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Declaration Forms in Form-1 to be filled in properly for registration
of employees. The Form should contain all relevant information asked
for in respect of each coverable employee and submitted to the Branch
Office concerned within ten days of entry into insurable employment.
Before filling Declaration Form it should be ensured that the worker was
not insured under the ESI Scheme in the past. If so, the old Insurance No. should
be indicated in the Form.
As a alternative, Declaration Form can be submitted online through Login/Password provided to employers, which can be accessed at |
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All fresh entrants into the insurable employment should be
advised to furnish two post card size family photographs (of IP and dependants only)
with the Declaration Form to the appropriate Branch Office. In case of
online submission of Declaration Form Photographs of IP, Family, IPs Signature can be
uploaded through Employer's Login.
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Temporary Identification Certificate annexed to the Declaration Form may be
obtained from the Branch Office Manager with his seal and signature and issued to
the insured employee forthwith. In case of online submission, TIC can be permitted
to print at Employer's end,subject to complete data and photographs uploaded.
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On receipt of Permanent Identity
Cards from the Local Office the same
should be passed on to the insured
employees without delay.
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In order to facilitate a newly
insured person to avail medical
benefit under the Scheme in absence
of an identity certificate!'
identity card, a 'Certificate of
Employment' may be issued to the
insured person in Form 86. This
certificate, issued by the employer,
remains valid for three months but
can be revalidated for a further
period not exceeding 3 months.
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Submit an “Accident Report” to the
Local Office/ESI dispensary
concerned immediately in respect of
accidents that could result in death
or disablement and within 24 hours
of its Occurrence otherwise. Minor
accidents which do not cause absence
from work need not be reported.
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Whenever events, such as, marriage
birth or death entails any additions
or deletions in the family
particulars of an insured person,
the requisite information has to be
conveyed by the employer in 'Form
1-B to the Branch Office within 15
days from the occurrence of such a
change.
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On re-entry of a person into
insurable employment or, where an
insured person had been disentitled
to medical benefit due to non
submission of Return of
Contribution, the employer may issue
a 'Certificate of re-employment' or
'continuing employment' to such
person in Form ESIC 37. This
certificate will enable the Insured
Person to avail medical benefit from
the date of issuance. |
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If an insured employee needs a
change of dispensary due to any
valid reasons an application may be
mad in Form 'ESIC53'. |
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Accident Report in respect of an
insured employee may be submitted
immediately in case of death or
serious injury and in other cases
within 24 hours of an accident. For
this Form 16 be filled up in
triplicate and one copy each
forwarded to the Branch Office and
Dispensary: Form-32 may also be
submitted along with the accident
report in case an accident has
occurred prior to the commencement
of the first Benefit Period of the
IP to enable the Branch Office
determine the rate of Disablement
Benefit. |
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Whenever an Insured Person goes out
of station on duty or leave he may
be issued a certificate in Form ESIC
105. This will enable him and his
family to avail medical treatment in
ESI Dispensaries/hospitals
elsewhere, if available at such
outstation. |
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If any insured person is in need of
a duplicate identity care, an
application may be made to the
Branch Office Manager in Form ESIC
72. |
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Return of Contribution may be
submitted in time with all relevant
particulars neatly filled up against
all insured persons with Insurance
Numbers in ascending order.
Remember, any inadvertent deletion
may debar an Insured Person from
availing benefit due to him/her.
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