CLAIM FOR BENEFIT NOT MAINTAINABLE

Can an employee covered under the E.S.I. Act claim disablement benefit from the Employees' Insurance Court without first approaching the E. S.1. Corporation?

The language of section 77(1) (I-a) of Employees' State Insurance Act is unambiguous and clear and leaves no scope for any exception. An employee claims benefits in accordance with the vari­ous regulations as contained in Chapter 3. Thereafter under Regula­tion 51, if the authority certifies the eligibility of the claim and, then the benefit shall be paid in accordance with Regulation 50. Regulations 53 to 64 deal with certification and claim from sickness and temporary disablement. After the scrutiny of the claim by the corporation. If the claim is denied by the corporation, then only the cause of action arises to an insured person under section 77 of the Act to commence the proceedings before the Employees' Insurance Court. In one case, court has held that in fact the application was premature and the E.!. Court acted illegally, in not directing the appellant insured person to approach the E.S.l. Corporation. It was also observed that the Corporation was also responsible for not invit­ing the attention of the court to decide the matter in respect of cause of action and maintainability of the application.

Radheyshyam vs. Employees State Insurance Corporation, Ujjain, 1989 (58) FLR 133 (M.P.HC Indore Bench),