SHORT NOTE ON LEGAL RESEARCH
This Research note is concerned about claiming money from the Employment State Insurance (ESI) policy.
National Workshop on Environmental & Consumer Laws organized by Voice & cuts in 1990 for rights of the litigants. In this workshop Chief Justice PN Bhagwati invited as Chief Guest. Chief Justice PN Bhagwati said it is useless to expect justice from the persons at higher level.
The Employees State Insurance Act, 1948 provide for certain benefits to employees in case of sickness, maternity & employment injury & to make provision for certain other matter in relation thereof.
There is no budgetary allocation for the ESI by the Government of India. The Employees’ State Insurance Act, 1948 provide for certain benefit to employee in case of sickness, maternity & employment injury & to make provision for certain other matter. Section 46 of ESI act provide for the benefits of ESI policy which involve Sickness benefits & medical benefits. Sickness benefit for employee during the period of sickness at the rate of 70% of wages is payable to insured workers during the period of certified sickness for maximum period of 91 days in a year.
ESI corporation had introduced a new scheme called “Rajiv Gandhi Shramik Kalyan Yojna which is a national level policy. The policy duration is 3 years. During the insurance period in case of unemployment or shut down of business allowance were given equal to 50% of wages for maximum period of up to 2 years. A scheme of unemployment allowance applicable to an insured period under ESI.
Atal Beema Vyakti Kalyan Yojana is a 3 months insurance policy. In case of unemployment allowance in case compensation were given equal to 25% wages for up to 90 days. Those employees are registered to ESI policy were also entitled to get benefit from the Atal Beema Vyakti Kalyan Yojana.
International Labour Organisation (ILO) adopted by the General Conference of the International Labour Organisation convened at Geneva. Medical and sickness benefit were provided under recommendation number 134 of ILO.
He is required to undergo curative or preventive medical care.
He is isolated for the purpose of quarantine.
He is placed under medical supervision for the purpose of rehabilitation.
He is on convalescent leave.
As per the definition of World Health Organisation, a complete state of physical, mental & social well being & not merely the absence of disease or infirmity.
Section 2(20) of ESI act, provide definition of sickness, a condition which require medical treatment & attendance & necessities abstention from work on medical grounds. Treatment can be curative or preventive in nature.
Regulation 100 of ESI (General) Regulation, 1950, the Director General may be special or general order relax any regulation under such circumstances and subject to such condition. Section 75 of ESI provided that matter to be decided by the Employees’ Insurance Court. ESI covers under the Consumer protection act. Employer is a consumer for having bought/availed the insurance policy of ESI for making premium. Employee is also a consumer for being beneficiary of the insurance policy. Aggrieved shall serve legal notice to ESI under ESI court or Consumer Court. Section 75(g) provides that Special court has jurisdiction to solve dispute between Employees & ESI.
On claiming insurance money in Consumer court ESI takes the plea that beneficiary is a commercial entity and not a consumer. In the case of Regional Provident Fund Commissioner V. Shiv Kumar Joshi the court held that definition of consumer under the act includes not only the person who hire the services for consideration but also the beneficiary, for whose benefits such services are hired. The policy is a contract of indemnity and not a source of profit for ESI to make easy money by simply collecting money from Employees & Employers.
National Commissioner Ruling where Commission held that policy in a contract of indemnity and not a source of profit generation.
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