Employees' State Insurance (ESIC) Medical & Cash Benefits — Assam
Statutory multi-dimensional medical and cash disability insurance for industrial wage-earners across Assam.
Sum Insured / Cover
100% Comprehensive Cashless (No Financial Limit)
Annual Premium
0.75% of wages (Employee) + 3.25% (Employer)
Claim Settlement
100% (Statutory Social Security)
Network / Scope
160 Empaneled
✦ Key Benefits & Policy Coverage
Complete outpatient, specialist consultation, surgical treatment, and maternity care across ESIC hospitals in Guwahati, Tinsukia. Includes sickness cash benefit (70% wages up to 91 days), temporary disablement benefit (90% wages), permanent disablement lifelong pension, and dependent family pension.
What is Missing: Critical Policy Exclusions & Limitations
Eligo disclosure: Private insurance agents and official ads rarely mention these limitations. Verify before relying on this coverage.
Applicable only to employees in organized factories/establishments earning up to ₹21,000/month (₹25,000 for PwD). Unorganized informal workers not covered. If employment terminates, medical cover ceases after standard run-off period.
✦ Eligibility Requirements
Employees drawing wages up to ₹21,000 per month working in factories and notified commercial establishments with 10 or more employees in Assam.
✦ Application, Enrollment & Claims Process
1. Employer registers establishment and generates IP (Insured Person) Pehchan Number on esic.gov.in.
2. Insured Person adds family dependents and seeds Aadhaar.
3. Download Pehchan e-Card via UMANG App or ESIC portal.
4. Walk into any local ESIC dispensary or hospital with Pehchan Card for cashless treatment.Official Portal
Official Government / PSU Portal
Apply or verify on the official administrative domain
✦ Documents Checklist
ESIC Pehchan Smart Card, Aadhaar Card of employee and dependents, Wage slip showing ESI contribution deduction.
✦ Life Situations Where This Scheme Helps
👶💼🏥♿
Having a Baby & Early Childhood
Government financial assistance, healthcare, nutritional support, and savings schemes for expecting mothers, newborns, and infants.
Job Loss, Skill Training & Livelihood
Guaranteed rural wage employment, urban street-vendor loans, free vocational training, and self-employment rehabilitation programs.
Health Emergency & Medical Care
Cashless hospital treatment up to ₹5 Lakh, free essential medicines, diagnostic services, and critical illness financial support.
Disability Support & Inclusion
Free assistive aids, specialized scholarships, accessible infrastructure grants, and pension schemes for Persons with Disabilities (PwD).
Underwriting Entity & Public Grievance Contact
Administering Body:
Government of India