Introduction
The Employees’ State Insurance Corporation (ESIC) is a statutory body established by the Government of India to provide social security benefits to employees in the organized sector. The ESIC Self Declaration of Insured Woman is a form that is used to declare the insured woman’s eligibility for maternity benefits under the Maternity Benefit Act, 1961. This form is required to be filled by the insured woman and submitted to the ESIC office. In this article, we will discuss the steps involved in filling the ESIC Self Declaration of Insured Woman related to the Maternity Benefit Act.
How To Fill ESIC Self Declaration Of Insured Woman Related To Maternity Benefit Act
1. Visit the official website of the Employees’ State Insurance Corporation (ESIC).
2. Click on the ‘Self Declaration of Insured Woman’ link.
3. Enter your ESIC number and other required details.
4. Read the instructions carefully and click on the ‘Submit’ button.
5. Fill in the required details in the form such as name, address, date of birth, etc.
6. Enter the details related to the maternity benefit act such as the date of commencement of employment, the date of delivery, the number of children, etc.
7. Enter the details of the employer such as name, address, etc.
8. Enter the details of the medical practitioner such as name, address, etc.
9. Enter the details of the hospital where the delivery was done.
10. Enter the details of the insurance policy taken by the insured woman.
11. Enter the details of the bank account where the maternity benefit will be credited.
12. Enter the details of the nominee for the maternity benefit.
13. Enter the details of the witnesses.
14. Click on the ‘Submit’ button to submit the form.
15. Take a printout of the form for your records.
Recently the central government of India has made amendments to maternity benefits 1961 that maternity leaves increased to 26 weeks from 12 weeks. But as per the latest amendment which was made in July 2017 these 26 weeks of maternity leaves will be applicable to the first two children only. After that only 12 weeks will be given to pregnant women. But in order to get maternity benefits, every insured woman should submit an ESIC self declaration form related to maternity benefit act.
↓ Download ESIC Self Declaration Form Of Insured Woman Related To Maternity Benefit act
Sample Filled ESIC Self Declaration Of Insured Woman Related To Maternity Benefit Act
Also Read: Maternity Leaves Increased To 26 Weeks From 12 Weeks
What Is the Use Of ESIC Self Declaration Of Insured Woman Related To Maternity Benefit Act
The main reason behind ESIC self declaration related to maternity benefit act is there were some differences in family particulars present in ESIC IP portal and real time. So Employee State Insurance Corporation has made it mandatory to submit ESIC self declaration of insured woman to ESIC office. The insured woman needs to submit ESIC self declaration form related to maternity benefits act along with ESIC claim form 19.
Is is there in deviation in ESIC maternity declaration form then ESIC branch manager will ensure only 12 weeks payment to the insured woman and remaining payment will be made with in 14 days after verifying the details. These details will be verified based on employer records.
Note: For the first Two maternity benefits insured woman will get 26 weeks maternity leave and insured woman will be eligible to take 8 weeks maternity leave before the day of delivery.
For the insured woman who has two or more surviving children will get 12 weeks maternity leaves and she is eligible to take 6 weeks maternity leave before the day of delivery.
Any false representation of ESIC self declaration of insured woman related to maternity benefit act will lead to 6 months imprisonment or 2000 Rs fine.
How To Fill ESIC Self Declaration Of Insured Woman Related To Maternity Benefit Act
The Employees’ State Insurance Corporation (ESIC) provides maternity benefits to insured women under the Maternity Benefit Act, 1961. To avail these benefits, an insured woman needs to fill a self-declaration form. This article will guide you through the process of filling the ESIC self-declaration form.
Steps to Fill ESIC Self Declaration Form
- Visit the official website of ESIC and download the self-declaration form.
- Fill in the details such as name, address, date of birth, etc. of the insured woman.
- Provide the details of the employer such as name, address, etc.
- Mention the date of joining and the date of leaving the job.
- Provide the details of the maternity leave taken by the insured woman.
- Mention the date of delivery and the type of delivery.
- Provide the details of the child such as name, date of birth, etc.
- Attach the necessary documents such as medical certificate, etc.
- Sign the form and submit it to the ESIC office.
Documents Required
- Medical certificate issued by a registered medical practitioner.
- Proof of identity such as Aadhaar card, PAN card, etc.
- Proof of address such as ration card, electricity bill, etc.
- Proof of employment such as salary slips, appointment letter, etc.
- Proof of maternity leave such as leave application, etc.
- Proof of delivery such as discharge summary, etc.
Once the form is filled and submitted, the ESIC office will process the application and the insured woman will be eligible to receive the maternity benefits.
