Road Accident Coverage In ESI Scheme - Employee Benefits

Dear Sir,

One of our employees has met with a road accident recently. He is covered under the ESI Scheme.

Is it possible to claim the benefits in ESI? If 'yes', please guide me.

Regards,
Jothi

Hi Jothi,

Was he on duty at the time of the accident? Or was he outside of the company premises for official work and met with the accident? If yes, he can get the benefit from ESIC. For getting the benefit from ESIC, the employer has to submit one letter stating that all staff with a certificate from the State Police of the accident (if registered) and other ESIC forms.

Regards,

If one is covered under the ESIC Act and is on duty at the time of the accident, then they are definitely entitled to receive the benefits of the accident under this act. You have to submit Form No. 16 (intimation of accident) under this act.

Swati

Dear,

I agree with Tushar, please submit the accident report and obtain a copy of the FIR from the police. Also, submit all required forms so that his family can receive maximum compensation.

Regards,

Vipin
:icon1::icon1:

Hi,

Please check if the time he met an accident was during duty hours or elsewhere on the premises. If it happened on duty, then only can he claim for ESI benefits. An application letter, ESIC form, and police report are required to be submitted to the ESIC office for this benefit. First, you should verify the eligibility for this ESI scheme.

That's all from my side.

Thanks & Regards,
C. Bhushan Sharma

Dear Sir,

This is Shekhar Srivastava. I would like to know about the duty time in the case of an accident of an ESI-covered employee.

Seniors,

Please guide if an employee covered under ESI meets with an accident while coming to duty from home or while going home after finishing his duty.

Please clarify.
Prasad

Dear Mr. Prasad,

Basically, when an employee reaches and stays inside the premises of the organization, then only he is eligible for any benefits in case of an accident.

In some cases, it is also considered that if a person is using the same way/path for incoming and outgoing to the factory/organization and if he or she meets an accident outside the premises but on the same path which he or she usually uses to go and come to work, then in some cases, he or she is also eligible to benefit under the ESI scheme. However, this does not fall under general practice but is a highly special case that will be considered by the ESIC Authorities and Court.

This is my perspective. Let others share their thoughts on this.

Thanks & Regards,
C. Bhushan Sharma

Dear Jothi,

Greetings!

As per the ESI Act:

51C. Accidents happening while traveling in employer's transport
(1) An accident happening while an insured person is, with the express or implied permission of his employer, traveling as a passenger by any vehicle to or from his place of work shall, notwithstanding that he is under no obligation to his employer to travel by that vehicle, be deemed to arise out of and in the course of his employment if:
(a) the accident would have been deemed so to have arisen had he been under such obligation; and
(b) at the time of the accident, the vehicle
(i) is being operated by or on behalf of his employer or some other person by whom it is provided in pursuance of arrangements made with his employer, and
(ii) is not being operated in the ordinary course of public transport service.
(2) In this section "vehicle" includes vessel and an aircraft.

51D. Accidents happening while meeting emergency
An accident happening to an insured person in or about any premises at which he is for the time being employed for the purpose of his employer's trade or business shall be deemed to arise out of and in the course of his employment if it happens while he is taking steps, on an actual or supposed emergency at those premises, to rescue, succor, or protect persons who are, or are thought to be or possibly to be, injured or imperiled, or to avert or minimize serious damage to property.

Hi Prasad,

As you asked the question, that particular person will not be eligible for any benefits from the ESIC Department. However, he or she can receive free treatment from an ESIC doctor if they have already registered with one.

Regards,