THE EMPLOYEES’ STATE INSURANCE (GENERAL) REGULATIONS, 1950

OYEES’ STATE INSURANCE CORPORATION
——
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.

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 :