ESIC Issues New Guidelines for Efficient Grievance Resolution

30 November 2024

On November 21, 2024, the Employees’ State Insurance Corporation (ESIC) released an important Office Memorandum aimed at improving the quality, effectiveness, and timeliness of public grievance resolutions. This action follows concerns about delays and inadequate responses to grievances from Insured Persons (IPs) and other ESI beneficiaries, particularly those submitted through the CPGRAMS portal and other channels.

Key Highlights from the ESIC Notification:

Priority Handling of Grievances: All Heads of Offices and Grievance Redressal Officers are now required to prioritize public grievances and resolve them within 21 days of receipt. Grievances can be submitted through various means, including the CPGRAMS portal, emails, hard copies, walk-ins, or complaint boxes. Effective coordination between different offices or branches is essential for prompt resolution.

Daily Monitoring of CPGRAMS: GROs must monitor the CPGRAMS portal twice daily, preferably in the morning and evening, to ensure timely attention to grievances.

Timely and Qualitative Responses: Grievances should be resolved within 15 days of receipt, with a clear and reasoned explanation provided to the petitioner. A telephone confirmation of the complainant’s satisfaction must be recorded in the CPGRAMS portal before marking the grievance as resolved.

Prioritization of Key Grievances: Grievances related to medical reimbursement, medical facilities, cash benefits, corruption, and issues concerning the coverage or under-reporting of employees under the ESI Act will be prioritized and resolved within 21 days.

Medical Reimbursement Grievances: ESIC offices must provide detailed information to petitioners regarding medical reimbursement claims, including the amount claimed, entitlement, applicable rates, and any deductions made according to CGHS rates.

Timely Responses to PG Appeals: Appeals against grievances must be addressed with a reasoned reply, referencing relevant rules and regulations, within 20 days of receipt. No appeal should remain pending for more than 30 days.

Increasing GROs for Efficiency: To enhance grievance resolution efficiency, the number of GROs may be increased if necessary, without compromising the quality of resolutions.

Updating GRO Information: Any changes in the Grievance Redressal Officer (GRO) due to transfer, new nomination, or revised work allocation must be immediately updated on the CPGRAMS portal and communicated to the PG Branch at Headquarters, New Delhi.

Language Requirements for Grievances in Hindi: Grievances submitted in Hindi must be replied to in Hindi to ensure better communication with petitioners.

Standard Operating Procedures (SOPs) for Grievance Redressal: ESIC’s SOPs and instructions, particularly those issued on December 8, 2020, must be meticulously followed. The SUVIDHA SAMAGAM events, aimed at providing on-the-spot resolutions and gathering feedback from Insured Persons and ESI beneficiaries, will continue as per previous guidelines.

Conclusion: The updated directives from ESIC are a significant step towards enhancing the grievance redressal process, ensuring that the concerns of Insured Persons and ESI beneficiaries are addressed promptly and effectively. These guidelines focus on efficiency, transparency, and quicker turnaround times, aiming to reduce dissatisfaction and improve the overall experience for insured persons. All ESIC officials are urged to adhere to these updated instructions and prioritize public grievances to ensure a smooth and effective resolution process.

 

Ministry of Labour and Employment Notification

The Ministry of Labour and Employment has issued a new notification (G.S.R. 715(E)) to amend the Employees’ Deposit-Linked Insurance Scheme, 1976. This amendment, known as the Employees’ Deposit-Linked Insurance (Second Amendment) Scheme 2024, will come into effect on April 28, 2024.

Key Amendments:

Scheme Title and Commencement:

  • The amendment is titled the Employees’ Deposit-Linked Insurance (Second Amendment) Scheme 2024.
  • It will be deemed effective from April 28, 2024.

Revised Benefits on Employee Death:

  • Upon the death of an employee who has been a member of the Fund or an exempted provident fund under section 17 of the Act, and who was employed continuously for the twelve months preceding their death, the beneficiaries will receive:
    • An amount equal to the average monthly wages (up to a maximum of ₹15,000) drawn during the twelve months preceding the death, multiplied by 35 times, plus 50% of the average balance in the deceased’s account during the preceding twelve months, subject to a ceiling of ₹1,75,000.
    • The assurance benefit will not be less than ₹2,50,000 and will not exceed ₹7,00,000.
    • The higher amount between the calculated benefit and the assurance benefit will be paid.

Special Provisions for Part-Time Employees:

  • For part-time employees who were members of the Fund or an exempted provident fund and worked in more than one establishment for a continuous period of twelve months preceding their death, the benefit will be calculated based on the aggregate average wages from all establishments, subject to the ₹15,000 wage ceiling.

These amendments aim to enhance the financial security of employees’ families by providing substantial benefits in the event of the employee’s death. The Ministry of Labour and Employment urges all relevant parties to adhere to these updated provisions to ensure timely and adequate support for beneficiaries.

 

Ministry of Environment, Forest and Climate Change Notification

New Guidelines for Nomination and Service Conditions of State Board Chairman

The Ministry of Environment, Forest and Climate Change has issued a notification detailing the procedures and conditions for the nomination and service of the Chairman of the State Board. The nomination will be made by the State Government based on recommendations from a Selection Committee, which includes high-ranking officials and an environmental expert. The Selection Committee will invite applications through advertisements in national newspapers and recommend a panel of candidates.

The Chairman will receive pay and allowances equivalent to a Central Government Group ‘A’ officer at Level-17 of the Seventh Central Pay Commission. The Chairman must not have any financial or other interests that could affect their duties. If the Chairman is a pensioner, their pay will be adjusted accordingly. The tenure is set for a maximum of three years or until the age of 65, with provisions for re-nomination.

The notification also outlines disqualification criteria, including marital status and grounds for removal, such as insolvency, conviction, incapacity, or misconduct. The State Government may issue Standard Operating Procedures to ensure smooth implementation of these rules.


 

 

 

 

Disclaimer: The information published in the above newsletter is collected from various sources in electronic medium and analyzed by the firm. The reader is advised to consult the attorney qualified in their jurisdiction, before acting on any information contained in this newsletter. India Juris excepts no liability what so ever in this regard. 

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