Employees covered under the scheme and their deceased dependents are entitled to get the benefit of medical treatment.In case of wage or earning capability loss due to some specific disasters they are also entitled to get cash benefits.Insured women is entitled to get maternity benefit in case of delivery.If the insured person dies due to injury during employment or due to a disease arising because of workplace then his/her dependents shall be entitled to pension benefit.Out of these benefits the responsibility to provide medical benefits rests with the state government which the state government provides to beneficiaries through various Employees State Insurance Hospitals and Dispensaries run under its control.Remaining five benefits are made available in the form of cash through the local offices of Employees State Insurance Corporation.
Medical Benefit
Liability to provide medical benefits rests with the state government. After joining with the insurable employment the insured and his/her dependents get entitled to get the benefit of medical benefit.Primary, outdoor, indoor and expert services are made available through Employees State Insurance Hospitals/dispensaries and panel clinics while the superspeciality services are made available eminent medical institutions of the country on referral basis.These services are made available in the hospitals and dispensaries on immediate basis.
Disease Benefit
Disease benefit is made available in the form of cash by Employees State Insurance Corporation. Disease benefit is payable to the insured person in case of diseased condition in cash. Provided that he had been absent from the work and his absence had been certified by the Authorized Insurance Medical Officer / Practitioner.Payment of this benefit is made within 7 days of disease certification at standard benefit rates and the rate of this benefit is not less than 50 per cent of daily wage.
Maternity Benefit
Maternity benefit is payable to insured women in case delivery or abortion or associated complications and is paid by the Employees State Insurance Corporation within 14 days of submitting the certified claim documents.
Handicap Benefit
Handicap benefit is payable to insured person who has become physically handicapped due to employment injury or workplace disease. Provided that the insured should be an employee on the date when accident occured. This benefit is payable within one month of submission of benefit claim documents.
Dependents Benefit
Dependents benefit (family pension), is payable to the dependents of the deceased insured in such cases where the insured dies of employment injury or occupational disease. This benefit is provided to the dependents within three months of the death of the insured and after that is paid regularly on monthly basis.
Funeral Benefit
Funeral expenditure of maximum up to Rs 10,000 / - for the funeral of insured is payable by the local office.