The Employees State Insurance (ESI) Scheme plays a vital role in providing healthcare and social security benefits to workers across India. In response to a query raised in the Lok Sabha, the Ministry of Labour and Employment shared the latest updates on the scheme’s enrollment, improvements, and steps taken to enhance service delivery.
As of March 31, 2024, a significant number of workers are enrolled under the ESI Scheme across India, including Tamil Nadu. This scheme covers employees earning up to Rs 21,000 per month (Rs 25,000 for persons with disabilities) in notified areas. The detailed state-wise and sector-wise statistics are annexed to the government response.
Awareness efforts for informal sector workers
The ESI Act applies to organized sectors and establishments employing 10 or more people. Workers in informal sectors remain largely uncovered. To address this gap, the Employees’ State Insurance Corporation (ESIC) actively promotes the scheme through its website and social media platforms to spread awareness about the benefits and eligibility criteria.
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Assessing effectiveness and improvements
The government regularly reviews the effectiveness of the ESI Scheme. To enhance healthcare services, ESIC has launched the Common Support Mission, which evaluates medical infrastructure, identifies gaps, and suggests improvements. Officials, including Medical Commissioners and Zonal Officers, visit health facilities frequently to ensure high standards of care. Regular meetings at the ESIC headquarters further aid in assessing the scheme’s performance.
Enhancing healthcare services
Efforts are underway to make ESI healthcare services more accessible and efficient. ESIC has implemented a Service Level Framework to uphold high standards of patient care and response times. This includes ongoing upgrades to medical infrastructure in identified gap areas.
Speeding up claim settlements
Delays in claims processing have been a concern for enrolled workers. To address this, ESIC has issued directives to ensure that medical reimbursement claims are settled within 30 days of receiving the bills. Field offices have been instructed to closely monitor and expedite the settlement process.
Conclusion
The ESI Scheme continues to evolve with a focus on improving healthcare accessibility, timely claim settlements, and expanding awareness to reach more workers. These updates highlight the government’s commitment to enhancing the social security framework for India’s workforce.
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