The Employees' State Insurance Corporation plays a significant role in ensuring the health and welfare of workers in India. In this context, examine the coverage gaps in occupation

GS3 Jobs & Inclusive Growth
The Employees' State Insurance Corporation plays a significant role in ensuring the health and welfare of workers in India. In this context, examine the coverage gaps in occupational health protection and suggest measures to make it more inclusive.

Examine

  • 15 marks
  • 8 min
  • 250 words
  • Medium

The Hindu

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Introduction

The Employees’ State Insurance Corporation (ESIC), established under the Employees’ State Insurance Act, 1948, provides social security and health insurance to workers against sickness, maternity, disability, and employment injury. As India’s largest contributory social insurance scheme, ESIC is central to worker welfare. However, changing labour patterns and the dominance of informal employment have exposed major gaps in occupational health protection.

Role of ESIC in Worker Welfare

1. Health and Medical Protection

  • Provides medical care, sickness benefits, maternity benefits, and disability compensation to insured workers and their families.

2. Employment Injury Coverage

  • Offers compensation for workplace injuries, occupational diseases, and death due to employment hazards.

3. Social Security for Low-Income Workers

  • Covers workers earning below the prescribed wage ceiling, reducing out-of-pocket healthcare expenditure.

4. Institutional Healthcare Network

  • ESIC operates hospitals, dispensaries, and medical colleges across India.

Coverage Gaps in Occupational Health Protection

1. Exclusion of Informal Sector Workers

  • Nearly 90% of India’s workforce is informal (PLFS data), but ESIC coverage is largely confined to formal establishments.

2. Limited Coverage of Gig and Platform Workers

  • App-based delivery workers and freelancers often lack occupational health insurance despite high workplace risks.

3. Inadequate Geographic Reach

  • Rural and semi-urban regions have limited ESIC healthcare infrastructure, affecting accessibility.

4. Underreporting of Occupational Diseases

  • Occupational illnesses such as silicosis and chemical exposure remain poorly diagnosed and compensated.

5. Administrative and Awareness Issues

  • Complex procedures, delayed claims settlement, and low awareness reduce effective utilisation.

Measures for Greater Inclusiveness

1. Expand Coverage to Informal and Gig Workers

  • Integrate ESIC with the e-Shram portal and implement provisions of the Code on Social Security, 2020 for platform workers.

2. Strengthen Occupational Health Surveillance

  • Develop a national database on occupational diseases and workplace injuries.

3. Improve Healthcare Infrastructure

  • Expand ESIC hospitals and telemedicine services in underserved regions.

4. Simplify Procedures and Digital Access

  • Introduce paperless claims processing and multilingual awareness campaigns.

5. Enhance Employer Accountability

  • Strict enforcement of workplace safety norms under the OSH Code, 2020.

Conclusion

ESIC has played a crucial role in institutionalising worker health protection in India. However, to remain relevant in an evolving labour market, it must move beyond formal-sector limitations and adopt a universal, technology-enabled, and inclusive approach to occupational health security.