{"id":39670,"date":"2025-06-19T12:09:58","date_gmt":"2025-06-19T06:39:58","guid":{"rendered":"https:\/\/www.kanakkupillai.com\/learn\/?p=39670"},"modified":"2026-03-19T14:14:21","modified_gmt":"2026-03-19T08:44:21","slug":"how-to-claim-esi-amount","status":"publish","type":"post","link":"https:\/\/www.kanakkupillai.com\/learn\/how-to-claim-esi-amount\/","title":{"rendered":"How to Claim ESI Amount?"},"content":{"rendered":"<p>The Employees\u2019 State Insurance (ESI) scheme is a social security program run by the Employees\u2019 State Insurance Corporation (ESIC), under the Ministry of Labour and Employment, Government of India. It provides health insurance, medical care, and cash benefits to employees earning \u20b921,000 or less per month (\u20b925,000 for people with disabilities). Both the employee and employer contribute to the ESI fund every month. If you are an insured person under this scheme, you are entitled to various benefits like medical care, sickness benefit, maternity benefit, disablement benefit, and more.<\/p>\n<p>In this article, we will explain how to claim ESI amount under different benefit categories, the process to follow, required documents, and other important information in simple language.<\/p>\n<h2>Types of Benefits under ESI<\/h2>\n<p>Before understanding how to claim the ESI amount, it is important to know what types of benefits are available under the scheme:<\/p>\n<ol>\n<li><strong>Medical\u00a0<\/strong><strong>Benefit-\u00a0<\/strong>Full\u00a0medical care is provided to the insured person and their dependents from the very first day of ESI registration.<\/li>\n<li><strong>Sickness Benefit-<\/strong> Cash compensation at the rate of 70% of wages is paid during certified sickness for a maximum of 91 days in a year.<\/li>\n<li><strong>Maternity Benefit-<\/strong> Paid to insured women for confinement (pregnancy), miscarriage, or sickness arising out of pregnancy.<\/li>\n<li><strong>Disablement\u00a0<\/strong><strong>Benefit-\u00a0<\/strong>Paid\u00a0to employees who suffer temporary or permanent disablement due to employment injury or occupational disease.<\/li>\n<li><strong>Dependent\u2019s Benefit-<\/strong> If an insured person dies due to employment injury, his dependents are entitled to receive monthly payments.<\/li>\n<li><span style=\"margin: 0px; padding: 0px;\"><strong>Funeral Expenses-\u00a0<\/strong>A lump sum amount is given to cover the funeral expenses of the deceased insured person.<\/span><\/li>\n<li><strong>Rehabilitation and Vocational\u00a0<\/strong><strong>Training- <\/strong>For injured or disabled workers, training and rehabilitation support are also provided .These benefits are available to all eligible employees, making ESI compliance a critical obligation for employers who <a class=\"underline underline underline-offset-2 decoration-1 decoration-current\/40 hover:decoration-current focus:decoration-current\" href=\"https:\/\/www.kanakkupillai.com\/partnership-firm-registration\">register private limited company<\/a> structures and employ staff within the prescribed wage threshold.<\/li>\n<\/ol>\n<h2>General Steps to Claim ESI Amount<\/h2>\n<p>The procedure for claiming ESI benefits may vary depending on the type of benefit. Below are the general steps:<\/p>\n<h3>1. Claiming Medical Benefit<\/h3>\n<p>No cash claim is involved here. Medical services are available at ESI hospitals and dispensaries.<\/p>\n<p><strong>Steps:<\/strong><\/p>\n<ul>\n<li>Visit the nearest ESI dispensary or hospital.<\/li>\n<li>Show your ESI card, temporary ID, or biometric Pehchan card.<\/li>\n<li>Consult a doctor and receive treatment free of cost.<\/li>\n<\/ul>\n<p><strong>Documents Required:<\/strong><\/p>\n<ul>\n<li>ESI card<\/li>\n<li>Aadhaar card<\/li>\n<li>Employer\u2019s referral letter (if required)<\/li>\n<\/ul>\n<h3>2. Claiming Sickness Benefit<\/h3>\n<p>This is a cash benefit provided to employees during periods of sickness when they are unable to attend work.<\/p>\n<p><strong>Eligibility:<\/strong><\/p>\n<ul>\n<li>Must have contributed for at least 78 days in the contribution period.<\/li>\n<\/ul>\n<p>Employers managing payroll must ensure that both ESI contributions and tax deductions are handled correctly. Those who are unclear about their tax obligations should also understand the <strong><a class=\"underline underline underline-offset-2 decoration-1 decoration-current\/40 hover:decoration-current focus:decoration-current\" href=\"https:\/\/www.kanakkupillai.com\/learn\/difference-between-withholding-tax-and-tds\/\">difference between withholding tax and tds<\/a><\/strong>, as both affect how salary-related deductions are processed and reported to the government.<\/p>\n<p><strong>Steps:<\/strong><\/p>\n<ol>\n<li>Visit an ESI hospital and get a medical certificate (Form 8).<\/li>\n<li>Submit Form 9 (claim for sickness benefit) to your employer.<\/li>\n<li>The employer will forward it to the ESI Branch Office.<\/li>\n<li>After verification, the ESI amount is directly transferred to your bank account.<\/li>\n<\/ol>\n<p><strong>Documents Required:<\/strong><\/p>\n<ul>\n<li>Medical certificate (Form 8)<\/li>\n<li>Sickness claim form (Form 9)<\/li>\n<li>ESI card and bank account details<\/li>\n<\/ul>\n<h3>3. Claiming Maternity Benefit<\/h3>\n<p>This benefit is available to insured women for up to 26 weeks of maternity leave.<\/p>\n<p><strong>Steps:<\/strong><\/p>\n<ol>\n<li>Visit the ESI dispensary and get the maternity certificate.<\/li>\n<li>Submit Maternity Claim Form (Form 19) and Confinement Certificate (Form 23) to the employer.<\/li>\n<li>The employer will forward the claim to the ESI Branch Office.<\/li>\n<li>After approval, the payment is made in instalments or a lump sum.<\/li>\n<\/ol>\n<p><strong>Documents Required:<\/strong><\/p>\n<ul>\n<li>Maternity certificate<\/li>\n<li>Maternity claim form<\/li>\n<li>Aadhaar card<\/li>\n<li>Bank account details<\/li>\n<\/ul>\n<h3>4. Claiming Temporary Disablement Benefit<\/h3>\n<p>If an employee is injured during work and is unable to work temporarily.<\/p>\n<p><strong>Steps:<\/strong><\/p>\n<ol>\n<li>Report the injury to the employer immediately.<\/li>\n<li>Visit the ESI dispensary and get an accident report.<\/li>\n<li>Submit Form 10 (Accident Report) and Form 14 (Accident Injury Benefit Claim).<\/li>\n<li>The employer must send a report to the ESI branch within 24 hours.<\/li>\n<li>After approval, payment is made.<\/li>\n<\/ol>\n<p><strong>Documents Required:<\/strong><\/p>\n<ul>\n<li>Accident report<\/li>\n<li>Injury benefit claim form<\/li>\n<li>Employer report<\/li>\n<li>Medical certificates<\/li>\n<\/ul>\n<h3>5. Claiming Permanent Disability Benefit<\/h3>\n<p>This is a monthly pension paid in case of permanent disability due to employment injury.<\/p>\n<p><strong>Steps:<\/strong><\/p>\n<ol>\n<li>Visit the ESI hospital for a medical board evaluation.<\/li>\n<li>Based on disability percentage, ESIC calculates the monthly amount.<\/li>\n<li>Submit the claim form and required supporting documents to the ESIC branch office.<\/li>\n<\/ol>\n<p><strong>Documents Required:<\/strong><\/p>\n<ul>\n<li>Disability certificate<\/li>\n<li>Claim form<\/li>\n<li>Medical board report<\/li>\n<li>Bank details<\/li>\n<\/ul>\n<h3>6. Claiming a Dependent\u2019s Benefit<\/h3>\n<p>If the insured person dies due to an employment injury, dependents like spouse, children, or parents can claim a monthly pension.<\/p>\n<p><strong>Steps:<\/strong><\/p>\n<ol>\n<li>Family members must inform the employer and the ESI branch office.<\/li>\n<li>Submit death certificate, accident report, and dependency proof.<\/li>\n<li>Fill and submit the Dependent\u2019s Benefit Claim Form (Form 15).<\/li>\n<\/ol>\n<p><strong>Documents Required:<\/strong><\/p>\n<ul>\n<li>Death certificate<\/li>\n<li>Dependents\u2019 ID proof<\/li>\n<li>Claim form<\/li>\n<li>Bank account details<\/li>\n<\/ul>\n<h3>7. Claiming Funeral Expenses<\/h3>\n<p>A one-time payment (currently up to \u20b915,000) is made for funeral expenses.<\/p>\n<p><strong>Steps:<\/strong><\/p>\n<ol>\n<li>The nearest relative or person who incurred the funeral expenses can apply.<\/li>\n<li>Submit a simple application to the ESI branch along with the death certificate.<\/li>\n<\/ol>\n<p><strong>Documents Required:<\/strong><\/p>\n<ul>\n<li>Death certificate<\/li>\n<li>Proof of relationship<\/li>\n<li>Bank details<\/li>\n<\/ul>\n<h2>Online ESI Claim Process (Where Available)<\/h2>\n<p>Some ESI claims can also be submitted online via the <strong>ESIC portal<\/strong>. Here\u2019s how:<\/p>\n<ol>\n<li>Visit <a href=\"https:\/\/www.esic.gov.in\/\">esic.in<\/a>.<\/li>\n<li>Login using employer credentials (for employer-submitted claims).<\/li>\n<li>Fill in the respective forms.<\/li>\n<li>Upload scanned documents.<\/li>\n<li>Submit and track the status online.<\/li>\n<\/ol>\n<p>For direct employee communication, visiting the nearest ESI branch or dispensary is advisable for guidance.Just as employers manage ESI claims through the ESIC portal, they also need to handle their TDS obligations through the <strong><a class=\"underline underline underline-offset-2 decoration-1 decoration-current\/40 hover:decoration-current focus:decoration-current\" href=\"https:\/\/www.kanakkupillai.com\/learn\/access-tds-login-on-traces-website\/\">tds cpc login<\/a><\/strong> on the TRACES website\u00a0 both portals are essential tools for employers managing their complete statutory compliance responsibilities.<\/p>\n<h2>Things to Keep in Mind<\/h2>\n<ul>\n<li>Always inform your employer about the incident (injury\/sickness\/death) at the earliest.<\/li>\n<li>Keep copies of all medical certificates and reports.<\/li>\n<li>Claims must be submitted within the specified time limit to avoid rejection.<\/li>\n<li>Make sure your Aadhar, bank details, and ESI card are linked and updated.<\/li>\n<li>For any disputes, you can approach the local ESI branch office or call the <strong>ESIC toll-free number 1800-11-2526<\/strong>.<\/li>\n<\/ul>\n<p>Timely ESI claim processing and contribution remittance are integral parts of <strong><a class=\"underline underline underline-offset-2 decoration-1 decoration-current\/40 hover:decoration-current focus:decoration-current\" href=\"https:\/\/www.kanakkupillai.com\/annual-compliance-of-a-private-limited-company\">pvt ltd company compliance<\/a><\/strong>, and failure to meet these obligations can result in penalties and legal consequences for both the employer and the company.<\/p>\n<h2>Common Reasons for Claim Rejection<\/h2>\n<ul>\n<li>Incomplete or incorrect documents.<\/li>\n<li>There is a delay in the submission of the claim.<\/li>\n<li>Not meeting eligibility criteria (like minimum contribution days).<\/li>\n<li>Medical treatment taken outside ESI network without referral (unless emergency).<\/li>\n<\/ul>\n<h2>Conclusion<\/h2>\n<p>Claiming ESI benefits may seem like a complicated process at first, but with the right information and documents, it becomes much easier. Always coordinate with your employer, ESI branch office, and hospitals for smooth processing. These benefits are your right as an insured person under the scheme, and they are meant to support you during times of need, like sickness, maternity, disability, or death in the family. Keeping proper records and being aware of your entitlements can help you claim the ESI amount without much hassle.<\/p>\n<p>If you need help, the <strong>nearest ESI branch office<\/strong> is the best place to start, or you can visit the official ESIC website.<\/p>\n<p>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Employees\u2019 State Insurance (ESI) scheme is a social security program run by the Employees\u2019 State Insurance Corporation (ESIC), under the Ministry&#8230;<\/p>\n","protected":false},"author":30,"featured_media":36034,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","footnotes":""},"categories":[5579],"tags":[],"class_list":{"0":"post-39670","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-esi"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v20.1 (Yoast SEO v27.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>How to Claim ESI Amount in India - Step-by-Step Guide<\/title>\n<meta name=\"description\" content=\"Claim your ESI amount easily. 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