Employees State Insurance Scheme Case Study

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Introduction:
The Employees’ State Insurance Scheme provides need based social security benefits to insured workers in the organized sector. ESI Corporation has taken up the daunting task of tailoring different benefit schemes for the needs of different worker groups. The scheme, which was first introduced at two centers in 1952 with an initial coverage of 1.20 lakh workers, as on 31/03/2014, the scheme applied to 6.70 lakh employers employing 1.95 crore insured persons at 815 centers. The Act is applicable to non-seasonal factories employing 10 or more persons. The Scheme has been extended to shops, hotels, and restaurants, cinemas including preview theatres, road-motor transport undertakings and newspaper establishments, Private Medical
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The findings showed that the insured persons are largely not satisfied with medical care and cash benefits and still a lot more effort is needed to improve the ESI Schemes and make it a success.
Dr.B. Vijayachandran Pillai , M.Divya (2014) in their paper analyzed the awareness and satisfaction of ESI Scheme in Kerala. Service sector beneficiaries were taken up for the study. The beneficiaries of educational Institutions were more aware of the scheme than the beneficiaries of shops and financing companies according to the study. It also revealed that the respondents preferred private hospitals rather than ESI Dispensaries or Hospitals as the ESI dispensaries/ hospitals were not functioning up to the expectation level of the insured persons.
Muthulakshmi.G (2014) in her paper has made an attempt to scrutinize the performance of Employee State Insurance Corporation with reference to Tuticorin District. The employees’ perception on ESI hospitals was studied and the service quality factors were rated with the help of a five point scale to identify the satisfaction level. Significant differences are observed in case of sickness benefit, no benefits availed and medical
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Majority of the respondents feel that the formalities followed in availing the ESI benefits is cumbersome with the highest mean score of 38.636. Prolonged waiting period, rude behaviour of the staff, and unsuitable timing of the dispensary are the subsequent problems faced by the respondents with a mean score of 36.364,34.091 and31.818 respectively. Distance of the dispensary/ hospital is ranked the fifth place with a mean score of 27.273.

Table: 3 Problems faced by the insured persons in availing the Medical Benefits

Problems faced by the respondents Rank 1 Rank 2 Rank 3 Rank 4 Rank 5 Mean Ranking

Poor treatment quality 1 4 7 10 22 50.000 5

Poor diagnostic services 20 12 9 2 1 45.455 1

Unavailability of medicines 7 15 10 11 1 34.091 2

Poor quality of medicines 1 2 9 15 17 34.091 4

Delay in reimbursement of treatment amount 15 5 11 6 7 25.000 3
Source: Survey

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