Which one of the following is not a benefit provided to an employee under the Employees' State Insurance Act, 1948 ?

Correct — D, (d) Health benefit. The booklet sets 'not' in bold italic — the item asks which of the four is NOT a benefit under the Act — and the answer turns on a single word that the scheme does not use.

Section 46(1) of the Employees' State Insurance Act, 1948 is a closed list. It provides that the insured persons, their dependants or the persons named in it shall be entitled to the following benefits, namely:

(a) sickness benefit — periodical payments to an insured person in case of his sickness certified by a duly appointed medical practitioner; (b) maternity benefit — periodical payments to an insured woman in case of confinement or miscarriage or sickness arising out of pregnancy, confinement, premature birth of a child or miscarriage; (c) disablement benefit — periodical payments to an insured person suffering from disablement as a result of an employment injury and certified to be eligible for such payments; (d) dependants' benefit — periodical payments to the dependants of an insured person who dies as a result of an employment injury; (e) medical benefit — medical treatment for and attendance on insured persons; (f) funeral expenses — a payment towards the expenditure on the funeral of a deceased insured person.

Six benefits, and 'health benefit' is not one of them. The benefit that delivers health care is called MEDICAL BENEFIT, and the name is not an accident of drafting. Five of the six benefits are periodical CASH payments; medical benefit is the one delivered in kind, as treatment and attendance through the Corporation's dispensaries, hospitals and panel practitioners, and it extends to the insured person's family as well. The ESI Act was the first Indian statute to provide a benefit of that sort, which is precisely why the Act gives it a distinct statutory name.

So options (a), (b) and (c) each reproduce a name that section 46 uses, and option (d) substitutes a plausible everyday word for the statutory one. On a list question, the statute's own vocabulary is the test.

Why the others are wrong

• (a)Sickness benefit — Sickness benefit is the first item in section 46(1) and cannot answer a 'not a benefit' stem. It is a periodical cash payment to an insured person during certified sickness, at the standard benefit rate, and rule 55 of the ESI (Central) Rules, 1950 caps it at ninety-one days in any two consecutive benefit periods. Beyond it the scheme carries extended sickness benefit for a list of long-term diseases and enhanced sickness benefit for insured persons undergoing sterilisation. Note the qualifying condition, which is what such items are usually built from: the insured person must have paid contributions for the prescribed number of days in the corresponding contribution period.
• (b)Maternity benefit — Maternity benefit is section 46(1)(b) and is squarely a benefit under the Act. It is a periodical payment to an insured woman in case of confinement or miscarriage, or sickness arising out of pregnancy, confinement, premature birth of a child or miscarriage, payable at a rate roughly equal to full average daily wages and for the period prescribed by the rules. Because the Maternity Benefit Act, 1961 covers the same ground for women outside the ESI scheme, section 5A of that Act keeps the two apart: a woman entitled to maternity benefit under the ESI Act is not entitled to it under the 1961 Act for the same period. One benefit, two statutes, no overlap.
• (c)Disablement benefit — Disablement benefit is section 46(1)(c) and is one of the six. It is payable to an insured person suffering disablement as a result of an EMPLOYMENT INJURY, and it comes in two forms: temporary disablement benefit, a periodical payment while the incapacity lasts, and permanent disablement benefit, payable for life at a rate proportionate to the loss of earning capacity assessed by a medical board. That employment-injury link is what distinguishes it from sickness benefit in option (a), which needs no connection with the work. If a question ever asks which benefit requires an employment injury, disablement benefit and dependants' benefit are the two.

Section 46 of the Employees' State Insurance Act, 1948 defines the whole output of the scheme in six named benefits: sickness benefit, maternity benefit, disablement benefit, dependants' benefit, medical benefit and funeral expenses. The single most useful way to hold them is by the cash-or-kind divide. Five are periodical cash payments that replace lost earnings — sickness when the insured person is ill, maternity on confinement or miscarriage, disablement after an employment injury, dependants' benefit to the family when an employment injury kills him, and funeral expenses as a one-off payment on death. The sixth, medical benefit under section 46(1)(e), is a service rather than a payment: medical treatment for and attendance on insured persons, delivered through ESI dispensaries, hospitals and panel practitioners and extending to the insured person's family. The ESI Act, which grew out of the report B. P. Adarkar was commissioned to prepare in 1943 and whose scheme was inaugurated at Kanpur in February 1952, was the first major Indian social-security statute and the first to provide medical care in kind rather than in money. Two of the six benefits — disablement and dependants' — depend on an employment injury as defined in section 2(8), and that dependency is the second organising line through the list.

Key facts

• ESI Act, 1948, section 46(1) lists six benefits: sickness benefit, maternity benefit, disablement benefit, dependants' benefit, medical benefit and funeral expenses.
• Section 46(1)(e) — medical benefit is medical treatment for and attendance on insured persons; it is the only benefit delivered in kind and it extends to the insured person's family.
• The other five are periodical cash payments, with funeral expenses a one-off payment.
• There is no benefit called 'health benefit' under the Act.
• Disablement benefit and dependants' benefit both require an employment injury within section 2(8); sickness benefit does not.
• Disablement benefit takes two forms — temporary disablement benefit while incapacity lasts, and permanent disablement benefit at a rate proportionate to the loss of earning capacity.
• Sickness benefit is limited by rule 55 of the ESI (Central) Rules, 1950 to ninety-one days in any two consecutive benefit periods.
• Section 5A of the Maternity Benefit Act, 1961 prevents a woman entitled to maternity benefit under the ESI Act from claiming it under that Act for the same period.
• The ESI Act, 1948 was India's first major social-security statute and the first to provide a benefit in kind; its scheme was inaugurated at Kanpur on 24 February 1952.

Common traps

• Answering the positive question. The emphasised word is 'not', and three of the four names are genuine benefits.
• Accepting 'health benefit' because the scheme obviously provides health care. The statutory name is medical benefit.
• Confusing sickness benefit with disablement benefit. Only the latter requires an employment injury.
• Assuming unemployment allowance is a section 46 benefit. It comes from a Corporation scheme, not from the section.

• practice — not a real PYQ

  Which one of the following benefits under the Employees' State Insurance Act, 1948 is provided in kind rather than as a periodical cash payment ?

  • (a)Sickness benefit
  • (b)Medical benefit
  • (c)Dependants' benefit
  • (d)Funeral expenses

  Answer(b) Medical benefit

• practice — not a real PYQ

  Under the Employees' State Insurance Act, 1948, dependants' benefit is payable where an insured person dies as a result of :

  • (a)Any illness certified by a medical practitioner
  • (b)An employment injury
  • (c)Any cause during the benefit period
  • (d)An accident occurring at his residence

  Answer(b) An employment injury