ESIC Non Contribution Since Employee Uses Spouse's Medical Facility

A lady contract employee's husband is working in a Central Public Sector Undertaking and hence she avails all medical facilities, as a spouse, from the employer of her husband (i.e., PSU). The medical facilities availed from the said PSU are definitely better than those of ESIC. As a rule, the medical facility should be availed from only one organization, i.e., either from the husband's employer or her own employer.

My question is, how can she declare this fact (regarding her availing medical facility from her husband's employer) to her Immediate Employer/Principal Employer/ESIC Authorities so that her ESI contribution is not deducted from her salary.

Experts and seniors, please guide me in this matter.

Regards,
BB Behera

1. Sir, by being an insured person/insured woman as a result of coverage under the ESI Act, 1948, and rules/regulations framed thereunder, the wife of the employee serving in a CPSU has her own rights and entitlements for various benefits under the said Act. She may be entitled to maternity benefits, temporary disablement, permanent disablement, and various other benefits. Her dependants may also be entitled (in the case of accidental death due to or in the course of employment) to dependant benefits and some other benefits. His spouse, who is working in the CPSU, may not be entitled to all such benefits. Coverage of an employee under the provisions of the above Act and rules/regulations is based on the fact of insurable employment and the level of wages he/she is receiving.

2. Under the above Act and rules/regulations, there are no provisions for the exemption of such employees from the purview of the said Act. Even if both the husband and wife are covered under the said Act and rules/regulations as an "employee/insured woman," even then there is no provision for exemption of the wife from the coverage of the said Act/rules and regulations. Social security coverage and benefits are compulsory in nature and not optional.

Dear BB Behera,

It is not a question of availing any outside medical facility by an IP, but it is an insurance cover available under ESI Scheme to IP which takes care of the liability of the Employer in case of Temporary/Permanent Disablement to IP. You cannot do away with the insurance cover by saying medical facility is available to IP from other sources. I agree with HarshKumarji in this regard.