OYEES’ STATE INSURANCE CORPORATION
——
NOTIFICATION
New Delhi, the 17th October, 1950
——
NOTIFICATION
New Delhi, the 17th October, 1950
*No. RS/5/48. — In exercise of the powers conferred by section 97 of the Employees’ State Insurance Act, 1948 (XXXIV of 1948), the Employees’ State Insurance Corporation is pleased to make the following regulations, the same having been previously published as required by sub-section (1) of the said section, namely —
THE EMPLOYEES’ STATE INSURANCE (GENERAL) REGULATIONS, 1950
| Preliminary |
| 1 Short title and extent |
| 2 Definition |
| 3 The manner in which the corporation may exercise its powers |
| 3-A Exercise of Powers by an Office |
| 4 Contribution and Benefit Periods |
| 5 Omitted |
| 6 Meetings of the Corporation, the Standing Committee and the Medical Benefit Council. |
| 7 Decision by majority |
| 8 Mode of Exercising Vote |
| 9 Matters to be brought before the Corporation |
| 10 Regional Boards. |
| 10-A Local committees |
| Collection of Contributions Etc |
| 10-B Registration of factories or Establishments |
| 10-C Submission of annual information by factories/establishments |
| 11 Declaration by person in employment on appointed day |
| 12 Declaration by persons engaged after the appointed day |
| 13 Omitted |
| 14 Declaration Form to be sent to appropriate office |
| 15 Allotment of Insurance Number |
| 15-A Registration of Families |
| 15-B Changes in Family |
| 16 The Corporation to receive assistance from employers |
| 17 Identity Cards |
| 17-A Issue of a Certificate of Employment |
| 17-B Issue of Permanent Acceptance Card |
| 18 Loss of Identity Card |
| 19 Omitted |
| 20 Omitted |
| 21 Omitted |
| 22 Omitted |
| 23 Omitted |
| 24 Omitted |
| 25 Refund for contribution stamps |
| 26 Return of contributions to be sent to appropriate Office |
| 27 Issue of Certificate of Contribution |
| 28 Omitted |
| 29 Payment of Contribution |
| 30 Omitted |
| 31 Time for payment of contribution |
| 31-A Interest on contribution due, but not paid in time |
| 31-B Recovery of interest |
| 31-C Damages or contributions or any other amount due, but not paid in time |
| 32 Register of employees engaged by immediate employer |
| 33 Other modes of payments of contribution |
| 34 Omitted |
| 35 Omitted |
| 36 Employment for part of a wage period |
| 37 Omitted |
| 38 Scheme by joint employers |
| 39 Reckoning of wages of employee employed by two or employers in the same wages period |
| 40 Refund of contribution erroneously paid |
| 41 Omitted |
| 42 Omitted |
| 43 Omitted |
| Benefits |
| 44 Claim for benefits |
| 45 When claim becomes due |
| 46 Availability of claim forms |
| 47 Claim on wrong form |
| 48 Evidence in support of claim |
| 49 Defective claim |
| 50 Claim for inappropriate benefit |
| 51 Authority for certifying eligibility of claimants |
| 52 Benefits when payable |
| 52-A Abstention verification |
| Certification and Claims For Sickness |
| 53 Evidence of sickness and temporary disablement |
| 54 Persons competent to issue medical certificate |
| 55 Medical certificate |
| 56 Time of granting medical certificate |
| 57 Medical certificate on first examination |
| 58 Final medical certificate |
| 59 Intermediate medical certificate |
| 60 Final medical certificate before commencing work for wages |
| 61 Intermediate certificate for a longer period |
| 62 Omitted. |
| 63 Form of claim for sickness or temporary disablement |
| 64 Failure to submit medical certificate |
| Disablement Benefit |
| 65 Notice of accident |
| 66 Maintenance of accident book |
| 67 Notice otherwise than by an entry in accident book |
| 68 Report of accident by an employer |
| 69 Employer to arrange first aid |
| 70 Employer to furnish further particulars of accident |
| 71 Directions by the Corporation |
| 72 Reference to a Medical Board |
| 73 Report of Medical Board |
| 74 Occupational Disease |
| 75 Constitution of Medical Board/ Special Medical Boards |
| 76 Appeal Tribunals |
| 76-A Submission of claims for permanent disablement benefit |
| 76-B Commutation of permanent disablement benefit |
| Dependants Benefit |
| 77 Report of death of insured person by employment injury |
| 78 Disposal of body of an insured person dying by employment injury |
| 79 Issue of death certificate |
| 80 Submission of claim for dependants benefit |
| 81 Notice for dependants benefit |
| 82 Intimation of decision regarding dependants benefit |
| 83 Date of accrual of dependants benefit |
| 83-A Submission of claims for dependants benefit |
| 84 Review of dependants benefit |
| Dependant's Benefit |
| 85 Deleted |
| Dependants Benefit |
| 86 Appointment of another guardian |
| Maternity Benefit |
| 87 Notice of pregnancy |
| 88 Claim for maternity benefit commencing before confinement |
| 89 Claim for maternity benefit only after confinement or for miscarriage |
| 89-A Claim for maternity benefit after the death of an insured woman leaving behind the child. |
| 89-B Claim for maternity benefit in case of sickness arising out of pregnancy, confinement,premature birth of child |
| 90 Other evidence in lieu of a certificate |
| 91 Notice of work for remuneration |
| 92 Date of payment of maternity benefit |
| 93 Disqualification for maternity benefit |
| 94 Authority which may issue certificate |
| 95 Obligations of Insurance Medical Officer |
| Medical Benefit To Families |
| 95-A Medical benefit to families of insured persons |
| Funeral Expenses |
| 95-B Report of death of insured person |
| 95-C Issue of death certificate |
| 95-D Other evidence in lieu of a certificate |
| 95-E Submission of claim for Funeral Expenses |
| Miscellaneous |
| 96 Authority for determining benefits |
| 96-A Reimbursement to expenses incurred in respect of Medical treatment |
| 97 Discontinuation or reduction of benefits |
| 98 Discharge , etc., of employee under certain conditions |
| 99 Suspension of sickness or temporary disablement benefit |
| 99-A Sickness or temporary disablement benefit during strike |
| 100 Relaxation |
| 101 Omitted |
| 102 Certain officers to have powers of inspection |
| 102-A Inspection book |
| 103 Medical benefit during disablement |
| 103-A Medical benefit after contribution ceases to be payable |
| 103-B Medical benefit to insured person who ceases to be in insurable employment on account of permanent disablement. |
| 104 Production of document for medical benefit |
| 105 Further certificates |
| 106 Change of circumstances to be notified |
| 107 Certificate in respect of a person claiming permanent disablement benefit |
| 107-A Declaration by and certificate in respect or a person claiming dependants benefit |
| 107-B Personal attendance of a person claiming permanent disablement benefit or dependents benefit. |
| 108 Omitted |
| 109 Submission of additional information by employer or insured person |
CHAPTER I
PRELIMINARY
1. Short title and extent. —
(1) These Regulations may be called the Employees’ State Insurance (General) Regulations, 1950.
(2) They extend to the whole of India.
2. Definitions. — In these regulations, unless the context otherwise requires —
(a) “ Act ” means the Employees’ State Insurance Act, 1948 (XXXIV 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 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 ;
(e) *** Omitted
(f) *** Omitted
(g) “ Employer ” means the principal employer as defined in the Act ;
(h) “ Employer’s Code Number ” means the registration number allotted by the appropriate Regional Office to a factory or establishment for the purposes of the Act, the Rules and these Regulations ;
(i) “ Factory or Establishment ” means a factory or establishment to which the Act applies ;
(j) ‘‘ Form ” means a form appended to these regulations ;
(k) “ Identity Card ” means a permanent identity card issued by the appropriate office to an insured person for identification for the purposes of the Act, the Rules and these Regulations ;
(kk) “ Family Identity Card ” means a card issued by the appropriate office to an insured person for identification of his family for the purposes of the Act, the Rules and these Regulations
(l) “ Social Security Officer ” means a person appointed as such by the Corporation under section 45 of the Act ;
(m) “ Instructions ” means instructions or orders issued by the Corporation or by such officer or officers of the Corporation as may be authorised by the Corporation in this behalf ;
(n) “ Insurance Medical Officer ” means a medical practitioner appointed as such to provide medical benefit and to perform such other functions as may be assigned to him and shall be deemed to be a duly appointed medical practitioner for the purposes of Chapter V of the Act ;
(o) “ Insurance Number ” means a number allotted by the appropriate Office to an employee for the purposes of the Act, the Rules and these Regulations ;
(p) “ Branch Office ” and “ Regional Office ” shall mean, according to the context, such subordinate office of the Corporation, set up at such place and with such jurisdiction and functions as the Corporation may, from time to time, determine ;
(q) “ Branch Manager ” means a person appointed by the Corporation as such or the officer-in-charge of a Branch Office ;
(r) “ State Rules ” means the rules made by a State Government under section 96 of the Act ;
(s) “ Regional Director ” means a person appointed by the Corporation as such for a specified region ;
(t) “ Registered Midwife ” means a person who is registered as a midwife under any law in force in any State providing for registration of nurses and midwives ;
(u) “ Rules ” means rules made by the Central or a State Government under the Act ;
(v) “ Specified ” means specified by instructions issued from time to time by the Corporation or any authorised officer;
(w) “ Year ” means a calendar year except when specifically stated otherwise ;
(x) All other words and expressions have the meanings respectively assigned to them in the Act or the rules, as the case may be.
3. The manner in which the Corporation may exercise its powers. —
(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 these regulations, shall be made by the Director General or by such other officers as may be authorised in this behalf by the Standing Committee.
3-A. Exercise of powers by an office. — Where a power is to be exercised by the appropriate office or appropriate Branch Office or appropriate Regional Office it shall be exercised by the officer for the time being incharge thereof or by such other officer as may be authorised for the purpose under general or special orders of the Director General.
4. Contribution and Benefit periods. —
(1) 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 first 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 9 months from the date of such employment.
5. Allotment of Contribution and Benefit Periods. — * * * - Omitted
6. Meetings of the Corporation, the Standing Committee and the Medical Benefit Council. — 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.
6. Meetings of the Corporation, the Standing Committee and the Medical Benefit Council. — 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.
7. Decision by majority. — 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 meeting and in case of equality of votes the Chairman of the meeting shall have an additional casting vote.
8. Mode of exercising 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.
9. Matters to be brought before the Corporation. — In addition to the matters which are, under any specific provision of the Act or the Central Rules, required to be placed before the 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 hospitals under section 59 ;
(f) any proposal to grant exemption under section 91 ;
(g) any proposal to enhance benefits under section 99 ;
(h) any other matter which the Corporation or its Chairman may direct the Standing Committee or the Director-General to place before the Corporation.
10. Regional Boards. — (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 ;
(d) (i) the Administrative Medical Officer or any other Officer directly in charge of the Employees’ State Insurance Scheme in the State or the Union Territory — ex-officio ;
(ii) the Regional Deputy Medical Commissioner of the Corporation — ex-officio ;
(e) one representative each of the employers and employees from the State or the Union Territory to be nominated by the Chairman of the Corporation in consultation with such organisations of the employers and the employees as may be recommended for the purpose by the State Government or the Union Territory ;
(f) members of the Corporation other than the Chairman and the Vice-Chairman and officials, if any, amongst those nominated by the Central Government under clause (c) of section 4 of the Act, residing in the State or the Union Territory — ex-officio ;
(g) members of the Medical Benefit Council nominated by the Central Government under clauses (e), (f) and (g) of section 10 of the Act, residing in the State or the Union Territory — ex-officio :
Provided that where the Chairman of the Corporation so considers it to be expedient, he may nominate such additional representatives of employers and employees, not exceeding three from each side with a view to providing for the adequate representation of important organisations not included in the nominations of the State Government or the Union Territory, and to maintaining the parity between the number of representatives of such employers and employees :
8. Mode of exercising 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.
9. Matters to be brought before the Corporation. — In addition to the matters which are, under any specific provision of the Act or the Central Rules, required to be placed before the 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 hospitals under section 59 ;
(f) any proposal to grant exemption under section 91 ;
(g) any proposal to enhance benefits under section 99 ;
(h) any other matter which the Corporation or its Chairman may direct the Standing Committee or the Director-General to place before the Corporation.
10. Regional Boards. — (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 ;
(d) (i) the Administrative Medical Officer or any other Officer directly in charge of the Employees’ State Insurance Scheme in the State or the Union Territory — ex-officio ;
(ii) the Regional Deputy Medical Commissioner of the Corporation — ex-officio ;
(e) one representative each of the employers and employees from the State or the Union Territory to be nominated by the Chairman of the Corporation in consultation with such organisations of the employers and the employees as may be recommended for the purpose by the State Government or the Union Territory ;
(f) members of the Corporation other than the Chairman and the Vice-Chairman and officials, if any, amongst those nominated by the Central Government under clause (c) of section 4 of the Act, residing in the State or the Union Territory — ex-officio ;
(g) members of the Medical Benefit Council nominated by the Central Government under clauses (e), (f) and (g) of section 10 of the Act, residing in the State or the Union Territory — ex-officio :
Provided that where the Chairman of the Corporation so considers it to be expedient, he may nominate such additional representatives of employers and employees, not exceeding three from each side with a view to providing for the adequate representation of important organisations not included in the nominations of the State Government or the Union Territory, and to maintaining the parity between the number of representatives of such employers and employees :
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