I would like all of your advice on the below-mentioned queries:
1. In case an employee meets with an accident, what is the maximum time within which an accident can be reported to ESIC? According to the ESIC act, accidents have to be reported within 24 hours to the branch office.
2. In case we have not reported any accidents to ESIC until now, can we report backdated cases to them (some are 3-4 months old)? If yes, what is the process to follow?
3. If an employee is not covered under ESIC, what is the process to follow for such cases, considering other acts?
4. What type of accidents do we have to report? How can we distinguish which accidents should be reported or not?
5. Do road accidents have to be reported to ESIC, just to be on the safer side?
6. What forms need to be submitted to the local ESIC office?
I would appreciate your prompt response to this.
From India, New Delhi
Acknowledge(0)
Amend(0)
181. In case an employee meets with an accident, what is the maximum time within which an accident can be reported to ESIC? According to the ESIC act, accidents have to be reported within 24 hours to the branch office.
2. In case we have not reported any accidents to ESIC until now, can we report backdated cases to them (some are 3-4 months old)? If yes, what is the process to follow?
3. If an employee is not covered under ESIC, what is the process to follow for such cases, considering other acts?
4. What type of accidents do we have to report? How can we distinguish which accidents should be reported or not?
5. Do road accidents have to be reported to ESIC, just to be on the safer side?
6. What forms need to be submitted to the local ESIC office?
I would appreciate your prompt response to this.
From India, New Delhi
Acknowledge(0)Amend(0)
Mr. Ranjeet,
Point 1: Employees are covered under ESIC. If an accident occurs, it is a statutory liability for the employer to submit the accident report within 24 hours from the date of the accident. Alternatively, proof of FIR from the Police Department can be obtained in case of a delay due to justifiable grounds. Submitting reports on back dates is not encouraged by ESIC. In such cases, medical expenses for hospitalization can be claimed, but sickness benefits cannot be legally claimed.
Point 2: Write a letter to the ESIC Branch Manager/Commissioner/Assistant Regional Director explaining the exact situation causing the delay in submitting the Accident Report and, if necessary, the FIR. If they are convinced, a domestic inquiry will take place. If legal action is preferred, the liability will be on the employer to pay benefits to the employee if the counter documents are not justifiable.
Point 3: Even if an employee is not covered under ESIC, it is still the employer's liability to provide compensation for any injury that occurs. Consider a Women's compensation policy offered by various insurance companies to cover all employees not under ESI preview. This helps in avoiding liability risks for the employer. Additionally, opt for group medical claim policies and accidental policies. It is advisable to go for Workmen's Policy, especially for employees in risky or hazardous roles.
Point 4: Submit the accident report using Form-16, ensuring all necessary fields are clearly specified.
Point 5: Road accidents can only be claimed if they occur during the course of employment. If an employee is traveling on the routine route to the office, insurance can be claimed, provided an FIR is filed.
Point 6: In the IT revolution, there is no need to submit any forms to ESIC other than Form 37 Employment/Re-Employment to avail medical treatment.
I hope I have clarified to the best of my knowledge. Seniors, please share your valuable advice.
Regards,
Naresh Gadde
From India, Hyderabad
Acknowledge(0)Amend(0)
Point 1: Employees are covered under ESIC. If an accident occurs, it is a statutory liability for the employer to submit the accident report within 24 hours from the date of the accident. Alternatively, proof of FIR from the Police Department can be obtained in case of a delay due to justifiable grounds. Submitting reports on back dates is not encouraged by ESIC. In such cases, medical expenses for hospitalization can be claimed, but sickness benefits cannot be legally claimed.
Point 2: Write a letter to the ESIC Branch Manager/Commissioner/Assistant Regional Director explaining the exact situation causing the delay in submitting the Accident Report and, if necessary, the FIR. If they are convinced, a domestic inquiry will take place. If legal action is preferred, the liability will be on the employer to pay benefits to the employee if the counter documents are not justifiable.
Point 3: Even if an employee is not covered under ESIC, it is still the employer's liability to provide compensation for any injury that occurs. Consider a Women's compensation policy offered by various insurance companies to cover all employees not under ESI preview. This helps in avoiding liability risks for the employer. Additionally, opt for group medical claim policies and accidental policies. It is advisable to go for Workmen's Policy, especially for employees in risky or hazardous roles.
Point 4: Submit the accident report using Form-16, ensuring all necessary fields are clearly specified.
Point 5: Road accidents can only be claimed if they occur during the course of employment. If an employee is traveling on the routine route to the office, insurance can be claimed, provided an FIR is filed.
Point 6: In the IT revolution, there is no need to submit any forms to ESIC other than Form 37 Employment/Re-Employment to avail medical treatment.
I hope I have clarified to the best of my knowledge. Seniors, please share your valuable advice.
Regards,
Naresh Gadde
From India, Hyderabad
Acknowledge(0)Amend(0)
Dear Naresh,
Thank you very much for your valuable explanation. I would also like to clarify that we have never filed any FIR for such cases, but due to some audit risk, we want to file the same in the ESIC office. Up to now, we have paid all the wages to employees for their absence and all the medical expenses incurred by the employer only.
Could you please elaborate on what we have to draft in a letter to the ESIC office because this is a relatively new thing for me? Regarding the purview over road accidents while coming on shift and going back from shift, it is no longer a concept in ESIC. What type of inquiry can it be?
In the case where an employee has not reported to work for only 1-2 days, do we need to report such cases to ESIC? Please suggest. We also appreciate views from other senior members as well.
Regards,
Ranjeet
From India, New Delhi
Acknowledge(0)Amend(0)
Thank you very much for your valuable explanation. I would also like to clarify that we have never filed any FIR for such cases, but due to some audit risk, we want to file the same in the ESIC office. Up to now, we have paid all the wages to employees for their absence and all the medical expenses incurred by the employer only.
Could you please elaborate on what we have to draft in a letter to the ESIC office because this is a relatively new thing for me? Regarding the purview over road accidents while coming on shift and going back from shift, it is no longer a concept in ESIC. What type of inquiry can it be?
In the case where an employee has not reported to work for only 1-2 days, do we need to report such cases to ESIC? Please suggest. We also appreciate views from other senior members as well.
Regards,
Ranjeet
From India, New Delhi
Acknowledge(0)Amend(0)
Dear Ranjit,
I am writing a covering letter to the dispensary regarding the reimbursement of bills incurred for the hospitalization of employees. I have enclosed the original medical bills and other necessary documents to be submitted to the dispensary.
Please note that claims should be processed through the employee only, as the employer is no longer connected to this process. Kindly advise the employee to meet with the medical director/Assistant Director/Medical Superintendent for reimbursement, and please do not involve the ESI authorities as the expenses have been covered by the employer.
I request the employee to provide a detailed account of their situation and feelings that occurred during the hospitalization. It is crucial to convince the authorities for reimbursement, which typically covers around 75% to 50%, depending on the circumstances.
Below is a simple letter template for your reference:
To
The Medical Director
ESIC
Dear Sir,
Sub: Reimbursement of medical expenses reg
Ins. No: , Emp. Code **
Name of Establishment
With reference to the above subject, a total amount of Rs. [amount spent] was incurred towards hospitalization due to an unavoidable situation requiring treatment at ESI hospitals on [date]. Kindly reimburse the amount for medical expenses on humanitarian grounds.
Please take necessary action on the above subject.
Yours sincerely,
[Your Name]
Feel free to expand on this draft further if needed, as my English drafting skills are not very strong.
Regarding accidents that occur on the premises, they are considered during the course of employment, as per recent amendments in the Act. You can verify this information from the ESI or other reliable sources. It is important to note that an FIR should be filed in the case of a road accident that occurs in a public place, as it serves as valid documentation of the incident.
Thank you,
Naresh
From India, Hyderabad
Acknowledge(0)Amend(0)
I am writing a covering letter to the dispensary regarding the reimbursement of bills incurred for the hospitalization of employees. I have enclosed the original medical bills and other necessary documents to be submitted to the dispensary.
Please note that claims should be processed through the employee only, as the employer is no longer connected to this process. Kindly advise the employee to meet with the medical director/Assistant Director/Medical Superintendent for reimbursement, and please do not involve the ESI authorities as the expenses have been covered by the employer.
I request the employee to provide a detailed account of their situation and feelings that occurred during the hospitalization. It is crucial to convince the authorities for reimbursement, which typically covers around 75% to 50%, depending on the circumstances.
Below is a simple letter template for your reference:
To
The Medical Director
ESIC
Dear Sir,
Sub: Reimbursement of medical expenses reg
Ins. No: , Emp. Code **
Name of Establishment
With reference to the above subject, a total amount of Rs. [amount spent] was incurred towards hospitalization due to an unavoidable situation requiring treatment at ESI hospitals on [date]. Kindly reimburse the amount for medical expenses on humanitarian grounds.
Please take necessary action on the above subject.
Yours sincerely,
[Your Name]
Feel free to expand on this draft further if needed, as my English drafting skills are not very strong.
Regarding accidents that occur on the premises, they are considered during the course of employment, as per recent amendments in the Act. You can verify this information from the ESI or other reliable sources. It is important to note that an FIR should be filed in the case of a road accident that occurs in a public place, as it serves as valid documentation of the incident.
Thank you,
Naresh
From India, Hyderabad
Acknowledge(0)Amend(0)
Dear Naresh,
Thanks a ton for the valuable guidance. I can see that we are only interested in reporting backdated accident cases in ESIC. We don't want to seek reimbursement or anything like that. I would appreciate the views of other members as well.
Regards,
Ranjeet
From India, New Delhi
Acknowledge(0)Amend(0)
Thanks a ton for the valuable guidance. I can see that we are only interested in reporting backdated accident cases in ESIC. We don't want to seek reimbursement or anything like that. I would appreciate the views of other members as well.
Regards,
Ranjeet
From India, New Delhi
Acknowledge(0)Amend(0)
1- In case an employee meets with an accident, what is the maximum time within which an accident can be reported to ESIC? According to the ESIC Act, an accident has to be reported within 24 hours to the branch office.
As per Regulation 65, the insured person sustaining injury needs to inform (notice - oral or written) the employer or his representative, and upon receiving the notice, the employer needs to make an entry in Form 15 - accident register. As per Reg. 68, the report of the accident has to be sent to the local office and ESIS IMO in Form 16. Information on the 'period' is contradictory. In the ESI Act by K.P. Srivastava, 3rd edition, 1986, on p. 723, the period mentioned is 24 hours, while in the local office manual, 3rd edition, year 2000, the period mentioned is 48 hours. I also have another publication, "A Brief Note on ESI Act," published by SRO, ESIC, Vadodara which informs the period to be 48 hours on p.13. I think 48 hours is the correct answer. These 48 hours are counted after the management comes to know.
2- In case we have not reported any accident to the ESIC until now, can we report now the backdated cases to them (some are 3-4 months back)? If yes, what is the process to follow?
Yes, you can, giving valid reasons thereof; once the local office receives the information, the Local Office Manager has to make an inquiry to verify the details. The manager will then decide whether to admit the case or not as an employment injury. If the worker has any remnant permanent disability, he can claim relevant benefits under the Act. If the accident is not reported by the management, he cannot claim any benefits. In that case, he can directly make an application in the ESI Court to claim benefits.
As you claim you do not intend to claim any cash benefits, then there is no meaning to send the form now. There is no logic. The logic may be to get the accident registered so as to get reflected in the data of accidents. The forum for this is the Factory Act where these data are compiled. Form 16 of the Factory Act should be filled up and sent instead of ESIC in such circumstances. Still, if your management is insisting, it is better you first visit the Manager, Local Office, explain the situation, and seek his guidance before taking any action.
3- In case an employee is not covered under ESIC, what is the process to follow for such cases keeping in mind other acts?
It is the Factory Act under which the management needs to intimate the Factory Inspectorate. If the employee is not covered under the ESI Act, then he is covered under the E.C. Act. Under Section 10-B of the Act, the employer is required to send a report to the Compensation Commissioner within 7 days of the incident.
4- What type of accident do we have to report? How can we distinguish that this accident should be reported or not?
Please refer to Sec. 88, 88-A, and 89 of the Factory Act.
In E.C. Act, it is either death or serious bodily injury.
In the ESI Act, information of the personal injury sustained by the insured person, the form has to be sent.
5- Whether road accidents have to be reported in ESIC on the safer side?
After the latest amendments, road accidents during commuting to and from work are considered employment injuries and need to be reported.
6- What are the forms to be submitted to the local ESIC office?
Form 16 in case of an accident and 16-A in case of an occupational disease.
I hope this will help you decide the course of action on your part.
From India, Coimbatore
Acknowledge(0)Amend(0)
As per Regulation 65, the insured person sustaining injury needs to inform (notice - oral or written) the employer or his representative, and upon receiving the notice, the employer needs to make an entry in Form 15 - accident register. As per Reg. 68, the report of the accident has to be sent to the local office and ESIS IMO in Form 16. Information on the 'period' is contradictory. In the ESI Act by K.P. Srivastava, 3rd edition, 1986, on p. 723, the period mentioned is 24 hours, while in the local office manual, 3rd edition, year 2000, the period mentioned is 48 hours. I also have another publication, "A Brief Note on ESI Act," published by SRO, ESIC, Vadodara which informs the period to be 48 hours on p.13. I think 48 hours is the correct answer. These 48 hours are counted after the management comes to know.
2- In case we have not reported any accident to the ESIC until now, can we report now the backdated cases to them (some are 3-4 months back)? If yes, what is the process to follow?
Yes, you can, giving valid reasons thereof; once the local office receives the information, the Local Office Manager has to make an inquiry to verify the details. The manager will then decide whether to admit the case or not as an employment injury. If the worker has any remnant permanent disability, he can claim relevant benefits under the Act. If the accident is not reported by the management, he cannot claim any benefits. In that case, he can directly make an application in the ESI Court to claim benefits.
As you claim you do not intend to claim any cash benefits, then there is no meaning to send the form now. There is no logic. The logic may be to get the accident registered so as to get reflected in the data of accidents. The forum for this is the Factory Act where these data are compiled. Form 16 of the Factory Act should be filled up and sent instead of ESIC in such circumstances. Still, if your management is insisting, it is better you first visit the Manager, Local Office, explain the situation, and seek his guidance before taking any action.
3- In case an employee is not covered under ESIC, what is the process to follow for such cases keeping in mind other acts?
It is the Factory Act under which the management needs to intimate the Factory Inspectorate. If the employee is not covered under the ESI Act, then he is covered under the E.C. Act. Under Section 10-B of the Act, the employer is required to send a report to the Compensation Commissioner within 7 days of the incident.
4- What type of accident do we have to report? How can we distinguish that this accident should be reported or not?
Please refer to Sec. 88, 88-A, and 89 of the Factory Act.
In E.C. Act, it is either death or serious bodily injury.
In the ESI Act, information of the personal injury sustained by the insured person, the form has to be sent.
5- Whether road accidents have to be reported in ESIC on the safer side?
After the latest amendments, road accidents during commuting to and from work are considered employment injuries and need to be reported.
6- What are the forms to be submitted to the local ESIC office?
Form 16 in case of an accident and 16-A in case of an occupational disease.
I hope this will help you decide the course of action on your part.
From India, Coimbatore
Acknowledge(0)Amend(0)
Dear All, Let me know the registers to be maintained by employer under ESIC scheme Regards Lokesh.V
From India, Bangalore
Acknowledge(0)Amend(0)
From India, Bangalore
Acknowledge(0)Amend(0)
Dear Mr.PTRC, Can you please send me the court case or latest amendment where it was decided that road accident have to be reported. Regards Ranjeet
From India, New Delhi
Acknowledge(0)Amend(0)
From India, New Delhi
Acknowledge(0)Amend(0)
For SR.NO.6 Accident details to be furnished to ESI in the FORM NO. 12 instead of FORM NO. 16 as form 16 replaced by form no. 12. Krishna Yadav
From India, Mumbai
Acknowledge(0)Amend(0)
From India, Mumbai
Acknowledge(0)Amend(0)
Dear All,
I would like all of your advice on the below-mentioned query. In my factory, a worker was working, and suddenly he fell down, but no physical injury occurred, neither did any cut marks appear on his body. We gave him first aid and then admitted him to the ESIC Dispensary, where he was referred to an ESIC affiliated private hospital and was admitted there for four days. Based on the non-appearance of any sign or mark of injury, we did not send his accident report. Now, the worker has raised his objection that we should treat this incident as an accident, and subsequently, the concerned Branch Manager of ESIC also directed us to send a report explaining why we did not inform him in the required form (Accident Report).
My question is: was this a case of an accident? If yes, then are we required to send a report for any kind of incident where we don't find any cut marks, pain, or any signs of an accident?
Regards,
Anand
From India, Ranchi
Acknowledge(0)Amend(0)
I would like all of your advice on the below-mentioned query. In my factory, a worker was working, and suddenly he fell down, but no physical injury occurred, neither did any cut marks appear on his body. We gave him first aid and then admitted him to the ESIC Dispensary, where he was referred to an ESIC affiliated private hospital and was admitted there for four days. Based on the non-appearance of any sign or mark of injury, we did not send his accident report. Now, the worker has raised his objection that we should treat this incident as an accident, and subsequently, the concerned Branch Manager of ESIC also directed us to send a report explaining why we did not inform him in the required form (Accident Report).
My question is: was this a case of an accident? If yes, then are we required to send a report for any kind of incident where we don't find any cut marks, pain, or any signs of an accident?
Regards,
Anand
From India, Ranchi
Acknowledge(0)Amend(0)Looking for something specific? - Join & Be Part Of Our Community and get connected with the right people who can help. Our AI-powered platform provides real-time fact-checking, peer-reviewed insights, and a vast historical knowledge base to support your search.