Problems faced by Industrial Workers due to ESIC -

ESIC - Employee State Insurance Corporation:

ESIC is one of the institution govern by the central government in association with state government is meant to help people engaged in industrial establishments. It is one of the social security act govern by The Employee State Insurance Act,1948. There are so many benefits available to employees covered under this scheme which is not useful for employees only but also to the dependents.

Government has implemented this in many areas of our country including the state of Maharashtra and once it is in force the employer has to comply with all the rules and regulations.

Palghar district is one of the major hub of Industries where ESI was implemented in August 2017 and Lakhs of people have been covered under the scheme.

There are so many benefits available to employees but all are on paper only, ESI officials are not taking any responsibilities and just talking the language of books. There are so many problems faced by the employees and employers. I am listing down these problems and hope this will at least read by someone.

Problem faced by Employees:

Earlier many companies have enrolled their workers in Mediclaim either provided by Private company or government company. The service was very good for both cashless and reimbursement as lots of hospitals were available to avail the benefits. As an employer they have very less liabilities for the hospitalization.

 Since the enforcement of ESI all the employees earning equals to and less than Rs. 21000/- were covered under the scheme. The process is very complex and required lots of time to enroll each worker in ESI benefits.

There are no hospitals available in the area and every time employees have to travel 100 KM to avail the hospitalization. The channel of hospitalization is very complex first a person has to visit primary care center where doctor will give reference then after he can go to the secondary care and same for tertiary care. If the patient is serious only miracles can save him/her when he/she is not financially strong.

The dependents staying outside the covered area cannot take benefits of ESI and hence has to bear the financial loss.

The story of reimbursement is even very critical and paid in CGHS (Central Government Health Scheme) rate which is a very old rate and not even revised by the government and hence no private hospitals are coming forward to enroll in ESI.

When a reimbursement claim is sent for settlement the reply received from ESI official is that - there are 40000 claims pending and how much time it will take to settle they cannot guarantee. It may be settled in 6 months also and 5 years also and will be paid in CGHS rate.

As a HR person I had also sent some claims but when I inquired the status of claims I received the same answers every time. It is very difficult to HR person to handle an employee's grievance when it comes to ESI benefits.

The problems faced by an Employer:

As an employer there are so many responsibilities that are carried and followed as far as employees and their liabilities are concerned. Employer has to comply with the rules and regulations framed by the government which sometimes very harsh.

Manpower is one of the asset of the organization and companies are spending so much on their employees. There are so many grievances which are handled by the companies, sometimes there are grievances which are not in the scope of company even though company handles it properly.

The unavailability of ESI hospitals, Improper services rendered by the hospitals, Waiting time in hospitals, deduction from employee and employer these all factors are attracting unnecessary grievances which are handled by the employer.

These all factors are also creating nuances to industrial workers because they may belongs to a poor family and once the hospitalization happens it creates a bigger financial loss for them. The only hope is ESI and when this will not help then what is the use of it.

Suggestions for the betterment:

As a citizen of India I have the right to give my suggestions for the betterment of our country and this is the reason why I am writing this blog.

Our government must....

1) Ensure the availability of hospitals with all facilities in implemented areas.

2) Enrolled employee can go to any of the ESI hospitals if he is eligible.

3) CGHS rate must be revised, this will attract private hospitals also to extend their services.

4) Reimbursement claims must be addressed as soon as received.

5) Dependents can also avail the benefits if staying outside implemented areas.

6) Cash benefits must be addressed quickly.

7) ESI officers must behave like a professionals.

8) Deductions from employee and employer must be reduced.

9) ESI must ensure the availability of branch office in implemented areas.

10) ESI must survey the problems faced by employees and employers and  must establish a forum ro        resolve queries practically.

By: Vikash Dubey

Jai Hind Jai Bharat