ESIC Cash Benefits Your Employees Can Claim: Sickness, Maternity, Injury and Job Loss
ESIC pays sickness benefit at 70% of wages for up to 91 days a year (78 contribution days needed), maternity benefit at full wages for 26 weeks (70 days in two contribution periods), disablement at 90% with no contribution condition, and unemployment relief: ABVKY at 50% for 90 days, valid to 30 June 2027, and RGSKY for closures and retrenchment.
Employees covered by ESI pay 0.75% of wages and their employer 3.25%, yet most of them know only about the medical card. The scheme also pays cash when they are ill, pregnant, injured or out of work. HR teams field these questions, so here is what each benefit pays and what the employee needs to qualify.
How eligibility works: contribution and benefit periods
ESI runs on two six-month cycles. Contributions paid in one period decide the cash benefits in a later one.
| Contribution period | Matching benefit period |
|---|---|
| 1 April to 30 September | 1 January to 30 June of the next year |
| 1 October to 31 March | 1 July to 31 December |
So a worker's April to September 2026 contributions decide sickness benefit from January to June 2027. Benefit amounts are based on the average daily wage on which contributions were paid in the relevant period.
The benefits at a glance
| Benefit | Rate | Duration | Contribution condition |
|---|---|---|---|
| Sickness | 70% of wages | Up to 91 days a year | 78 days in the corresponding contribution period |
| Extended sickness | 80% of wages | Up to 2 years, for 34 listed long-term diseases | Longer insured service, as ESIC specifies |
| Enhanced sickness (sterilisation) | 100% of wages | 7 days (vasectomy), 14 days (tubectomy) | As for sickness |
| Maternity | 100% of wages | 26 weeks, plus one month on medical advice | 70 days in the two preceding contribution periods |
| Miscarriage or medical termination | 100% of wages | 6 weeks | As for maternity |
| Temporary disablement | 90% of wages | While the disablement lasts | None |
| Permanent disablement | 90% of wages, scaled to loss of earning capacity | Monthly, for life | None |
| Dependants' | Up to 90% of wages, shared | Monthly pension | None |
| Funeral expenses | Actual cost up to ₹20,000 | One-time | None |
| Confinement expenses | ₹15,000 per case | Where ESI facilities are unavailable | Insured woman, or insured man for his wife |
Sickness benefit is not paid for the first two days of a spell of sickness (the waiting period), unless the spell starts within 15 days of an earlier spell for which sickness benefit was paid (rule 55 of the ESI (Central) Rules, 1950).
Sickness, maternity and temporary disablement cannot be drawn together for the same days. The employee chooses one.
Maternity details HR gets asked about
- ✓An insured woman who adopts, or a commissioning mother, gets 12 weeks from the date the child is handed over.
- ✓If the mother dies during the benefit period leaving a child, the benefit is paid for the whole period for the child's care.
- ✓A woman eligible for ESIC maternity benefit cannot also claim it from the employer. The employer's duty under the Code is for women not covered by ESIC.
Unemployment: two schemes, both running
Atal Beemit Vyakti Kalyan Yojana (ABVKY). Started as a pilot on 1 July 2018 and extended several times, it is now valid until 30 June 2027.
- ✓Relief: 50% of wages for up to 90 days, once in a lifetime.
- ✓Conditions: at least one year of insurable employment immediately before losing the job, and at least 78 days of contributions in the completed contribution period within the 12 months before unemployment.
- ✓Payment falls due 30 days after the date of unemployment.
Rajiv Gandhi Shramik Kalyan Yojana (RGSKY). In force since 1 April 2005.
- ✓For workers insured two years or more who lose their job through closure of the establishment, retrenchment, or permanent invalidity of 40% or more from a non-work injury.
- ✓Allowance: 50% of wages for the first 12 months, then 25% for the next 12 months, in the worker's lifetime.
- ✓Medical care continues for the worker and family while the allowance is paid, and ESIC pays fees for vocational training.
After retirement
A worker insured for at least five years who retires, takes VRS or premature retirement can keep ESI medical care for self and spouse by paying ₹600 a year in advance.
A worked example
A Surat textile processing unit employs a machine operator on ₹18,000 a month. From April to September 2026, ESI contributions were paid on ₹1,08,000 of wages for 180 days.
- Average daily wage: ₹1,08,000 / 180 = ₹600.
- He contributed for more than 78 days, so he qualifies for sickness benefit from January to June 2027.
- In February 2027 he has typhoid and is certified unfit for 20 days. This is a fresh spell, so the first two days are the unpaid waiting period and 18 days are paid. Sickness benefit: 70% x ₹600 x 18 = ₹7,560.
- If he lost his job in a closure in August 2027 after more than a year of insurable employment, with 78 days of contributions in the last completed period, ABVKY would pay up to 50% x ₹600 x 90 = ₹27,000, using the wage figure ESIC works out for that claim.
His colleague on ₹16,000 a month who delivers a baby in March 2027 would get 26 weeks at her full average daily wage, provided she had 70 contribution days across the two preceding contribution periods.
What the employer does
- ✓Pay contributions on time, so the employee's days are recorded.
- ✓Treat certified sickness, maternity and disablement absences as leave without pay unless your policy tops up wages, since ESIC pays the cash benefit.
- ✓Do not dismiss or reduce the pay of an employee while they are receiving sickness, maternity or disablement benefit.
- ✓Help the employee with the claim at the ESIC branch office and keep a copy of the medical certificates.
Frequently asked questions
Can an employee get sickness benefit in the first months of joining?
Usually not. Cash sickness benefit needs 78 contribution days in a completed contribution period, and the matching benefit period starts three months after it ends. Medical care, though, starts from day one.
Is ABVKY relief available more than once?
No. It is payable for up to 90 days once in a lifetime.
Does ESIC pay benefits to an employee who now earns above ₹21,000?
Benefits already earned through past contributions stay payable for the matching benefit period. Coverage ends at the end of the contribution period in which pay crossed the limit.
Sources
- ✓ESIC: information on benefits
- ✓ESIC: temporary disablement benefit
- ✓ESI (Central) Rules, 1950, rule 55 (sickness benefit and waiting period), ESIC
This is a summary, not legal advice. Confirm current conditions with your ESIC branch office or on esic.gov.in before advising an employee.
Written by
HR Manager, Airwix Technologies (Sleet)
Nihit Dobariya is the HR Manager at Airwix Technologies in Ahmedabad, where he runs HR and payroll for the team behind Sleet. He writes about payroll, PF and ESIC, professional tax, the labour codes and everyday HR practice for Indian employers, and checks each rule against the official notification before it is published.
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