Retired, disabled staff eligible for ESI benefits, says High Court

The Madras High Court has held that regulations of Employees State Insurance Act, viz ESI (General) Regulations 1950, more particularly 103-B, provided for continuation of medical benefits even to persons who became disabled or retired.

Noting an order of the Industrial Tribunal in I.D. No 115 of 2000, Mr Justice K. Chandru ruled that it was for ESI authorities to recover contribution, if any, due from the employer and continue to grant the medical benefit to the employee.

In the present writ petition, Mr S. Thangasamy, who joined the Sunderam Industries Rubber Factory in Usilampatty, Madurai 6 on October 1, 1976 and who was dismissed from service on May 21, 1999, sought for a writ in the nature of declaration, declaring that he was entitled to have benefit of ESI scheme as also treatment in the ESI hospital on having attained the age of superannuation.

According to the petitioner, even while case was pending before the Tribunal, he attained superannuation on March 11, 2003. Though he was suffering from ill health and his wife was suffering from diabetes and hypertension, the 1{+s}{+t} respondent ESI Corporation in Chennai was not extending the medical benefits.

The Judge ruled that in view of the judgment of the Supreme Court [reported in (2003) 2 SCC 138 (Bharagath Engg vs R. Ranganayaki], it was for ESI to recover amount, if any, due and continue to grant benefit to the petitioner. The said judgment held, inter alia , that according to Section 2(14) of the ESI Act, ‘insured person' meant a person who is, or was, an employee in respect of whom contributions are or were payable under this Act, and who is, by reason thereof, entitled to any of benefits provided by the Act. The crucial expression in Section 14 was ‘are or were payable'. It was the obligation of employer to pay contribution from date the Act applied to the factory or establishment.

The respondent ESI argued that petitioner had himself admitted that he was dismissed from service on May 21, 1999 and it was clear that he was not in insurable employment from date of dismissal to date of superannuation, ie, March 11, 2003. As being so, the employer did not contribute and submit return of contribution in respect of petitioner to the ESI. Hence, he was not eligible for medical benefit under Rule 61 of ESI (Central) Rules 1950.

The petitioner contended that since the Tribunal set aside the dismissal order and held that he was deemed to have been in service as on date of dismissal till date of superannuation. He was also entitled to 50 per cent of backwages for the said period.

The Judge said that ESI submitted that during the period of petitioner's absence, no contribution had been paid, and therefore, he was not eligible to get any amount. It must be noted that term ‘insured person' was defined under Section 2(14), which meant a person who is or was an employee in respect of whom contributions are or were payable, and who was, by reason thereof entitled to any of benefits provided by Act. In view of said apex court judgment, it was for ESI authorities to recover the amount, if any due and continue to grant benefit to petitioner as he was deemed to have become superannuated from service.

The writ petition was disposed of accordingly, the Judge held.

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