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Declaration Forms in Form-1 to be filled in properly
for registration of employees. The Form should contain all relevant information
asked for in respect of each coverable employee and submitted to the Branch Office
concerned within ten days of entry into insurable employment. Before filling Declaration
Form it should be ensured that the worker was not insured under the ESI Scheme in
the past. If so, the old Insurance No. should be indicated in the Form.
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All fresh entrants into the insurable employment should
be advised to furnish two post card size family photographs (of IP and dependants
only) with the Declaration Form to the appropriate Branch Office.
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Temporary Identification Certificate annexed to the Declaration
Form may be obtained from the Branch Office Manager with his seal and signature
and issued to the insured employee forthwith.
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On receipt of Permanent Identity Cards from the Branch
Office the same should be passed on to the insured
employees without delay.
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In order to facilitate a newly insured person to avail
medical benefit under the Scheme in absence of an
identity certificate, identity card, a 'Certificate
of Employment' may be issued to the insured person
in Form 86. This certificate, issued by the employer,
remains valid for three months but can be revalidated
for a further period not exceeding 3 months.
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Whenever events, such as, marriage birth or death
entails any additions or deletions in the family
particulars of an insured person, the requisite
information has to be conveyed by the employer in
'Form 2 to the Branch Office within 15 days from the
occurrence of such a change.
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On re-entry of a person into insurable employment or,
where an insured person had been disentitled to medical
benefit due to non submission of Return of Contribution,
the employer may issue a 'Certificate of re-employment'
or 'continuing employment' to such person in Form ESIC 37.
This certificate will enable the Insured Person to avail
medical benefit from the date of issuance.
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If an insured employee needs a change of dispensary
due to any valid reasons an application may be mad in
Form 'ESIC53'.
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Accident Report in respect of an insured employee may
be submitted immediately in case of death or serious
injury and in other cases within 24 hours of an
accident. For this Form 11 be filled up in triplicate
and one copy each forwarded to the Branch Office and
Dispensary: Form-32 may also be submitted along with
the accident report in case an accident has occurred
prior to the commencement of the first Benefit Period
of the IP to enable the Branch Office determine the
rate of Disablement Benefit.
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Whenever an Insured Person goes out of station on duty
or leave he may be issued a certificate in Form ESIC
105. This will enable him and his family to avail
medical treatment in ESI Dispensaries/hospitals
elsewhere, if available at such outstation.
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If any insured person is in need of a duplicate
identity care, an application may be made to the
Branch Office Manager in Form ESIC 72.
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Return of Contribution may be submitted in time with
all relevant particulars neatly filled up against
all insured persons with Insurance Numbers in
ascending order. Remember, any inadvertent deletion
may debar an Insured Person from availing benefit
due to him/her.
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