The number of COVID-19 cases in India have increased to 9,000. As it spreads, one of the most vulnerable groups is migrant and low-income workers, living in close spaces – often five or six to a room – and in unsanitary conditions.
Now is the opportunity for ESIC (Employee State Insurance Corporation) to support those who are or should be registered with ESIC.
ESIC is the government arm that provides healthcare insurance and treatment through its 159 hospitals, 1,500 dispensaries and 148 AYUSH units.
With more than four crore formal sector workers registered with it, and their dependents covered by this scheme, there are more than 12 crore Indians connected with and dependent on ESIC for their healthcare benefits and compensations when sick and/or injured.
Increasing proportion of contract workers – in our experience more than 70% of injured workers that we have assisted – who do not have permanent jobs are exposed to exploitation. It is even more important that at least those contract workers who are covered by ESIC are taken care of well during this crisis.
ESIC is highly profitable. Just last year, its revenue income exceeded its revenue costs by Rs 9,000 crores.
ESI recently reduced insurance premiums for businesses by 1.5% of salary and workers by 1% of salary. In the past few weeks, ESIC has also permitted businesses to delay ESIC contributions up to 45 days instead of 15 days. These are good measures directed mainly for businesses, but right now, ESIC should use its infrastructure, reserves and influence to play a much bigger role in healthcare, cashflows and indeed social security of the workers and their families.
This is not only a humanitarian issue but a need to get our production and productivity back on track quicker. It is also an opportunity to meaningfully improve ESIC internal systems for worker services for future.
Businesses should work with ESIC for not only its own benefit but also for direct benefit to workers. It’s not the time to cut corners and do jugaad for your own good. If COVID-19 tells us anything, it is that we are all connected, and we have to look after each other for collective and personal good.
ESIC has now taken a few good steps – they have designated some of their facilities for quarantine and treatment of COVID-19 cases, allowed workers to purchase of medicines from private chemists and claim reimbursement, allowed treatment at tied-up hospitals, and have deferred payments of ESIC contributions for businesses and workers.
These measures will help the affected workers in this lockdown situation and a good start, but we recommend further actions that we believe ESIC is capable of:
ESIC infrastructure to be used/equipped better for COVID-19
ESIC has now created 2000+ isolation beds at eight COVID-19 dedicated hospitals in eight states, out of its 159 hospitals. Another 1,100 quarantine beds have been created at its four hospitals in four states. These will need to be reviewed frequently and quickly to expand and react to the emerging situation.
ESIC has now also said that their staff is being trained and coached to provide COVID-19 guidance. This needs to be done at all its dispensaries, AYUSH units and hospitals. Even the claims staff needs to be trained for assisting workers sensitively and proactively during these times.
ESIC compensation process needs short-circuiting for a few months
ESIC staff should proactively assist workers during this time for their compensations. The approved Disability Pensions of February have only just been remitted according to a press release from ESIC. These payments need to be aggressively expedited as the beneficiaries depend on these monthly payments for their daily livelihood. We recommend that workers on disability pensions should be given the option to take advances against their future payments.
Other pending compensations (sickness, maternity, death etc) should be paid immediately; we recommend interim payments for six months, with any delayed administrative processes completed at a later stage.
In our experience, majority of the 500+ claims we have assisted with are approved sooner or later anyway. In the short term, delays by employees to provide documents should no longer count as a reason for a delay in payment.
We have made several such worker-centric, process re-engineering suggestions to ESIC in the past two years. See this video for worker feedback on the challenges with the compensation processes.
ESIC data analytics for prevention and improved action
ESIC can use its gross data to specifically address COVID-19 challenges. For example, the prime minister has asked us to be sensitive towards employees and remit full salaries.
ESIC data can show workers losing jobs (as their contributions stop) to identify such hotspots. Appropriate actions can be taken by ministry of labour at those hotspots, like temporarily enrolment in PDS in cities where the migrant workers are but cannot access PDS.
ESIC has made a number of improvements in the past two years.
This time of stress can be used to codify lessons from the above and other actions in the next few months and utilise the learnings to improve its systems and processes – making them simpler, easier and with an objective to provide support to the workers in the most timely and humane manner, and improving Indian labour productivity.
Sandeep Sachdeva is the co-founder and CEO of Safe In India. Vinay Dixit is business transformation expert and strategist.
The authors acknowledge the support from Chitra Khanna, Masab Shamsi and rest of the Safe in India team. Safe in India has been assisting injured workers with their ESIC services and its recommendations are based on experiences with 2,000+ such workers and constructive engagement with ESIC.