Social Security Measures to Private Employees

Here we will be discussing the facilities/ Schemes available under the PF / ESIC/ LWF to the private employees in case of any health issue or Death:

EPFO (Employee Provident Fund Organization)

A. EDLI (Employee Deposit Linked Insurance)

• Once you are enrolled for the EPFO then you are auto-enrolled for this group insurance.
• Premium is paid monthly by the employer @ 0.5 % of your Basic + DA.
• Need to have contributed at least one month in EPFO.
• Minimum assured coverage of Rs.2.5 Lakhs and Maximum coverage up to Rs. 7 Lakhs
• Claim settlement is within 30 days if all the details mentioned in the form are correct.
• Claim amount under EDLI is calculated as = (35 X Basic average salary or Maximum 15000/-) + (50% of average balance EPF account or maximum 1.75 Lakh)

Example: Basic average salary Rs 10,000 and EPF balance of 1 lakh

= 35 X 10,000 + 50,000

= 3,50,000 + 50,000

= 4,00,000 (Total EDLI amount will be 4 Lakhs)

B. Pension

• The pension can be availed by the widow and up to 2 children until they attain the age of 25 Years or in the case of the female child until she gets married (Before 25 years only) and later the pension can be moved to the next child if any.
• Pension is provided in following percentage, Widow – 50%, Child 1- 25%, Child 2 - 25%
• Minimum pension of Rs.1000 per month.

C. The total accumulated PF amount can be withdrawn.

Documents required for Claim:

• Combined Death Claim Form
• Death Certificate in Original
• Laboratory report certifying having tested positive for COVID-19 (original or certified copy)
• Death Summary by the hospital where the death occurred.
• Aadhaar Card (Deceased, Deceased Parents, Wife & Children)
• Separate bank passbook xerox (preferably SBI same branch) Nominee, Deceased Parents & Children’s)
• Family Color Photograph Wife & Children (Backside Signature)
• 3 each color passport size photograph (Wife & Children)

N.B: Member KYC details need to update (Aadhaar, Pan & Bank details) along with nominee details to be updated and nominee should also know the password of the PF member portal to avoid any kind of delay. KYC can be updated using the below link:

https://unifiedportal-mem.epfindia.gov.in/memberinterface/

ESIC Medical & Cash Benefit:

• In ESIC hospitals 20% of its bed’s capacity is dedicated as Covid-19 for ESIC IPS & Beneficiaries.
• ESIC beneficiaries may seek emergency medical treatment from tie-up hospitals directly without any referral letter.
• In case of the IP or family members being infected with covid-19 takes treatment in any private institution, the reimbursement of expenditure may be claimed.
• In case of any insured person becomes unemployed, he may avail relief under Atal Beemit Vyakti Kalyan Yojana (ABVKY) @ 50 % of average per day earning for a maximum of 90 days, IP can submit his claim online at www.esic.com

Documents Required for Claim

• Form 15 (Penson Claim)
• Form 22 (Funeral expense claim
• Accident Report
• Witness Report / Attendance report
• Hospital Bill if admitted.
• FIR Copy / Police Inquest report
• Chemical Analysis report/ Postmortem report
• Death Certificate (Original)
• ID proof of the expired employee
• Bank accounts of the dependents
• Birth certificate of dependent Children.
• Marriage Certificate
• 3 photos of wife & Children

Labour Welfare Fund (It is applicable only in 15 states)

• The lumpsum claim of Rs. 2 lakhs to the nominee
• The funeral expense of 15 K (If Gross salary is less than 25 K)

Document required:

• Dependent ID card/ Aadhaar
•  Death certificate – need to upload on the portal by an employer.
• Minimum 6 months service is mandatory

Please do spread the word about this scheme it can make a difference to a LOT of people.