Introduction:

The Employee State Insurance (ESI) scheme requires individuals to submit necessary forms via the ESIC portal to file claims. Key forms include Form 72, Form 23, Form 24, among others.

The ESI scheme is a health insurance initiative aimed at protecting workers during medical emergencies such as maternity, sickness, physical disabilities, and injuries related to employment that affect earning capacity. This is a self-financing social security scheme with employers contributing 4.75% and employees contributing 1.75% of wages.

Guided by the ESI Act, 1948, the scheme is managed by the Employees’ State Insurance Corporation under the Ministry of Labour and Employment. It targets workers with a monthly income of Rs.21,000 or less, offering a variety of benefits like medical, maternity, sickness, pension, dependent care, disablement, and funeral expenses.

Various ESI Forms

Beneficiaries must fill out and submit relevant forms, available on the ESIC portal, to access ESI scheme benefits. Below are some of the forms:

• Form 72: Request for duplicate ESIC smart card
• Form 23: Life certificate for permanent disablement benefit
• Form 24: Declaration and certificate for disablement benefit
• Form 22: Claim for funeral expenses
• Form 20: Maternity benefits claim after the insured's death
• Form 19: Maternity benefits claim and work notice
• Form 16: Claim for periodical disablement payment
• Form 15: Claim for dependent benefits
• Form 14: Claim for permanent disability benefit
• Form 12: Accident report from employer
• Form 11: Accident book
• Form 9: Claim for sickness and temporary disablement/maternity benefit
• Form 6: Employee register
• Form 5A: Advance ESIC payment for beneficiary contribution
• Form 5: Contribution return by employee
• Form 3: Declaration return form
• Form 2: Amendment declaration form
• Form 1: Declaration form
• Form 01: Employer's registration form
• Form 1A: Family declaration form
• Form 142: Claim for earnings and conveyance allowance compensation
• Form 105: Certificate of entitlement
• Form 86: Certificate of employment
• Form 63: Declaration for legal heir payment
• Form 53: Change application for insured person's details
• Form 37: Re-employment or continuous employment certificate
• Form 32: Wage-contributory record for disablement benefit

These forms are downloadable from the ESIC portal, facilitating claims under the ESI scheme.

ESI Scheme Registration Process

Companies employing over 10 individuals must register under the ESI scheme. This registration is available on the ESIC portal at www.esic.in, requiring submission of specific details. After registration, a 17-digit code is emailed to the employer with a registration form and ESIC login credentials. Employers can use these to log in and provide the needed information. For registration issues, employers can reach ESIC IT support at itcare@esic.in.