time has to wait for nearly 9 months before becoming eligible to sickness benefit, because his corresponding benefit period starts only after that interval.

(iii)Sickness Benefit is not payable for the first two days of a spell of sickness except in case of a spell commencing within 15 days of closure of earlier spell for which sickness benefit was last paid. This period of 2 days is called "waiting period". This provision should be clearly understood by IMOs/IMPs as actual experience shows that such of IPs who want to avail medical leave on flimsy grounds generally come for First Certificate/First & Final Certificate within 15 days of earlier spell, usually on unpaid holidays and/or on each weekly off etc, to avoid loss of benefit for 2 days due to fresh waiting period.

For entitlement to this benefit an insured person should have been in insurable employment for atleast two years. He/she should also have paid contribution for a minimum of 156 days in the preceding four contribution periods or say two years.

ESB is payable for a maximum period of two years on the basis of proper medical certification and authentication by the designated authority.

Amount payable in cash as extended sickness benefit is equal to about 70 per cent of the daily wages.

The benefit is payable within 7 days following the submission of complete claim papers at the Branch Office concerned.

IPs suffering from long term diseases were experiencing great hardship on expiry of 91 days Sickness benefit. Often they, though not fit for duty, pressed for a Final certificate. Hence, a provision for paying Sickness Benefit for an extended period (Extended Sickness Benefit)of upto 2 years in a ESB period of 3 years.

1. An IP suffering from certain long term diseases is entitled to ESB, only after exhausting Sickness Benefit to which he may be eligible. A common list of these long term diseases for which ESB is payable, is reviewed by the Corporation from time to time. The list was last reviewed on 5.12.99 and revised provisions of ESB became effective from 1.1.2000 and at present this list includes 34 diseases which are grouped in 11 groups as per International Classification of diseases and their names of many existing diseases have been changed as under :-

I Infectious Diseases

Tuberculosis

Leprosy

Chronic Empysema

AIDS

II Neoplasm

Malignant Diseases

 III Endocrine, Nutritional and Metabolic Disorders

Diabetes Mellitus-with proliferative retinopathy/diabetic foot/nephropathy.

IV Disorders of Nervous System

Monoplegia

Hemiplegia

Paraplegia

Hemiparesis

Intracranial Space Occupying Lesion

Spinal Cord Compression

Parkinson’s disease

Myasthenia Gravis/Neuromuscular Dystrophies

V Disease of Eye

Immature Cataract with vision 6/60 or less

Detachment of Retina

Glaucoma

VI Diseases of Cardiovascular System

Coronary Artery Disease:-

Unstable Angina

Myocardial infraction with ejection less than 45%

  Congestive Heart Failure- Left , Right

Cardiac Vascular Diseases with failure/complications

Cardiomyopathies

Heart disease with surgical intervention alongwith complications

VII Chest Diseases

Bronchiectasis

Interstitial Lung Disease

Chronic Obstructive Lung Diseases (COPD) with congestive heart failure (Cor Pulmonale)

VIII Diseases of the Digestive System

Cirrhosis of liver with ascities/chronic active hepatitis

IX Orthopaedic Diseases

Dislocation of vertebra/prolapse of intervertebral disc

Non union or delayed union of fracture

Post Traumatic Surgical amputation of lower extremity

Compound fracture with chronic osteomyelitis

X Psychoses

Sub-group under this head are listed for clarification

Schizophrenia

Endogenous depression

Manic Depressive Psychosis (MDP)

Dementia

XI Others

More than 20% burns with infection/complication

Chronic Renal Failure

Reynaud’s disease/Burger’s disease.

1. In addition to the above list, Director General/Medical Commissioner are authorised to sanction ESB for a maximum period upto 730 in cases of rare but treatable diseases or under special circumstances, such as, adverse reaction to drugs which have not been included in the above list, depending on the merits of each case, on the recommendations of RDMC/AMO or either authorised officers running the medical scheme.

2. To be entitled to the Extended Sickness Benefit an Insured Persons should have been in continuous employment for 2 years or more at the beginning of a spell of sickness in which the disease is diagnosed and should also satisfy other contributory conditions.

3. ESB shall be payable for a period of 124 days initially and may be extended up to 309 days in chronic suitable cases by Regional Dy. Medical Commissioner/Medical Referee/Administrative Medical Officer/Chief Executive of the E.S.I. Scheme in the State or his nominee on the report of the specialist(s).

This cash benefit is payable to insured persons in the productive age group for undergoing sterilisation operation, viz. vasectomy/tubectomy.

It was introduced w.e.f 1.8.1976 as an incentive to IPs/IWs for undergoing Vasectomy /Tubectomy. Insured Persons eligible to ordinary sickness benefit are paid enhanced sickness benefit at double the rate of sickness benefit i.e., about full average daily wage for undergoing sterilisation operations for family welfare. Duration of enhanced Sickness Benefits is upto 7 days in the case of Vasectomy and upto 14 days in the case of the Tubectomy from the date of operation or from the date of admission in the hospital as the case may be. The period is extendable in case of post operative complications.

Maternity Benefit is payable to insured women in case of confinement or miscarriage or sickness related thereto.

Maternity Benefit is payable to an Insured Woman in the following cases subject to contributory conditions:-

Confinement-payable for a period of 12 weeks (84 days) on production of Form 21 and 23.

Miscarriage or Medical Termination of Pregnancy (MTP)-payable for 6 weeks (42 days) from the date following miscarriage-on the basis of Form 20 and 23.

Sickness arising out of Pregnancy, Confinement, Premature birth-payable for a period not exceeding one month-on the basis of Forms 8, 10 and 9. In the event of the death of the Insured Woman during confinement leaving behind a child, Maternity Benefit is payable to her nominee on production of Form 24 (B).

Maternity benefit rate is double the Standard Benefit Rate, or roughly equal to the average daily wage.

(a) TDB is payable to an employee who suffers employment injury (EI) or Occupational Disease and is certified to be temporarily incapable to work. "Employment Injury" has been defined under Section 2(8) of the Act, as a personal injury to an employee caused by accident or occupational disease arising out of and in the course of his employment, being in insurable employment, whether the accident occurs or the occupational disease is contracted within or outside the territorial limits of India.

Certificates Required for TDB:

Accident Report in form 16,

Form 8,9,10, 11 and ESIC Med.13.

Eligibility for TDB :

The benefit is not subject to any contributory conditions. An IP is eligible from the day he joins the insurable employment.

(d) TDB Rate is 40% over and above the normal sickness benefit rate. This works out to nearly 70 % of the average daily wages.

There is no prescribed limit for the duration of TDB. This is payable as long as temporary disablement lasts and significant improvement by treatment is possible. If a Temporary Disablement spell lasts for less than 3 days (excluding day of accident), IP will be paid sickness benefit, if otherwise eligible.

(a) PDB is payable to an IP who suffers permanent residual disablement as a result of EI (including Occupational Diseases) and results in loss of earning capacity. The proper authority for assessing loss of earning capacity for injuries is the Medical Board and for Occupational Diseases, Special Medical Board.

(b) The duration of PDB may be for the period given by Medical Board, if assessment is provisional or for entire life if assessment is final.

(c) PDB Rate: The PDB rate is calculated as percentage of loss of earning capacity as assessed by the Medical Board/MAT/EI Court in relation to TDB. List of injuries deemed to result in permanent total disablement and percentage loss of earning capacity has been previewed in 2^nd Schedule to ESIC Act, 1948. Hence, the maximum rate of PDB can be equal to the rate of TDB.

PDB amount is revised by the ESIC from time to time to adjust for inflation. The latest enhancement is with effect from 01.08.2002

 (d) Commutation of PDB (Regulation 76-B): IP whose PDB has been assessed as final and who has been awarded the same at the rate not exceeding Rs. 5.00 per day may apply for commutation of periodical payments of PDB into a lump-sum. When an application for commutation is made within 6 months of the date of communication of Medical Board decision periodical payments shall be commuted into a lump sum provided the total commuted value does not exceed Rs. 30,000/- at the time of commencement of final award. However, where such an application is made after expiry of 6 months, LO/RO will refer the case to MR/PTMR to certify whether the IP has an average expectation of life for his age. Such a certificate is issued by Medical Referee in the relevant place on RO/LO letter.

(e) Age of an IP will have to be proved to the satisfaction of the Corporation in all cases. Medical Boards assess the age of IPs who are not able to produce satisfactory proof of age and opinion of Medical Board shall be final in this regard.

Dependants benefit (family pension) is payable to dependants of a deceased insured person where death occurs due to employment injury or an occupational disease.

The dependants’ benefit is payable to the dependants as per Section 52 of the Act read with provision of 6(A) of Section 2 in cases where an IP dies as result of EI. The age of dependants, has to be determined either by production of

Documentary evidence as specified in Regulation 80(2) or

Age certified by Medical Officer In charge of Government Hospital or Dispensary.

 The minimum rate of DB w.e.f 1.1.90 is Rs.14/- per day and these rates of the DB are increased from time to time. The latest enhancement is with effect from 01.08.2002

Some other benefits offered by the Scheme are:-

a)     Funeral expenses on death of an I.P. subject to a maximum of Rs.2500/- payable at the Branch Office.

b)    Vocational Rehabilitation in case of disabled insured persons under 45 years of age with 40 percent or more disablement.

c)     Free supply of physical aids and appliances such as crutches, wheelchairs, dentures, spectacles and other such physical aids.

d)     Preventive health care services such as immunisation, family welfare services, HIV/AIDS detection, treatment etc.

e)     Confinement Allowance @ Rs.1000/- is paid to an insured woman or in respect of the wife of an insured person in case she does not avail medical facilities of the scheme for child delivery.

a) Duties of Employers

i) Right to receive payment of any benefit under the Act shall not be transferable or assignable.

ii) Cash Benefits payable under the Act are not liable to attachment or sale in execution of any decree or order of any court.

 

iii) Employer shall not dismiss, discharge or reduce the wages or otherwise punish a covered employee during the period he/she is in receipt of Sickness Benefit or Maternity Benefit etc.

iv) By reason of his liability to pay his share of contribution under the ESI Act, no employer shall directly or indirectly reduce the wages of a covered employee.

v) Right to register their grievances/complaints at any level for immediate redressal.

vi) Right to approach ESI Court against any action/decision of the Medical Board etc.

The ESIC is to ensure that:-

The quality and quantity of benefits is as per norms and standards laid down by the Corporation for the purpose.

The benefits are made available within the given time frame to insured persons and beneficiaries.

No harassment is caused to the beneficiaries across the counter at the grass root level by way of word or deed.

All requisite information, procedural guidance etc. is made available to the beneficiaries for claiming benefits.

All types of forms etc. are made available to the beneficiaries free of cost as may be required by them for filing claims etc.

No beneficiary is exploited at any level in any way in the process of delivery of benefits.

Office hours as notified for ESIC/ESIS establishments are strictly adhered to by the staff and displayed prominently so as to avoid any inconvenience being caused to the beneficiaries in smooth flow of benefits.

Drugs, dressings, injections etc. as prescribed by the authorised doctors are made available timely.

A complaint box is fixed within the office premises for posting written complaints.

To develop a responsive, purposive and productive relationship with employers.

Seek their active involvement in the improvement of the scheme as a confidence building measure.

Provide them necessary guidance in fulfilling their lawful obligations under the ESI Act.

Make available to them requisite Forms and proforma’s as may be required by them from time to time.

To ensure that any lax medical certification on part of ESIC does not bring down the productivity of a factory or establishment.

To ensure that in case of any difficulty, doubt or misunderstanding employer is given a chance to be heard at an appropriate level.

To ensure that all correspondence emanating from the employer is responded to, timely and objectively.

To ensure that an employer is not being harassed by any official of the Corporation authorised to inspect the premises or the records.

To ensure that any grievances received from employers are looked into promptly and pointedly for speedy redressal.

ESI Scheme, being a multi-discipline service intensive social security programme for workers, an estimated 3.5 lakh beneficiaries visit the service outlets at the grassroots level daily, either for treatment or for availing cash benefits. In such a highly interactive and dynamic system there is sufficient scope for any inadvertent or wilful harassment being caused to the beneficiaries. The Corporation has, therefore, set up an elaborate system for speedy redressal of public grievances and complaints at various levels. Grievances can be reported in writing, on telephone, by post or in person to any of the following officers:-

For vigilance related issues Employers and Employees covered under the scheme can contact the Regional Director ESIC of their area or write to the:-

Chief Vigilance Officer/AC {Vigilance},

Employees’ State Insurance Corporation,

Panchdeep Bhawan, Kotla Road,

New Delhi-110002.

Tel: 011-23239424, 011-23234092 (Extn.214/233).

For any other information about the scheme individuals or organisations may log on to ESIC Website:

Director Public Relations,

ESI Corporation,

Panchdeep Bhawan, C.I.G. Road,

New delhi – 110 002.

Tel.: 23236764/23234092 (Extn.212/221)

 CORPORATE HEADQUARTERS

DIRECTORATE GENERAL,

EMPLOYEES’ STATE INSURANCE CORPORATION,

Panchdeep Bhawan, C.I.G.Road, New Delhi – 110 002.

PBX : 011 – 23234092 : 011 – 23234093

FAX : 011 - 23234537

E-mail : hq@esic.org.in

Website : esic.nic.in, esic.org.in

Telegrams : Rajyabeema, New Delhi

CHAPTER-II

(1) The powers and duties of the officers in the rank of R.D’s/J.D’s/D.D’s/ARD’s in the Regional Offices and the delegation of powers to Jt. Director I/c. of Sub-Regional Offices and of the Branch Manager, Gr.-I, II in the Branch Offices are as shown in the book with the title ESI CORPORATION, COMBINED BOOK-LET OF DELEGATION OF POWERS-2005, issued by MSU Hqrs..

(2) The delegation of powers of SSMC’s and SMC’s are also published in a booklet form.

(3) The powers of the Director General are as contained in schedule-‘A’, and those of the I-Financial Commissioner, II-Insurance Commissioner, III-Medical Commissioner, IV-Additional Commissioner-(P&A) and V-Chief Engineer are as explained in schedule-‘B’, in the booklet "EMPLOYEES’STATE INSURANCE CORPORATION"-RULES OF BUSINESS (Annexure-IV) available from the CPIO’s.

Similarly, the powers and duties of the following staff and officers are as per their Job-cards prepared by M.S.U. are as under:-

(1) Director-(MSU) (8) U.D.C. (15) Gestetner/Operator

(2) Principal Pvt. Secretary (9) I.I. (16) Driver

(3) Section Officer (10) L.D.C. (17) Mali

(4) Head Clerk (11) Librarian (18) Farash

(5) Stenographer (12) Peon (19) Chowkidar

(6) Care-taker (13) Assistant (20) Sweeper

(7) UDC-Cashier (14) Lift Attendant (21) Record Sorter

Further, there are 58 posts in the medical / para-medical services in ESIC is given in Chapter X.

ESI Corporation is a statutory body which functions under ESI Act-1948 as passed by the Parliament and the Rules and Regulations, framed by the Central Government and the Corporation, as envisaged under the ESI Act.

All decisions regarding amendments in the ESI Act can only be taken by the Parliament.

Any decision regarding change in the rules/procedure and rate of contribution or the benefits etc. can only be taken by the Central Government, i.e., the Ministry of Labour, Government of India. However, decision regarding formation of a new regulation or amendment in the existing regulations can be taken by the Corporation. The Corporation meets twice a year to review the policy, functions, performance etc. of the Corporation.

The Standing Committee is the apex decision making authority of the Corporation regarding its day-to-day functions. However, all the decisions of the Standing Committee require approval of the Corporation.

The Director General is the Chief Executive of the ESI Corporation. All executive powers are vested in the Director General. The Director General delegates his powers to the subordinate’s officers, considering his convenience, the importance and gravity of the issues, and hierarchy of the officers whom the power is delegated. However, in most cases, the decisions are taken by the Director General as per the proposals and recommendations of the lower functionaries, based on instructions, rules and regulations, under the ESI Act. The decision regarding appointment, posting, transfer and disciplinary action in respect of Group A and Group B Officers are taken only by the Director General, who is also the appellate authority in the case of disciplinary action in respect of Insured Inspectors, Manager Gr.-II and Senior Hindi Translators.

For functional convenience, the working in the Hqrs. Office is divided into three divisions namely Insurance Division, Medical Division and Finance Division which are headed by respective Commissioner and further there are branches, viz., administration, finance and accounts, construction, medical, insurance benefit actuarial, law, official language etc.. A proposal for any decision is to be put up by an Assistant in the branch. That proposal is scrutinized by the supervisory officers based on rules, regulations and instructions and after scrutiny, it goes to the appropriate authority for decision as per delegation of powers. There is a collective responsibility in the normal course. However, the authority (the person) who takes decision is responsible and accountable for that decision. The matters of complicated issues from the field offices are referred to Hqrs. Office for decision making as per instructions similarly there are cases that are beyond the powers of Regional Directors in Regional Offices where the decisions are to be taken by the Senior Officers working in Hqrs.. The decisions taken at the Hqrs. Office in respect of any issue referred by any region is applicable for all regions in such similar matters.

Any matter is put up by the clerical staff as per interpretation of instructions, rules, regulations, existing procedures/procedures etc. by them which are scrutinized by the supervisory officer and put for decision by the Branch Officer (Dy. Director or Jt. Director for decisions of the Regional Director, i.e., the Head of the Regional Office of the M.S. of the hospital as per delegation of powers issued by the Hqrs. Office. The matters regarding determination of contribution, interest and damages, rate and quantum of benefits as referred to by the Branch Office, transfer and posting of staff and officers. Similarly decisions on administrative matters in case of upto the level of Insured Inspectors are taken by the Regional Director/Medical Superintendent of the hospital. Recruitment upto the level of Assistant alongwith transfer and posting of upto Insurance Inspectors are taken by the RD/MS only. R.D. also decides the grievances received in the Regional office.

Branch Office.

Decision regarding rate and amount of any payment in respect of beneficiaries are taken by the Branch Managers on the basis of instruction and rate of contribution of the Insured Persons and their average daily wages. The Branch Manager also decides the distribution of work in the branch office i.e. about the item of work to be dealt by the staff posted in the Branch Office. Branch Managers also acts as the Public Grievance Officer pertaining to/for the Branch Office.

As a general rule, the instructions issued by the Ministry of Labour vide letter No. I-11034/19/2001-IWSU dated 15.01.2003 regarding channel of submission and levels of final disposal of different categories of cases and which are framed by the Committee of secretaries headed by the Cabinet Secretary for the quicker disposal of the work are followed in ESI Corporation. As per these instructions:-

(a) As a general rule, levels for final disposal may be restricted to three.

(b) Ordinarily, not more than two working days may be taken by an officer to dispose of a file.

(c) There shall be a review of the existing guidelines regarding channels/levels of submissions of different categories of cases to delegate powers to lower functionaries and clearly indicate the level of final decision-making.

 

 

 

 

 

In view of the guidelines laid-down in the Manual of General Office Procedure in Para 4, 7, Sub Para (4), at Page No. 22, the IC has approved to fix time limit for disposal of various applications/requests received from the officers and employees posted in the offices of the Corporation, detailed vide Letter No. Z-11/12/1/92-MSU Dated 27.03.2003 are as under:-

All officers/employees are required to furnish their application/requests complete in all respects so that the application/requests may be disposed of within the time limit mentioned above. In case of delay they may kindly bring the matter to the notice of the Jt. Director/Dy. Director/(Complaint Officer) in the R.O. and Jt. Director (E-II) in the Hqrs. Office, as the case may be.

Norms set for the disposal of claims of beneficiaries are as given in the local office manual. These are as under:-

(1) Sickness Benefit : Within 7 days

(2) Funeral expenses : Within 15 days

(3) Maternity Benefit : Within 14 days (in case of first payment)

(4) Temporary Disablement Benefit : Within 30 days (in case of first payment)

(5) Permanent Disablement Benefit : Within 30 days (in case of first payment)

(6) Dependent’s Benefit : Within 90 days (in case of first payment)

There are following categories of documents held in ESIC. Viz.

(1) Documents regarding the Officers and employees of the Corporation for example Service Book of each employee, Service cards of all the officers, Confidential Reports, Probation Progress Reports and their personal files. Various Hypothecation documents for the loan and advances taken by the employees and officers. For example, HBA, Motor vehicle advance etc.

(2) Documents in the Construction Division, for example, registry of plots and building acquired by the Corporation, tender and deeds with various Construction Agencies, Rate Contract for maintenance etc.

The other documents regarding establishment in the Hqrs. Office are: -

i. Seniority List.

ii. Recruitment Regulation Rules.

iii. D.P.C. Minutes

(a) Transfer Policy.

(b) List of officers of the ESI Corporation & employees working in the Hqrs. Office.

(c) Instructions on establishment matters.

(d) The ESIC (Staff & Conditions of Service) Regulations-1959.

(3) Records regarding recruitment of Staff including Para-Medical Staff, doctors & officers for example application forms along with enclosures, copies of testimonials etc., Medical Certificate for fitness. Results of examination etc. along with process of examination, offer of appointment and its acceptance. Results of DPC for promotion to higher post, record of pay-fixation, pay bills, record of annual increment, record of vigilance action if any against the employees & officers of the Corporation of ESI.

(4) Record of purchase, Service and Maintenance of the furniture’s and fixtures including stationery & miscellaneous items of all types in the offices, dispensaries & hospitals of the ESI Corporation such as:-

(1) Copy of purchase Orders.

(2) Agenda/minutes of meeting of Corporation/Standing Committee.

(3) List of members of Corporation/Standing Committee with their names and capacity in which they represented in the Corporation.

(4) Policy in respect of medical arrangements for serving employees.

(5) Sanctioned/in-position strength of officers and staff in Hqrs. Office/different regions/sub regions and other offices.

(6) Location of establishments.

(5) A The documents in the Revenue Branches of Regional Offices are

(i) 01 Form & 01-A Application for Registration of Factories & Establishments.

(ii) Survey Report of the Insurance Inspector recommending coverage of the factory & Establishment based on the information collected/obtained on a visit to the factory or establishment.

(iii) C-11 coverage letter issued to the Employer covering the factory or establishment under the provisions of Section 2(12) (a), 2(12) (b) Section 15 of the ESI Act.

 

(iv) Inspection Report prepared by the Insurance Inspector or verification of the records of the Employer and discrepancy letter/observation letter issued to the employer.

(v) Recovery actions taken against defaulting employers i.e. Notices issued-C-18, Show Cause Notice for prosecution and notice for levy of damages-D-18.

(vi) Speaking Orders passed u/s 45-A determining contribution payable and u/s 85-B determining levy of damages. Prosecution sanction orders and Recovery Certificates.

(vii) Challans of contribution paid by the Employer and the half yearly returns of contributions submitted by the employer and correspondence with the employer.

B. Documents maintained in Revenue Branch of Hqrs. Office are:-

(i) Instructions on Revenue matters.

(ii) Data on Arrears.

(iii) Data on Monthly Contribution Income received.

(iv) BIFR Cases-status of.

(v) Supreme Court cases-decided cases.

(6) The list of documents pertaining to the benefit matters is as under:-

A. Registration

1. Return of Declaration Form

2. Declaration Form

3. Form 72-A

4. Certificate of Employment

B. Contribution

1. Return of Contribution

2. ESIC-71

3. ESIC-37

4. Live List

1. Medical Certificates

2. Claim Forms

3. Second Opinion of Medical Referee

4. ESIC-47

5. Ledger Sheet

D. Temporary Disablement Benefit/Permanent Disablement Benefit/Dependent’s Benefit.

1. Accident Report/BI-1

2. Investigation Report and the statement of witnesses etc.

3. ESIC-32

4. Medical Certificates

5. All Claim Forms

6. Opinion of the Medical Referee

7. Request for Medical Board

8. Form BI-1 (a)

9. Form BI-2

10. Medical Board Register

11. Form BI-2

12. ESIC-154

13. Ledger Sheet for TDB

14. Ledger Sheet for PDB

15. Ledger Sheet for DB

16. Application for commutation

17. Decision of commuted value of PDB

18. Live Certificates for PDB & DB

19. Claim form for PDB & DB

1. Notice of pregnancy

2. Certificate of expected confinement

3. Certificate of confinement

4. Claim forms

5. Ledger Sheet.

6. Abstention verification of forms.

1. Death Certificate

2. Claim form

1. Application for Unemployment Allowance.

2. Certificate in respect of retrenchment/closure of a factory.

3. Rate Card of Unemployment Allowance.

4. Ledger Sheet

1. Claim Form

2. Certificate of training

3. Ledger Sheet

1. MRE Medical Record Envelop

2. Medical Record Card

3. ESIC-37

4. Live List

5. ESIC-48

6. Certificate of Employment

(7) Documents maintained in the Medical Division and Hospitals.

1. Duty Chart of class A,B & C,D, Groups.

2. Records of indoor patients maintained in all the hospitals.

(i) Central Admitting and Enquiry Services and preparation of patients name index cards.

(ii) Census of in-patients.

(iii) Admission and discharge statistical analysis.

(iv) Completing of records.

(v) Coding of diseases and operative procedures.

(vi) Indexing-Diagnostic and operations coding.

(8) Records maintained in the Finance & Accounts Division in Hqrs. Office.

i. Investment policy under Rule 27 of ESI Central Rules 1950.

ii. Monthly Accounts.

iii. Cash Book.

iv. Receipt Book.

v. Bank Scroll.

vi. Schedule Sheet.

(9) Documents maintained in Planning & Development Branch of Hqrs. Office are:-

(i) Documents of Phased Programme for implementation of scheme in new areas.

(ii) Documents relating to implementation of scheme in an area i.e. notifications of implementation.

(iii) Details of non-implementations.

10. Documents in Public Relations Division

(i) Documents of Annual accounts of ESIC.

Such an arrangements exists in the ESI Corporation at different levels.

These are:-

(1) Local Committees : are functioning at the grass route level i.e. Branch Office level. It is headed by the Distt. Labour Commissioner or the Distt. Magistrate / Distt. Commissioner / Collector and includes representatives of employees, employers, Officer from District Medical Services and the Branch Manager of ESI Corporation. They supposed to meet every quarter to discuss the arrangement and facilities of ESI to the employees and their family members. Any complaints etc. against satisfactory working of the scheme are discussed and remedial measures are suggested for being taken at appropriate level.

(2) The Regional Board : The Regional Board functions at the Regional level. It is headed by the State Labour Minister and representatives of employees & employers, Director ESI Scheme are its members. The Regional Directors ex-officio Secretary of the Regional Board. It is required to have its quarterly meeting and discuss matter and framed policy for the efficient functioning of the ESI Scheme in that region.

(3) At the National level, it is the ESI Corporation, its Standing Committee and the Medical Benefit Council that discuss all the matters and framed policies for the working of the scheme at the National level.

In every region, there can be one or more Medical Boards as constituted by the respective State Government to decide references from the Regional Offices for deciding the percentage of loss of earning capacity of the Insured Person in case of employment injury for deciding the quantum of pension to be paid per month in case of employment injury. The Medical Board comprises of a CMO i.e. Chief Medical Officer or some other senior doctors along with two other doctors who may be specialist in Orthopedic, Ophthalmology (Eye Specialist) a surgeon as required in the cases.

Over & above the Medical Board, there may be Medical appellate Tribunal (MAT) to decide disputes out of Medical Board decisions in the MAT there are three members (1) a Civil Judge (2) a doctor (3) representative from the "Workers Union".

There is a Medical Benefit Council under the Chairmanship of Director General of Health Services of India and the Dy. Director General of Health Services as the Vice-Chairman the other members of the MBC are: -

1. Medical Commissioner of ESIC,

2. One member each from the States and Union Territories to which this Act applies, to be appointed by the concerned State Govt.,

3. Three members from the employers to be appointed by the Central Govt.

4. Three members from the employees to be appointed by the Central Govt.

5. Three members, with atleast a women representing Medical Profession, to be appointed by the Central Govt.

The MBC shall look into the matters relating to Medical Benefits imparted by ESIC.

A DIRECTORY OF THE OFFICERS AND EMPLOYEES OF THE ESI CORPORATION:

 

The Public Relation Division in the Hqrs. Office publishes a list of the Officers of the ESI Corporation which contains Sl. No., Name of the Officer, Educational qualifications, Date of birth, Date of entry in ESIC, present designation, place of posting, Date of present posting. The list contains the names and other above particulars in respect of all the officers in the rank of Assistant Regional Directors/Section Officers and above which is priced publication.

This list was previously printed on 1^st January-2001 and is available with the Additional Commissioner (PR).

The details of other officers and employees i.e. Class-III & Class-IV employees, are maintained region-wise and are always available with the Administrative Branch of respective Regional Offices or Directorate (Medical) Delhi & Noida. This information is available in detail with the Central Public Information Officer’s and Central Assistant Public Information Officer’s of the concerned unit.

As contained in the provisions under Section-17 of the ESI Act-1948, the method of recruitment, salary and allowances, discipline and other conditions of service of the members of the Staff of the Corporation shall be such as may be specified in the regulations made by the Corporation in accordance with the rules and orders applicable to the officers and employees of the Central Government drawing corresponding scales of pay. Accordingly, the report of Vth Pay Commission is accepted and applicable to all the employees and officers of the ESI Corporation. Considering the recruitment rules, nature of job, duties and responsibilities of the post held by any officer or employee of the ESI Corporation are paid remunerations as per pay scale applicable to their post. The other usual allowances for example; Dearness allowance, Dearness pay, House Rent Allowance, CCA., Transport Allownace, Non-Practice Allowance (in case of doctors) and any other allowance are paid to the employees of Corporation as are payable in the case of Central Govt. employees of equivalent posts and pay scales.

The various posts and their pay scales in ESI Corporation are as under:-

The Annual Budget with details of sub-heads is published every year by the Finance & A/cs. Division and is available in book form

There is no provision of any subsidy programme in the ESI Corporation. However, like any other Central Govt. Department, the ESIC allows its employees and officer’s some interest free advances such as, the festival advance, and fan advance alongwith some subsidize loan and free liveries to the Class-IV employees as payable any other Central Govt. employees.

Further, the beneficiaries are given all benefits payable to them as per the ESI Act, Central Rules and Regulations as already explained in chapter of this manual.

Particulars of receipitients: The E Corporation is all for its Insured Persons/Insured women and their family members who are the beneficiaries for the various benefits under the scheme.

Information available by the Corporation in electronic form is available on its web site : www.esic.org.in & @ www.esic.nic.in & E Mail Hq. @ esic.org.in wherein all information about the introduction and particulars of ESI Corporation alongwith the list of officers is available.

Any citizen can approach any of the Central Public Information Officers for any information at any time during the working hours. Further, the information can be retrieved at any time from the Website of ESI Corporation.

Rules framed by DOPT under the Right to Information Act. 2005

Government of India

Ministry of Personnel, Public Grievances and Pensions

(Department of Personnel and Training)

New Delhi, dated the 16^th September, 2005

Notification

G.S.R….., In exercise of the powers conferred by clauses (b) and (c) of sub-section (2) of section 27 of the Right to Information Act., 2005 (22 of 2005), the Central Government hereby makes the following rules namely: -

1. Short title and commencement – (1) These rules may be called the Right to Information (Regulation of Fee and Cost) Rules, 2005.

(2) They shall come into force on the date of their publication in the Official Gazette.

2. Definitions – In the rules, unless the context otherwise requires,-

(a) ‘Act’ means the Right to Information Act, 2005;

(b) ‘section’ means section of the Act;

(c) all other words and expressions used herein but not defined and defined in the Act shall have the meanings assigned to them in the Act.

3. A request for obtaining information under sub-section (1) of section 6 shall be accompanied by an application fee of rupees ten by way of cash against proper receipt or by demand draft or bankers cheque payable to the Accounts Officer of the public authority.

4. For providing the information under sub-section (1) of section 7, the fee shall be charged by way of cash against proper receipt or by demand draft or bankers cheque payable to the Accounts Officer of the public authority at the following rates: -

(a) Rupees two for each page (in A-4 or A-3 size paper) created or copied;

(b) Actual charge or cost price of a copy in larger size paper;

(C) Actual cost or price for samples or models; and

(d) For inspection of records, no fee for the first hour; and a fee of rupees five for each fifteen minutes (or fraction thereof) thereafter.

5. for providing the information under sub-section (5) of section 7,

The fee shall be charged by way of cash against proper receipt or by

demand draft or bankers cheque payable to the Accounts Officer of

the public authority at the following rates: -

(a) for information provided in diskette or floppy rupees fifty per diskette or floppy; and

(b) for information provided in printed form at the price fixed for such publication or rupees two per page of photocopy for extracts from the publication.

 

Government of India

Ministry of Personnel, Public Grievances and Pensions

(Department of Personnel and Training)

New Delhi, dated the 16^th September, 2005

Notification

G.S.R….., In exercise of the powers conferred by clauses (e) and (c) of sub-section (2) of section 27 of the Right to Information Act., 2005 (22 of 2005), the Central Government hereby makes the following rules namely: -

1. Short title and commencement – (1) These rules may be called the Central Information Commission (Appeal Procedure) Rules, 2005. (2) They shall come into force on the date of their publication in the Official Gazette.

2. Definitions – In these rules, unless the context otherwise requires,-

(a) ‘Act’ means the Right to Information Act, 2005;

(b) ‘section’ means section of the Act;

(c) "Commission" means the Central Information Commission.

(d) words and expressions used herein and not defined but defined in the Act. shall have the meanings respectively assigned to them in that Act.

3. Contents of appeal.- An appeal to the Commission shall contain the following information, namely :-

i) name and address of the appellant;

ii) name and address of the Public Information Officer;

iii) particulars of the order against which the appeal is made including number, date and the Central Public Information Officer who passed the order;

iv) brief facts leading to the appeal;

v) prayer or relief sought,

vi) grounds for the prayer or relief,

vii) provisions of the Act or the rules;

viii) verification by the appellant and

ix) any other information which the Commission may deem necessary for deciding the appeal.

4. Documents to accompany appeal.- Every appeal made to the Commission shall be accompanied by the following documents, namely: -

i) attested true copy of the Order against which the appeal is being preferred;

ii) copies of documents relied upon by the appellant and referred to in the appeal; and

 

iii) an index of the documents referred to in the appeal.

5. Procedure in deciding appeal.- In deciding the appeal the Commission shall.

i) hear oral or written evidence on oath or on affidavit from concerned or interested person.

ii) peruse or inspect documents, public records or copies thereof;

iii) inquire through authorized officer further details or facts;

iv) hear Central Public Information Officer, Assistant Central Public Information Officer or such Senior Officer who decide the first appeal, as the case may be;

v) hear third party; and

vi) receive evidence on affidavits from Central Public Information Officer, Assistant Central Public Information Officer, such Senior Officer who decided the first appeal or third party.

6. Service of notice by Commission

Notice to be issued by the Commission may be served in any of the following modes, namely: -

i. service by the party itself;

ii. by hand delivery (dasti) through Process Server;

iii. by registered post with acknowledgement due; or

iv. through Head of Office or Department.

7. Signing of order.- Order of the Commission pronounced in open proceedings shall be in writing and authenticated by the Registrar or any other officer authorized by the Commission for the purpose.

Government of India

Ministry of Personnel, Public Grievances and Pensions

(Department of Personnel and Training)

New Delhi, dated the 28^th October, 2005

Notification

G.S.R….(E)., In exercise of the powers conferred by clauses (e) and (f) of sub-section (2) of section 27 of the Right to Information Act., 2005 (22 of 2005), the Central Government hereby makes the following rules namely: -

1. Short title and commencement – (1) These rules may be called the Central Information Commission (Appeal Procedure) Rules, 2005.

(2) They shall come into force on the date of their publication in the Official Gazette.

2. Definitions – In these rules, unless the context otherwise requires,-

(a) ‘Act’ means the Right to Information Act, 2005;

(b) ‘section’ means section of the Act;

(c) "Commission" means the Central Information Commission;

(d) words and expressions used herein and not defined but defined in the Act. shall have the meanings respectively assigned to them in that Act.

3. Contents of appeal.- An appeal to the Commission shall contain the following information, namely :-

i) name and address of the appellant;

ii) name and address of the Public Information Officer against the decision of whom the appeal is preferred;

iii) particulars of the order against which the appeal is made including number, if any, against which the appeal is preferred;

iv) brief facts leading to the appeal;

v) if the appeal is preferred against deemed refusal, the particulars of the application, including number and date and name and address of the Central Public Information Officer to whom the application was made;

vi) prayer or relief sought,

vii) grounds for the prayer or relief,

viii) verification by the appellant and

ix) any other information which the Commission may deem necessary for deciding the appeal.

4. Documents to accompany appeal.- Every appeal made to the Commission shall be accompanied by the following documents, namely: -

i) self-attested copy of the Order or document against which the appeal is being preferred;

ii) copies of documents relied upon by the appellant and referred to in the appeal; and

iii) an index of the documents referred to in the appeal.

5. Procedure in deciding appeal.- In deciding the appeal the Commission may.-

i) hear oral or written evidence on oath or on affidavit from concerned or interested person.

ii) peruse or inspect documents, public records or copies thereof;

iii) inquire through authorized officer further details or facts;

iv) hear Central Public Information Officer, Central Assistant Public Information Officer or such Senior Officer who decide the first appeal, or such person against whom the complaint is made, as the case may be;

v) hear third party; and

vi) receive evidence on affidavits from Central Public Information Officer, Central Assistant Public Information Officer, such Senior Officer who decided the first appeal, such person against whom the complaint lies or third party.

6. Service of notice by Commission.- Notice to be issued by the Commission may be served in any of the following modes, namely: -

v. service by the party itself;

vi. by hand delivery (dasti) through Process Server;

vii. by registered post with acknowledgement due; or

viii. through Head of Office or Department.

7. Personal presence of the appellant or complainant.- (1) The appellant or the complainant, as the case may be, shall in every case be informed of the date of hearing at least seven clear days before that date.

(2) The appellant or the complainant, as the case may be, may at his discretion at the time of hearing of the appeal or complaint by the Commission to be present in person or through his duly authorised representative or may opt not to be present.

(3) Where the Commission is satisfied that the circumstances exist due to which the appellant or the complainant, as the case may be is being prevented from attending the hearing of the Commission, then, the Commission may afford the appellant or the complainant, as the case may be, another opportunity of being heard before a final decision is taken or take any other appropriate action as it may deem fit.

(4) The appellant or the complainant, as the case may be, may seek the assistance of any person in the process of the appeal while presenting his points and the person representing him may not be a legal practitioner.

8. Order of the Commission.- Order of the Commission shall be pronounced in open proceedings and be in writing duly authenticated by the Registrar or any other officer authorised by the Commission for this purpose.

The Director General, ESI Corporation, has designated all the Divisional Heads (Director / Addl. Commissioner) in Hqrs., all Assistant Director / Dy. Director (Admn.) in Regional Office / Sub-Regional Office / Divisional Offices / ESI Hospitals / D(M)D / D(M) Noida and all Branch Managers in Branch Offices in the ESI Corporation as Central Public Information Officers (CPIO) in respect of their jurisdictions under Section 5(1) of the RTI Act. 2005.

The Director General, ESI Corporation, has also designated all the Regional Directors in Regional Offices and Jt. Directors Incharge of Sub-Regional Offices as appellate authority for all the Branch Offices and Regional Offices / Sub-Regional Offices under their charge. The M.S. of ESI Hospitals and D(M)D and D(M) Noida as appellate authority in respect of the field formation under their charge. Further, the Director General has designated the Medical Commissioner as appellate authority in respect of Medical Division for Hqrs. and the Insurance Commissioner as appellate authority in respect of other Divisions of Hqrs. at Hqrs. Office level.

The names, designation and particulars of the CPIOs at Hqrs. Office and in the Regional Offices, Sub-Regional Offices, Divisional Offices D(M)D, D(M) Noida and Hospitals of ESI Corporation are as given below.

The Director General has also ordered that whenever any officer holding the charge of CPIO goes out of office on transfer / leave / training or for any other reason than the officer to hold charge in his place shall also be designated as CPIO in his place. A specific mention to this effect must be made in the orders for the same by the competent authorities and the name of CPIO must be prominently displayed in that office.

Date: 23.8.2005

LIST OF CENTRAL PUBLIC INFORMATION OFFICERS RO/ SRO/ DIV. OFF/ BRANCH OFFICES / ESI HOSPITALS IN ESI CORPORATION