Introduction
The Employees’ State Insurance Corporation (ESIC) is a social security organization that provides financial and medical benefits to employees in India. It is managed by the Ministry of Labour and Employment, Government of India. One of the benefits provided by ESIC is the maximum claim limit, which is the maximum amount of money that can be claimed by an employee in case of an illness or injury. This limit is set by the ESIC and is based on the employee’s salary and other factors. In this article, we will discuss the maximum claim limit in ESIC and how it is determined.
What is the Maximum Claim Limit in ESIC
The maximum claim limit in ESIC is Rs. 21,000 per month.
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Under the Employee State Insurance Act 1948 there is no maximum limit for ESIC claim amount for getting medical treatment. If an ESIC member fulfills all the eligibility criteria for a certain medical treatment then he or she will get complete treatment for free of cost. Insured members can check their eligibility for various benefits under the ESIC scheme at ESIC IP portal by using their IP number.
Other than medical benefits in ESIC for remaining benefits there is a certain limit for the claim amount, here are the details.
| ESIC Benefit | Claim Limit |
| For medical benefits | No claim limit |
| Sickness Benefit | 70% of wages will be paid to the insured person during the certified sickness period, maximum for 91 days in a year. |
| Extended Sickness Benefit | Sickness benefit will be extended to 2 years in the case of 34 malignant and long term diseases and 80% of wages will be paid to the insured worker. |
| Enhanced Sickness Benefit | Full wages will be paid to male and female workers for 7 days & 14 days respectively during sterilization. |
| Temporary Disablement | 90% of wages will be paid as long as disablement continues. |
| Permanent Disablement | 90% of wages will be paid as monthly payment depending on the based on the loss of earning capacity. |
| Dependents Benefit | 90% of wages as a monthly payment in case of occupational hazards. |
| Funeral Expenses | 15000 Rs |
| Atal Bimit Vyakti Kalyan Yojana Scheme | 25% of daily earnings will be paid to the unemployed insured person for 90 days. |
| Maternity Benefit | 100% of wages for 26 weeks. |
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What is the Maximum Claim Limit in ESIC?
The Employees’ State Insurance Corporation (ESIC) is a social security organization that provides medical and financial benefits to employees in India. It is managed by the Ministry of Labour and Employment, Government of India. The ESIC provides a range of benefits to its members, including medical care, maternity benefits, disability benefits, and death benefits. One of the benefits provided by the ESIC is the maximum claim limit.
The maximum claim limit is the maximum amount of money that an employee can claim from the ESIC in a given year. The maximum claim limit is determined by the employee’s salary and the number of years of service. The maximum claim limit for an employee with a salary of Rs. 15,000 per month and 5 years of service is Rs. 1,50,000. This amount can be claimed for medical expenses, maternity benefits, disability benefits, and death benefits.
The maximum claim limit is revised every year by the ESIC. The revised amount is based on the inflation rate and the cost of living. The revised amount is applicable to all employees who are members of the ESIC. The revised amount is also applicable to the dependents of the employee.
The maximum claim limit is an important benefit provided by the ESIC. It helps employees to cover their medical expenses and other benefits in case of an emergency. It also helps to protect the financial security of the employee and his/her family.
