Full Text
5595 GI/2026 (1)
REGD. No. D. L.-33004/99
The Gazette of India
EXTRAORDINARY
PART III—Section 4
PUBLISHED BY AUTHORITY
No. 468] NEW DELHI, WEDNESDAY, JULY 22, 2026/ASHADHA 31, 1948
CG-DL-E-29072026-274902
EMPLOYEES STATE INSURANCE CORPORATION
NOTIFICATION
New Delhi, the 13th July, 2026
No. X-11014/31/2026-P&D:- Whereas subsequent to the enactment of Code on Social
Security, 2020 (36 of 2020) (The said Code) by Parliament. The said Code was enforced vide
notification no. S.O. 5319 ( E) dated 21.11.2025, in the Government of India Extraordinary Part II
Section 3-Sub Section(ii) and the Social Security (Central) Rules, 2026 under the Code on Social
Security, 2020 (36 of 2020) was notified vide notification no. G.S.R. 344(E) dated 08.05.2026 in the
Gazette of India , EXTRAORDINARY, PART-II-Section 3-Sub-section (i).
Now therefore, the following draft Regulation, which the Employees’ State Insurance
Corporation proposes to make in exercise of the powers conferred by section 157 of the Code on Social
Security, 2020 (36 of 2020) read with section 24 of the General Clauses Act, 1897(10 of 1897) in
supersession of the Employees’ State Insurance (General) Regulations, 1950, as the case may be, which
are repealed by section 164 of the said Code on Social Security, 2020, except as respects things done or
omitted to be done before such supersession, are hereby notified, as required by section 158, for
information of all persons likely to be affected thereby and the notice is hereby given that the said draft
notification will be taken into consideration after the expiry of a period of forty-five days from the day
on which the copies of the Official Gazette in which this notification is published are made available to
the public;
1. Any objection or suggestion, which may be received from any person in respect of the said draft
Regulations within the period specified above, will be considered by the Employees' State Insurance
Corporation.
2. The objections and suggestions, if any, may be addressed to Shri A. K. Sahu, Insurance
Commissioner, Employees' State Insurance Corporation, Panchdeep Bhawan, C.I.G. Marg, New Delhi
110002 or through e-mail to e-mail ID [email protected].
3. The objections and suggestions should be sent in a proforma containing column (1) specifying
the name and address of the person/organization, column (2) specifying the chapter and regulation or
sub-regulation which is proposed to be modified, column (3) specifying the revised regulation or sub
regulation proposed to be substituted and column (4) reasons therefor; Objections and suggestions,
which may be received from any person with respect to the said draft regulation before expiry of the
period specified above, will be considered by the Corporation.
DRAFT REGULATIONS
Employees’ State Insurance (General) Regulations, 2026
CHAPTER I
PRELIMINARY
1. Short title and extent. — (1) These Regulations may be called the Employees’ State
Insurance (General) Regulations, 2026.
(2) They extend to the whole of India.
2. Definitions. — (1) In these Regulations, unless the context otherwise requires—
(a) “Appointed Day” means with reference to an establishment, the day from which
the contribution from the employers and employees of such establishment shall be
payable under Section 29 of the Code and any benefits under Chapter IV of the Code
relating to the Employees’ State Insurance Corporation are provided by the Corporation
to the employees of such establishment.
(b) “Appropriate Office”, “appropriate Branch Office”, “appropriate DCBO”
“appropriate Regional Office” or “appropriate Sub-Regional Office", shall mean with
reference to any action taken under these Regulations, such office of the Corporation as
may be specified for that purpose under a general or special order of the Corporation;
(c) “Branch Manager” means a person appointed by the Corporation as such or the
officer-in-charge of a Branch Office or a Branch Manager of a DCBO;
(d) “Branch Office”, “DCBO”, “Regional Office” and “Sub-Regional Office” shall
mean, according to the context, such subordinate office of the Corporation, set up at
such place and with such jurisdiction and functions as the Corporation may, from time
to time, determine;
(e) “Central Rules” means the rules made by the Central Government under section
154 and 155 of the Code;
(f) “Code” means the Code on Social Security 2020 (Act 36 of 2020);
(g) “DCBO” means Dispensary cum Branch Office established by the Corporation.
(h) “Employer” means the employer as defined in the Code;
(i) “Employer’s Code Number” means the registration number allotted to an
establishment for the purposes of the Code, the Rules and these Regulations;
(j) “Establishment” means an establishment to which the Code applies;
(k) ‘‘Form” means a form appended to these Regulations;
(l) “Insured Person Card” means an identity card to be provided by the Corporation
to an Insured Person or Insured Woman and his/her family members electronically or
otherwise for identification for the purposes of the Code, the Rules and these
Regulations, and which contains details of the Insured Person and his/her family
member(s);
(m) “Inspector cum Facilitator” means a person appointed by notification by the
Central Government under section 122 of the Code for the purpose of Chapter IV of the
Code;
(n) “Instructions” means instructions or orders issued by the Corporation or by such
officer or officers of the Corporation as may be authorised by the Corporation in this
behalf;
(o) “Insurance Medical Officer” means a medical practitioner appointed as such to
provide medical benefit and to perform such other functions as may be assigned to him
and shall be deemed to be a duly appointed medical practitioner for the purposes of
Chapter IV of the Code;
(p) “Insurance Number” means a system generated registration number allotted by
the specified portal to an employee for the purposes of Chapter IV of the Code, the
Rules and these Regulations.
(q) “Medical Board” means a body constituted by the Corporation under these
Regulations, consisting of duly appointed medical practitioners, including specialists
wherever required, to examine, assess and certify the condition of an insured person in
respect of sickness, temporary or permanent disablement, occupational disease, or other
matters referred to it under the Code, the Rules or these Regulations; and shall include
any Special Medical Board constituted for such purposes.
(r) “Regional Director” means a person appointed by the Corporation as such for a
specified region;
(s) “Registered Midwife” means a person who is registered as a midwife under any
law in force in any State providing for registration of nurses and midwives;
(t) “Rules” means rules made by the Central or a State Government under the Code;
(u) “Specified” means specified by instructions issued from time to time by the
Corporation or any officer authorised by the corporation;
(v) “State Medical Officer” means an Insurance Medical Officer appointed as such
by the Corporation;
(w) “State Rules” means the rules made by a State Government under sections 154
and 156 of the Code;
(x) “Wage Period” in relation to an employee, mentioned in sub-section (3) of section
29 of the Code, means the period in respect of which wages are ordinarily payable to
him in terms of the contract of employment whether expressed, implied or otherwise.
(y) “Year” means the year as defined in the Social Security (Central) Rules, 2026 or
as specified otherwise;
(2) All other words and expressions have the meanings respectively assigned to them in
the Code or the Rules, as the case may be.
3. The manner in which the Corporation may exercise its powers. — (1) Where a
Regulation empowers the Corporation to specify, prescribe, provide, decide or
determine anything or to do any other act, such power may be exercised by a resolution
of the Corporation or subject to the provisions of sub-section (4) of section 5 of the
Code by a resolution of the Standing Committee:
Provided that the Corporation or the Standing Committee may delegate any of the
powers under these Regulations to a sub-committee or to such officers of the
Corporation as it may specify in that behalf:
Provided further that no power shall be delegated under this Regulation which under the
Code is required to be exercised by the Corporation only.
(2) Any appointment to be made by the Corporation under these Regulations, shall be
made by the Director General or by such other officers as may be authorised in this
behalf by the Standing Committee.
4. Exercise of powers by an office. —
Where a power is to be exercised by the appropriate office or appropriate Branch Office
or appropriate DCBO or appropriate Regional Office or appropriate Sub-Regional
office, it shall be exercised by the officer for the time being in charge thereof or by such
other officer as may be authorised for the purpose under general or special orders of the
Director General.
5. Contribution and Benefit periods. — (1) Contribution periods and the
corresponding benefit periods shall be as under: —
+---------------------------+-------------------------------------+
| Contributory Period | Corresponding Benefit Period |
+===========================+=====================================+
| 1st April to 30th September | 1st January of the year following to 30th June. |
+---------------------------+-------------------------------------+
| 1st October to 31st March | 1st July to 31st December. |
| of the year following | |
+---------------------------+-------------------------------------+
Provided that in the case of a person who becomes an employee within the meaning of
the Code for the first time, the first contribution period shall commence from the date of
such employment in the contribution period current on that day and the corresponding
benefit period for him shall commence on the expiry of the period of 9 months from the
date of such employment.
6. Mode of exercising vote in the meetings of the Corporation, the Standing
Committee and the Medical Benefit Committee. — The votes in the meetings of the
Corporation, the Standing Committee and the Medical Benefit Committee shall be taken
by show of hands, electronically or otherwise and the names of persons voting in favour
and against any proposition shall be recorded only if any member present requests the
Chairman to do so.
7. Matters to be brought before the Corporation. — In addition to the matters which
are, under any specific provision of the Code or the Central Rules, required to be placed
before the Corporation, the following matters shall be referred to the Corporation for its
decision:
(a) Regulations under section 157 and amendments thereto before final publication;
(b) any measures proposed under section 33, 44 and 45 of the Code;
(c) any proposal to extend medical benefit to families under sub-section (2) of section
32;
(d) any dispute proposed to be referred to arbitration under sub-section (4) of section
40;
(e) any proposal to set up hospitals under sub-sections (7), (8), (9) and (10) of section
40;
(f) Any proposal to grant exemption under section143 (1).
(g) any proposal to review and alter the scale of any benefit admissible under the
Code and the period for which such benefit may be given under sub-rule (8) of Rule 22
of the Central Rules.
(h) any other matter which the Corporation or its Chairman may direct the Standing
Committee or the Director-General to place before the Corporation.
8. Committees to assist the Corporation. — (1) The Corporation may, by order,
constitute with effect from such date as may be specified therein, one or more
committees to assist the Corporation upon such matters which the Corporation may
refer to it for its recommendations.
(2) The Committees may consist of the following:
(i) A Chairperson;
(ii) Equal number of members representing employees and employers;
(iii) Official members; and
(iv) Any other member(s)
as nominated by the Chairman of the Corporation:
(3) The terms of reference of each committee shall be as specified in the said order.
(4) All such committees shall meet at least twice in a year or at such frequency as
specified by the Corporation.
9. Regional Board. — (1) A Regional Board may be set up for each State or Union
Territory by the Chairman of the Corporation and shall consist of the following
members, namely: —
(a) a Chairman to be nominated by the Chairman of the Corporation in consultation
with the State Government or the Administration of the Union Territory;
(b) a Vice-Chairman to be nominated by the Chairman of the Corporation in
consultation with the State Government or the Administration of the Union Territory;
(c) one representative of the State or the Union Territory to be nominated by the State
Government or the Administration of the Union Territory;
(d) (i) Administrative Medical Officer or any other Officer directly in charge of the
Employees’ State Insurance Scheme in the State or the Union Territory, ex-officio;
(ii) the State Medical Officer of the Corporation, ex-officio;
(e) one representative each of the employers and employees from the State or the
Union Territory to be nominated by the Chairman of the Corporation in consultation
with such organisations of the employers and the employees as may be recommended
for the purpose by the State Government or the Union Territory;
(f) members of the Corporation other than the Chairman and the Vice-Chairman and
officials, if any, amongst those nominated by the Central Government under clause (c)
of sub-section (1) of section 5 of the Code, residing in the State or the Union Territory,
ex-officio;
(g) members of the Medical Benefit Committee nominated by the Central
Government residing in the State or the Union Territory, ex-officio;
(h) Permanent Invitees:
(i) Insurance Commissioner appointed by the Corporation;
(ii) Medical Commissioner appointed by the Corporation:
Provided that where the Chairman of the Corporation so considers it to be expedient, he
may nominate such additional representatives of employers and employees, not
exceeding three from each side, with a view to providing for the adequate representation
of important organisations not included in the nominations of the State Government or
the Union Territory, and to maintaining parity between the number of representatives of
such employers and employees:
Provided further that the Chairman of the Corporation shall nominate such additional
representatives of employers and employees not exceeding three from each side where
the number of representatives of employers and employees including the ex-officio
members, is less than three each.
(2) A Regional Board may, if it considers it desirable, co-opt the Officer In-charge of a
Sub-Regional office set up within its boundaries, and/or a member of the medical
profession in the Region and the person(s) so co-opted shall continue to be member(s)
during the pleasure of the Regional Board.
(3) The Regional Director of the Regional Office shall be the Member Secretary of the
Board.
(4) (i) Save as expressly provided in this Regulation, the term of office of the
members of the Regional Board referred to in clause (e) of and the proviso to sub
regulation (1) shall be three years commencing from the date on which their nomination
is notified, provided that the members of the Regional Board, shall, notwithstanding the
expiry of the said period, continue to hold office until the nomination of their successors
is notified or for one year, whichever is earlier.
(ii) Save as expressly provided in this Regulation, the members of the Regional Board
referred to in clause (c) of sub-regulation (1) shall hold office during the pleasure of the
State Government nominating them.
(iii) A member of the Regional Board referred to in clause (f) of sub-regulation (1) shall
cease to hold office when he ceases to be a member of the Corporation or ceases to
reside in that area.
(iv) Any member referred in clause (1) of this sub-regulation nominated to fill a casual
vacancy shall hold office for the remainder of the term of office of the member in whose
place he is nominated.
(v) An outgoing member shall be eligible for re-nomination.
(5) A member of the Regional Board referred to in clause (e) of and the proviso to sub
regulation (1) above, may resign his office by notice in writing to the Chairman of the
Corporation, through the Chairman, Regional Board, and his seat shall fall vacant on the
acceptance of the resignation.
(6) (i) A member of the Regional Board referred to in clause (e) of and the proviso to
sub-regulation (1) shall cease to be a member of the Board if he fails to attend three
consecutive meetings thereof provided that his membership may be restored by the
Chairman of the Corporation on his being satisfied as to the unavoidable, nature or the
circumstances which led to his non-attendance.
(ii) When any person nominated to represent an employers’ or employees’ organisation
on the Regional Board has ceased to represent such organisation, the Chairman of the
Corporation may, by notification in the Gazette of India, declare that such person shall
cease to be a member thereof with effect from such date as may be specified therein.
(7) The members of the Regional Board shall receive such fees and allowances as may
be prescribed by the Central Government for members of the Corporation.
(8) A member shall be disqualified for being nominated or for being a member of the
Regional Board —
(i) if he is declared to be of unsound mind by a competent Court; or
(ii) if he is an undischarged insolvent; or
(iii) if before or after the commencement of the Regulations he has been convicted of
an offence involving moral turpitude.
(9) A Regional Board shall meet at least twice every year. The Secretary shall, with the
approval of the Chairman, fix the date, time and place of, and also draw up the agenda
for every meeting. Notice of not less than ten days from the date of posting shall
ordinarily be given to every member for each meeting, provided that if it is necessary to
convene an emergency meeting, a reasonable notice thereof shall be given to every
member. No matter other than that included in the agenda shall be considered except
with the permission of the Chairman.
(10) No business shall be transacted at any meeting unless there is a quorum of not less
than one third of the number of the members of the Board: provided that if at any
meeting, sufficient number of members are not present to form a quorum, the Chairman
may adjourn the meeting to a date not later than seven days from the date of original
meeting and it shall thereupon be lawful to dispose of the business at such adjourned
meeting irrespective of the number of members present.
(11) All matters shall be decided by a majority of persons present and voting and in case
of equality of votes, the Chairman shall have a casting vote or a second vote.
(12) The Chairman or in his absence the Vice-Chairman of the Regional Board shall
preside at the meetings. In the event of the absence of both the Chairman and the Vice
Chairman, the members present may elect one from amongst themselves to preside.
(13) (i) The minutes of each meeting showing inter alia the names of the members
present thereat shall be forwarded to all members of the Regional Board as soon after
the meeting as possible and in any case not later than fifteen days from the date of the
meeting.
(ii) The records of the minutes of each meeting shall be signed by the Chairman after
confirmation with such modifications as may be considered necessary at the meeting at
which the minutes are confirmed.
(14) A Regional Board shall perform the following functions in respect of the Region
for which it is set up:
(a) Such administrative and/or executive functions as may, from time to time be
entrusted or delegated to it by a resolution, by the Corporation or the Standing
Committee.
(b) To make recommendations from time to time in regard to changes which may in
its opinion be advisable in the Code, Rules and Regulations and forms and procedure to
be followed in the running of the Scheme.
(c) To decide within the broad framework of the general decisions and programme of
priorities of the Corporation, the following matters, provided that where the specific
approval of the Corporation or the appropriate Government is required, such approval
shall be taken: —
(vii) Extension of the Scheme to new areas and extension of medical care to families;
(viii) Adoption of special measures to meet peculiar conditions in the area;
(ix) Improvement in benefits;
(x) Provision of indoor medical treatment;
(xi) Measures and arrangements for the rehabilitation of insured persons in the area,
who are permanently disabled;
(xii) Securing compliance by employers with the various provisions of the Code, the
Regulations and other Rules and instructions;
(d) To review from time to time the working of the Scheme in the State both on the
medical side as well as cash benefit side and to advise the Corporation and the State
Government on measures to improve the working of the Scheme both in regard to
payment of cash benefits and administration of medical benefit and in particular to
promote preventive health measures, safety and personal hygiene and to review and
check lax certification and other abuses of the Scheme.
(e) To look into general grievances, complaints and difficulties of insured persons,
employers, etc., as it may consider necessary.
(f) To advise the Corporation on such matters as may be referred to it for advice by
the Standing Committee or the Director-General.
The Regional Board may set up suitable sub-committees for carrying out any of its
functions and may seek the assistance or advice of Local Committees where necessary.
(15) (i) If in the opinion of the Corporation, the Regional Board persistently makes
default in performing the duties imposed on it by or under this Regulation or abuses its
powers, the Corporation may by notification in the Gazette of India supersede the
Regional Board.
(ii) Upon the publication of a notification under clause (i) above superseding the
Regional Board all the members of the Regional Board shall from the date of such
publication be deemed to have vacated their offices.
(iii) When the Regional Board has been superseded the Corporation may —
(a) immediately constitute a new Regional Board in accordance with this Regulation;
or
(b) appoint such agency for such period as it may think fit to exercise the powers and
perform the functions of the Regional Board and such agency shall be competent to
exercise all powers and perform all the functions of the Regional Board.
10. Local Committee. — (1) A local committee may be set up for such area as may be
considered appropriate by the Regional Director of the State/Union Territory and shall
consist of following members namely: —
(a) A Chairperson to be nominated by Regional Director of the State / Union
Territory;
(b) An official of the State to be nominated by the State Government;
(c) The Administrative Medical Officer in charge of the Scheme in the area
concerned, ex-officio, or any other medical officer nominated by him;
(d) Six representatives of employees out of which (i) two longest contributing
employees of such area, (ii) two representatives of employees in the area representing
organizations of employees and (iii) two employees from ESI registered MSME
establishments, to be nominated by Regional Director of the state / Union Territory;
(e) Six representatives of the employers out of which (i) two employers who are
contributing the highest value during the last three years (ii) two employers from ESI
registered establishments of MSME Category and (iii) two employers representing
employers/industry association in the area to be nominated by the Regional Director of
the State/Union territory;
(f) Senior most Manager of Branch Office or DCBO in such area, as ex-officio
member secretary.
Provided that where the Chairman, Regional Board, so considers it to be expedient, he
may nominate such additional representatives of employers and employees, not
exceeding two from each side, with a view to providing for the adequate representation
of important organisations not included in the nominations of the State Governments and
to maintaining the parity between the number of representatives of such employers and
employees;
Provided further that in any area in which medical care is provided through a panel
system, a local committee may co-opt a member representing the local Insurance
Medical Practitioners.
(2) (i) The term of office of the members of a local committee nominated under
clauses (c) and (d) of sub-regulation (1) shall be three years, commencing from the date
on which their nomination is notified by the Regional Director, provided that such
members, shall, notwithstanding the expiry of the said period, continue to hold office
until the nomination of their successor is notified.
(ii) The members of a local committee nominated under clauses (a), and (b) of sub
regulation (1) shall hold office during the pleasure of the authority nominating them.
(3) A member of a local committee may resign his office by notice in writing to the
Regional Director and his seat shall fall vacant on the acceptance of the resignation.
(4) (i) A member of a local committee shall cease to be a member of the Committee if
he fails to attend three consecutive meetings thereof provided that his membership may
be restored by the Regional Director on being satisfied as to the unavoidable, nature or
the circumstances which led to his non-attendance.
(ii) Where in the opinion of the Regional Director, any person nominated to represent
employers or employees on a local committee has ceased to represent such employers or
employees, the Regional Director, may declare that such person shall cease to be a
member thereof with effect from such date as may be specified by him.
(5) The members of the committee shall receive such fees and allowances as may be
specified by the Central Government.
(6) A Local Committee shall meet once in every three months. The Secretary shall, in
consultation with the Chairman, fix the date, time and place of, and also draw up the
agenda for every meeting. Notice of not less than seven days shall ordinarily be given to
every member for each meeting. No matter other than that included in the agenda shall
be considered except with the permission of the Chairman.
(7) No business shall be transacted at any meeting of a committee unless there is a
quorum of not less than one-third of the number of the members of the Committee.
(8) All matters at the meeting of a local committee shall be decided by a majority of
persons present at the meeting and voting, and in case of equality of votes, the
Chairman shall have a casting vote or a second vote.
(9) A local committee shall perform the following functions in respect of the area for
which it is set up, namely: —
(a) to discuss local problems in regard to the Employees’ State Insurance Scheme so
as to secure its efficient working with the full co-operation of all parties concerned and
to make recommendations;
(b) to refer such complaints as it may consider necessary to the Regional Director
concerned; or in the case of complaints concerning medical benefit, to the State
Government or such authority of the State Government; and
(c) to advise the Corporation or the Regional Board concerned on such matters as
may be referred to it for advice.
CHAPTER II
DECLARATION BY EMPLOYEE, INSURED PERSON CARD, RETURN OF
CONTRIBUTIONS, ETC.
11. Declaration by persons in employment on Appointed Day. — Every employer
shall require every employee to furnish, and such employee shall on demand furnish to
him either before or on the Appointed Day correct particulars along with his/her
photograph and that of his/her family required for the purpose of registering him/her on
the specified portal. Such employer shall enter the particulars in Form 1 (hereinafter
referred to as the Declaration Form) and obtain the signature or the thumb impression of
such employee and also complete the form as indicated thereon.
Every employer shall preserve the Declaration Form for every employee during the
service period of employment of such employee with him.
12. Declaration by persons engaged after the Appointed Day. — Every employer
shall, before taking any person into employment after the Appointed Day, require such
person (unless he can produce an Insured Person Card or other document in lieu thereof
issued to him under these Regulations) to furnish and such person shall on demand
furnish to him correct particulars along with his/her photograph and that of his/her
family required for the purpose of registering him/her on the specified portal. Such
employer shall enter the particulars in Form 1(hereinafter referred to as the Declaration
Form) and obtain the signature or the thumb impression of such employee and also
complete the form as indicated thereon.
Every employer shall preserve the Declaration Form for every employee during the
service period of employment of such employee with him.
13. The Corporation to receive assistance from employers. — An employer shall
render all necessary assistance which the Corporation may require in connection with
the registration of his establishment and the registration, or updation of particulars, of
his employees and their family.
14. Insured Person Card. — On registration of the Insured Person on the specified
portal by the employer, an Insurance Person Card (IP Card) shall be generated
electronically in Form 1A for the Insured Person containing details of the Insured
Person and his/her family member(s).
15. Changes in family. — An insured person shall intimate electronically or otherwise
all changes in the membership of the family as defined under the Code, to the employer
as soon as the change has occurred and the employer shall ensure to incorporate such
changes in the registration details of the Insured Person as available on the specified
portal in Form 1B.
Every employer shall preserve the intimations of the changes to the Declaration Form
submitted by every employee till the last day of employment of such employee with
him.
16. Monthly return of contribution — Every employer shall file monthly returns of
contribution in Form -2 on the specified portal in respect of all employees engaged by
them or through their contractor for whom contributions are payable, within fifteen days
from the end of the month;
Provided that the employer shall in any case file all monthly returns for a contribution
period within 45 days of the termination of contribution period;
Provided further that in case of permanent closure of the establishment, the employer
shall file all monthly returns within 15 days of the date of such permanent closure.
17. Certificate of Contribution. — An employer shall, on demand from the
appropriate office, issue certificate of contributions paid or payable in respect of an
insured person in Form 3.
18. Payment of Contribution. — Contribution payable under Chapter IV of the Code
shall, except when otherwise provided, be paid electronically into a bank duly
authorised by the Corporation.
19. Time for payment of contribution. — An employer who is liable to pay
contributions in respect of any employee shall pay those contributions within 15 days of
the last day of the calendar month in which the contributions fall due:
Provided that where an establishment is permanently closed, the employer shall pay all
contributions within 15 days of the date of such permanent closure.
20. Appellate Authority. — The Appellate Authority under section 126 of the Code
shall be the Insurance Commissioner, the Additional Commissioner, Regional Director,
Director and Joint Director.
21. Interest on contribution due but not paid in time. —
(1) An employer who fails to pay contribution within the periods specified in
Regulation 19, shall be liable to pay simple interest at the rate as notified by the Central
Government in respect of each day of default or delay in payment of contribution.
(2) Any interest payable on the contribution paid after the due date shall be recovered as
if it were an arrear of land revenue.
22. Damages on contributions or any other amount due but not paid in time. —
(1) If an employer fails to pay contribution within the periods specified under
Regulation 19, or any other amount payable under the Code, the Corporation may levy
damages at the rate of 1.0 per cent on the amount due for every month of delay.
Provided that the Corporation may reduce or waive the damages levied subject to the
terms and conditions specified by notification by the Central Government as provided in
Section 128 of the Code.
(2) Any damages payable under sub-regulation (1) shall be recovered as if it were an
arrear of land revenue.
23. Interest on amounts refunded to the employer. — If an employer finally succeeds
in the appeal under section 126 of the Code, the amount deposited by him with the
Corporation, in full or part, as per decision of the Appellate Authority, shall be refunded
to him along with simple interest at the same rate as specified in Regulation 21(1).
24. Register of Employees. —
(1) Every employer shall maintain, electronically or otherwise, a register in Form 4 in
respect of every employee of his establishment.
(1A) Register of employees engaged by contractor. — Every contractor shall
maintain, electronically or otherwise, a register in Form 4 in respect of every employee
engaged by him and submit the same to the employer before the settlement of any
amount payable under sub-section (6) of section 31 of the Code.
(2) Every employer shall preserve every register maintained under this Regulation after
it is filled, for a period of five years from the date of last entry therein.
(3) The employer shall give a reasonable opportunity to any of his employees, if he so
desires to see entries in respect of such employee in this register once a month.
25. Other modes of payment of contribution. — Subject to the directions of the
Standing Committee, the Director General may, if he thinks fit and subject to such terms
and conditions as he may impose, approve of any arrangement, whereby the
contributions are paid at times or in a
manner other than those specified in these Regulations and such arrangements may
include provision for the payment to the Corporation of such fees as may be determined
by him to represent the estimated additional expenses to the Corporation, and may
require such deposit of money by way of security as he may determine.
26. Employment for part of a wage period. — Where an employee is employed by an
employer for part of a wage period, the contributions in respect of such wage period
shall fall due on the last day of the employment by such employer in that wage period.
27. Reckoning of wages of employee employed by two or more employers in the
same wage period. — Where an employee is employed by an employer for only a part
of the wage period, or where an employee is employed by two or more employers in a
wage period, only the wages payable to him for the days up to and including the day on
which the contribution falls due for that wage period shall be taken into account in
reckoning wages for the purposes of determining the average daily wages of the
employee for that wage period.
28. Refund of contribution erroneously paid. — (1) Any contribution paid by a
person under the erroneous belief that the contributions were payable by that person
under Chapter IV of the Code may be refunded without interest by the Corporation to
that person, if application to that effect is made in writing before the commencement of
the benefit period corresponding to the contribution period in which such contribution
was paid.
(2) Where any contribution has been paid by a person at a rate higher than that at which
it was payable the excess of the amount so paid over the amount payable may be
refunded without interest by the Corporation to that person, if application to that effect
is made before the commencement of the benefit period corresponding to the
contribution period in which such contribution was paid.
(3) In calculating the amount of any refund to be made under this Regulation the
amount, if any, paid to any person, by way of benefit on the basis of the contribution
erroneously paid and for the refund of which the application is made, may be deducted.
(4) Where the whole or part of the amount of any contribution referred to in sub
regulations (1) and (2), was recovered from a contractor or deducted from the wages of
an employee by the employer, he shall, on getting the refund of the amount from the
Corporation, be liable to pay back the amount so recovered or deducted to the person
from whom the amount was so recovered or deducted.
(5) Applications for refund under this Regulation shall be made in such form and in
such manner and shall be supported by such documents as the Director General may,
from time to time, determine.
CHAPTER III
BENEFITS
29. Claim for benefits. — Every claim for a benefit payable under Chapter IV of the
Code shall be made in accordance with these Regulations, to the appropriate Branch
Office electronically or otherwise on the form appropriate for the purpose of the benefit
for which the claim is made, or in such other manner as the appropriate office may,
subject to its being in electronic form or otherwise, accept as sufficient in the
circumstances of any particular case or class of cases. Assistance for filling in the form
of claim in case of insured persons who cannot do so themselves shall be provided at
such places and in such manner as specified by the appropriate office. The claim for any
benefit shall be acknowledged electronically or otherwise.
PROVIDED that in case of permanent disablement benefit and dependants’ benefit,
claim shall be required to be made electronically or otherwise only for the first payment,
and no claim shall be required for subsequent periodical payments.
30. When claim becomes due. — A claim for any benefit under the Code shall, for the
purposes of Regulation 119, become due on the following days: —
(a) for sickness benefit or for disablement benefit for temporary disablement for any
period, on the date of issue of the regulation certificate in respect of such periods;
provided that in cases where a person is not entitled to sickness benefit for the first two
days of sickness, the due date shall be deferred by such days;
(b) for maternity benefit: —
(i) in case of confinement, on the date of issue, in accordance with these Regulations,
of the certificate of expected confinement or on the day eight weeks preceding the
expected date of confinement so certified whichever is later or, if no such certificate is
issued, on the date of confinement; and
(ii) in case of miscarriage and in case of sickness arising out of pregnancy,
confinement, premature birth of child or miscarriage, on the date of issue of the medical
certificate of such miscarriage or sickness, as the case may be;
(c) for first payment of disablement benefit for permanent disablement, on the date
on which an insured person is declared as permanently disabled in accordance with the
chapter IV of the Code and these Regulations;
(d) for first payment of dependants’ benefit, on the date of the death of the insured
person in respect of whose death the claim for such benefit arises or, where disablement
benefit was payable for that date, on the date following the date of death or, where the
beneficiary becomes entitled to a claim on any subsequent date, on the date on which he
or she becomes so entitled;
(e) for subsequent payments of disablement benefit for permanent disablement and
for subsequent payments of dependants’ benefit, on the last day of the month to which
the claim relates; and
(f) for funeral expenses, on the date of the death of the insured person in respect of
whose death the claim for such benefit arises.
31. Availability of claims forms. — Claim forms shall be available to intending
claimants electronically or otherwise from such persons and such offices of the
Corporation as it may appoint or authorise for that purpose and shall be supplied free of
charge.
32. Claims on wrong form. — Where a claim for any benefit has been made
electronically or otherwise on an approved form other than the form appropriate to the
benefit claimed, the Corporation may treat the claim as if it was made on the appropriate
form:
Provided that the Corporation may in any such case require the claimant to complete the
appropriate form.
33. Evidence in support of claim. — Every person who makes a claim electronically
or otherwise for any benefit shall, in addition to the medical certificate and other forms
specifically required under these Regulations, furnish such other information and
evidence for the purpose of determining the claim as may be required by the appropriate
office, and, if reasonably so required, shall for that purpose attend at such office or place
as the appropriate office may direct.
34. Defective claim. — If, in the absence of due signature or of due certification, a
claim made electronically or otherwise is defective on the date of its receipt by an office
of the Corporation, the office of the Corporation may in its discretion, refer the claim to
the claimant and if the form is returned electronically or otherwise duly signed and/or
certified within three months from the date on which it was so referred, the office may
treat the claim as if it had been duly made in the first instance.
35. Claim for inappropriate benefit. — Where it appears that a person who has made
a claim for any benefit payable under chapter IV of the Code may be entitled to a
benefit other than that which he has claimed, any such claim may be treated as a claim
in the alternative for that other benefit.
36. Authority for certifying eligibility of claimants. — The authority which is to
certify eligibility of claimants shall be the appropriate Branch Office or appropriate
DCBO in respect of sickness, maternity, temporary disablement benefits and funeral
expenses and the appropriate Regional Office or Sub-Regional office, in respect of
permanent disablement and dependants’ benefits.
37. Benefits when payable. — (1) Any benefit payable under Chapter IV of the Code
shall be paid —
(a) in the case of sickness benefit, not later than 7 days;
(b) in the case of funeral expenses not later than 15 days;
(c) in the case of the first payment in respect of maternity benefit not later than 14
days;
(d) in the case of the first payment in respect of temporary disablement benefit not
later than one month;
(e) in the case of first payment in respect of permanent disablement benefit not later
than one month;
(f) in the case of first payment in respect of dependants’ benefit not later than three
months,
after the claim therefore together with the relevant medical or other certificates and any
other documentary evidence which may be called for under these Regulations
electronically or otherwise has been furnished complete in all particulars to the
appropriate office.
(2) Second and subsequent payments in respect of any maternity, temporary
disablement, permanent disablement or dependants’ benefit shall be paid along with the
first payment in respect thereof, or within the calendar month following the month to
the whole or part of which they relate, whichever is later subject to submission of any
documentary evidence electronically or otherwise which may
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