My ESI claim was rejected but I was not given any reason. Can RTI compel ESIC to explain the rejection?

Yes. Under the RTI Act, 2005, ESIC — as a statutory corporation and public authority under Section 2(h) — is obligated to provide information about decisions it has made, including the reasons for rejecting a claim. File RTI with the CPIO at the Regional or Sub-Regional Office that processed your claim, asking specifically for: (1) the date on which the claim was received and the date on which it was disposed of; (2) the reason for rejection and the specific provision of the ESI Act, 1948, or the ESI (General) Regulations, 1950, under which the rejection was made; (3) the inspection report or medical examination report (if any) on which the rejection is based. Once you have the reason in writing from the RTI response, you can challenge an incorrect rejection under Section 75 of the ESI Act before the ESI Court (Employees' Insurance Court), or file a First Appeal and then a Second Appeal to the CIC if ESIC does not provide information.

My employer has been deducting ESI from my salary but not depositing it with ESIC. How can RTI help?

This is a serious violation. Under the ESI Act, 1948, the employer is responsible for both the employer's share (currently 3.25% of wages) and the employee's share (0.75% of wages) — and failure to deposit is recoverable with damages under Sections 45B and 45C of the Act. File RTI with the CPIO at the ESIC Regional Office for your employer's coverage area, asking for: (1) whether contributions for your IP Number have been received for the periods in question; (2) whether any inspection or enquiry has been conducted at your employer's premises; (3) whether any recovery notice or show-cause notice has been issued to the employer. The RTI response will confirm whether the arrears are on ESIC's record. You can also simultaneously file a complaint at the ESIC Regional Office — under Section 45-AA, ESIC can recover arrears with interest and damages up to three times the contribution amount.

How do I find out my IP (Insured Person) Number if my employer never gave it to me?

Your IP Number is a unique 17-digit identification number assigned to you when your employer first registers you with ESIC. If you were never given this number, you have several options: (1) Check your payslips — many employers print the IP Number on payslips; (2) Log into the ESIC employee self-service portal at esic.gov.in → 'Insured Person' using your name, date of birth, and employer's ESI code; (3) Visit the nearest ESIC branch office or ESI dispensary with your employer's name, address, and employment start date — they can look up your registration. If your employer registered you but withheld your IP Number, file RTI with the CPIO at the ESIC Regional Office, providing your name, date of birth, employer name, and employment period, and ask for your registration status and IP Number. If your employer never registered you with ESIC despite you being eligible (earning up to ₹21,000/month in a covered establishment), that is a violation of Section 2A of the ESI Act.

What is the difference between ESIC and EPFO? I am confused about which one covers my health insurance and which covers my provident fund.

ESIC (Employees' State Insurance Corporation) and EPFO (Employees' Provident Fund Organisation) are two completely separate statutory bodies under the Ministry of Labour and Employment, covering different benefits. ESIC administers the Employees' State Insurance (ESI) Scheme under the ESI Act, 1948 — it covers medical benefits (hospitalisation, OPD, medicines), sickness cash benefit, maternity benefit, disablement benefit, and dependants' benefit. ESIC applies to employees earning up to ₹21,000 per month (₹25,000 for persons with disabilities) in covered establishments (factories and establishments with 10 or more employees in notified areas). EPFO, on the other hand, administers the Employees' Provident Fund (EPF) and Employees' Pension Scheme (EPS) under the EPF & MP Act, 1952 — it deals with retirement savings (PF), pension, and EDLI insurance. If your problem is about health treatment, medical bills, sickness cash, or maternity leave payment from the insurance fund — file RTI with ESIC. If your problem is about PF balance, withdrawal, pension, or UAN — file RTI with EPFO.

Can I claim maternity benefit under ESIC and how does RTI help if my maternity benefit claim is stuck?

Yes. Under the ESI Act, 1948, an insured woman is entitled to maternity benefit (cash payment at double the standard benefit rate for 26 weeks for the first two children) provided she has contributed for at least 70 days in the two consecutive contribution periods immediately preceding the expected date of delivery. Maternity benefit under the ESI scheme is separate from the Maternity Benefit Act, 1961 — the ESI scheme's maternity benefit replaces the employer's maternity obligation under the Maternity Benefit Act for covered establishments. If your maternity benefit claim is delayed or rejected, file RTI with the CPIO at the ESIC Regional Office, asking: (1) whether your contribution record for the qualifying periods (70 days in the relevant two contribution periods) is on record; (2) the current status of your maternity benefit claim — date received, date of expected disposal, amount sanctioned or reason for delay or rejection; (3) the name and designation of the officer responsible for processing your claim. The RTI response and subsequent appeals can be used to compel timely processing. For urgent matters where delay affects life or livelihood, note that Section 7(1) proviso mandates a 48-hour response if the information is necessary to protect life or liberty.

Home/Guides/How to File RTI for ESIC Employee State Insurance Claims and Benefits

Central Government

How to File RTI for ESIC Employee State Insurance Claims and Benefits

Step-by-step guide to file RTI with ESIC for insurance claim status, ESI contribution records, medical benefit disputes, employer non-compliance, and maternity benefit queries. Includes a ready-to-use sample RTI draft and FAQs.

Updated 27 May 2026

Quick Facts

MinistryMinistry of Labour and Employment

Address RTI ToCentral Public Information Officer (CPIO), ESIC Regional Office / Sub-Regional Office

Application Fee₹10 under RTI (Regulation of Fee and Cost) Rules, 2005. Free for BPL cardholders.

Response Time30 days from receipt (Section 7(1), RTI Act 2005). 48 hours if the matter involves life or liberty.

File Online Athttps://rtionline.gov.in

All information on this page is based on the Right to Information Act, 2005 (Act No. 22 of 2005) and the RTI (Regulation of Fee and Cost) Rules, 2005. First Appeal: Section 19(1). Second Appeal to CIC/SIC: Section 19(3).

The Employees' State Insurance Corporation (ESIC) is one of India's largest social security organisations, administering the Employees' State Insurance (ESI) Scheme under the Employees' State Insurance Act, 1948. The scheme provides comprehensive social security to workers — covering medical treatment, sickness cash benefit, maternity benefit, disablement benefit, and dependants' benefit — for employees earning up to ₹21,000 per month (₹25,000 for persons with disabilities) in factories and other covered establishments.

ESIC is a public authority under Section 2(h) of the RTI Act, 2005, and its Regional Offices, Sub-Regional Offices, and Branch Offices are all subject to RTI obligations.

ESIC at a Glance

Feature	Detail
Governing Act	Employees' State Insurance Act, 1948
Coverage threshold	Employees earning up to ₹21,000/month (₹25,000 for PwD)
Applicable establishments	Factories and notified establishments with 10 or more employees
Contribution — Employer	3.25% of wages
Contribution — Employee	0.75% of wages
Contribution periods	April–September and October–March (two per year)
Benefits	Medical, sickness benefit, maternity benefit, disablement benefit, dependants' benefit
Filing portal	rtionline.gov.in

What Can You Achieve with RTI to ESIC

Workers and insured persons face a range of problems when dealing with ESIC — delayed claims, unexplained rejections, employers who deduct ESI contributions but never deposit them, and dependants who cannot access medical benefits because of registration errors. RTI is often the fastest way to force ESIC to put its records on paper.

Specifically, RTI to ESIC can help you:

Verify your contribution record: Confirm that your employer has actually deposited ESI contributions on your wages for every contribution period, and identify gaps or shortfalls.
Establish claim status: Find out whether a pending sickness benefit, maternity benefit, disablement benefit, or medical reimbursement claim has been received, processed, or stuck — and why.
Understand rejection reasons: If ESIC rejected or short-settled a claim without an adequate explanation, RTI can compel the corporation to provide the exact legal provision under which the decision was made.
Expose employer non-compliance: If your employer is not depositing contributions, RTI can reveal whether ESIC is aware of the arrears and what action (if any) it has taken.
Confirm dependant registration: Verify whether your spouse, children, or dependent parents are correctly registered as dependants on your IP Number for medical benefit entitlement.
Obtain ESI dispensary and hospital lists: Get the list of ESIC dispensaries, ESIC hospitals, and empanelled private medical practitioners in your area.

Where to File: The Right Authority

ESIC has a three-tier structure — Headquarters (New Delhi), Regional Offices, and Sub-Regional / Branch Offices. For RTI, the correct authority depends on the nature of your query:

ESIC Headquarters, New Delhi — Policy, national data, HQ-level decisions
        ↓
Regional Office — Covers a state or large region; handles employer registrations,
                  contribution accounts, major claims, appeals
        ↓
Sub-Regional / Branch Office — Covers districts; processes most individual
                                employee claims and benefit payments
        ↓
ESI Dispensary / Hospital — Provides medical treatment; not an RTI authority itself
                             (medical records queries go to Regional Office)

For individual benefit and claim queries (sickness benefit, maternity benefit, contribution record, claim rejection): file with the CPIO at the Regional Office or Sub-Regional Office whose jurisdiction covers your employer's place of business.

For employer compliance and registration queries: file with the Regional Office that issued or should have issued the employer's ESI code.

For policy-level or national statistical information: file with the CPIO at ESIC Headquarters, New Delhi, through rtionline.gov.in.

Note on ESI dispensaries and hospitals: An ESI dispensary or ESIC hospital is a medical service delivery point — it does not have independent RTI machinery. All RTI applications must be addressed to the CPIO at the Regional or Sub-Regional Office with jurisdiction over that dispensary or hospital.

How to File: Step by Step

Step 1 — Identify your ESIC Regional Office

Find which Regional Office covers your employer's location by visiting esic.gov.in → Contact → Regional Offices, or by calling the ESIC helpline (1800-11-2526, toll-free). Note the complete mailing address of the Regional Office.

Step 2 — Gather your details before writing

You will need: your IP (Insured Person) Number, your employer's name and ESI Employer Code, the contribution periods in question, and (for claim-related RTIs) the claim ID or reference number. If you do not know your IP Number, see the FAQ below on how to find it.

Step 3 — Draft your RTI application

Use the sample RTI provided above as a starting point. Be specific: ask for information period by period, claim by claim. Vague requests like "tell me everything about my account" invite partial or evasive responses. Ask for documents — contribution challans, inspection reports, claim processing records — by name if you know them.

Step 4 — File online or by post

For the online route, visit rtionline.gov.in, select Ministry of Labour and Employment, then Employees' State Insurance Corporation, and select the relevant Regional Office as the public authority. Pay the ₹10 fee online. For the postal route, send your application by registered post or speed post to the CPIO at the Regional Office address, with a demand draft or Indian Postal Order for ₹10 drawn in favour of "PAO, ESIC" (payable at the station of the Regional Office). BPL cardholders are exempt from the fee — attach a copy of your BPL card.

Step 5 — Track, appeal, and escalate if needed

ESIC must respond within 30 days (Section 7(1), RTI Act). If ESIC does not respond, or the response is incomplete or incorrect, file a First Appeal with the First Appellate Authority (FAA) at the same Regional Office within 30 days of the date of decision or expiry of the 30-day response period, whichever is applicable (Section 19(1)). If still unsatisfied, file a Second Appeal with the Central Information Commission (CIC) within 90 days of the FAA's decision (Section 19(3)). ESIC is a Central Government body — second appeals always go to the CIC, not a State Information Commission.

What Specific Information Can You Ask For

Contribution records:

Month-wise (or contribution-period-wise) contribution statement for your IP Number, showing wages, employee share, employer share, and deposit date for each period
Whether any contribution arrears exist against your employer — amount outstanding and period of default
Copies of ESI contribution challans deposited by the employer for specified periods

Claim status and processing: 4. Status of a specific claim by Claim ID — whether received, under processing, approved, or rejected, and the date of each stage 5. The reason for rejection or partial settlement, with the specific provision of the ESI Act, 1948, or ESI (General) Regulations, 1950, cited 6. The name and designation of the officer who processed or rejected the claim, and the date of the decision

Employer compliance: 7. Whether your employer is registered with ESIC and the employer's ESI Code number 8. Whether any inspection of the employer's premises has been conducted under Section 45 of the ESI Act — the inspection report and findings 9. Whether a show-cause notice, recovery notice, or prosecution has been initiated against the employer under the ESI Act — and the current status

Medical benefit and dependant registration: 10. Whether your dependants (spouse, children, dependent parents) are registered on your IP Number — names and relationship as registered 11. The list of ESI dispensaries and empanelled private medical practitioners in your area — names and addresses 12. Whether a specific ESI dispensary or ESIC hospital has the facility for specific treatment or specialist that you have been denied

Maternity and disablement: 13. The contribution record for the qualifying periods (the two contribution periods preceding the date of delivery or disablement) and whether you meet the 70-day qualifying threshold 14. The rate at which maternity benefit or disablement benefit has been calculated and the basis for that rate

Appeals

First Appeal (Section 19(1)): File with the First Appellate Authority (FAA) at the ESIC Regional Office within 30 days of the date of decision or expiry of the 30-day response period, whichever is applicable.

Second Appeal (Section 19(3)): File with the Central Information Commission (CIC) within 90 days of the FAA's decision. ESIC is a Central Government statutory body — second appeals go to the CIC, never to a State Information Commission.

Penalty: If ESIC's CPIO fails to respond without reasonable cause, or provides false information, the CIC can impose a penalty of ₹250 per day (up to ₹25,000) on the CPIO under Section 20 of the RTI Act.

Sample RTI Application Draft

To,
The Central Public Information Officer (CPIO),
Employees' State Insurance Corporation,
[Regional / Sub-Regional Office Address]

Subject: Application under the Right to Information Act, 2005 — ESI Claim Status, Contribution Records and Employer Compliance

Sir/Madam,

I, [Your Full Name], an insured person bearing IP Number [Your IP No.], employed at [Employer Name and Address], submit this application under Section 6 of the Right to Information Act, 2005, to seek the following information:

Details of the insured person:
  IP Number: [Your IP No.]
  Name: [Your Full Name]
  Employer Name: [Employer's Registered Name]
  Employer Code: [Employer ESI Code, if known]
  Period of employment: [From MM/YYYY to MM/YYYY or "continuing"]

Information sought:

1. Please provide the month-wise ESI contribution record for my IP Number [Your IP No.] for the last two years (April [YYYY] to March [YYYY]), showing — for each contribution period — the wages on which contribution was calculated, the employee's share of contribution, the employer's share of contribution, and whether the contribution was actually deposited with ESIC.

2. What is the current status of my ESI claim bearing Claim ID / Reference No. [Claim No.], submitted on [DD/MM/YYYY] for [nature of claim — e.g., sickness benefit / maternity benefit / medical reimbursement]? Please provide the date of receipt of the claim, the date of disposal, and the amount sanctioned or the reason for rejection if the claim has been rejected or is pending beyond the prescribed timeline.

3. If my claim has been rejected or partially settled — please provide the specific reason for rejection or partial settlement and the provision of the ESI Act, 1948, or ESI (General) Regulations, 1950, under which the decision was made.

4. Whether my employer [Employer Name], ESI Employer Code [Code], has deposited all ESI contributions due for the period [From MM/YYYY to MM/YYYY] within the prescribed timelines. If any contributions have not been deposited or have been deposited with delay, please provide details of the arrears amount and any action taken by ESIC against the employer.

5. Whether any show-cause notice, inspection report, or recovery proceeding has been initiated against [Employer Name] under the Employees' State Insurance Act, 1948, in connection with contribution arrears or non-compliance — and the current status of such proceedings.

6. What is my current entitlement to medical benefits under the ESI scheme — specifically, whether I am currently in an eligible contribution period and whether my dependants (spouse, children, dependent parents) are registered with ESIC as dependants on my IP Number?

I am enclosing the application fee of Rs. 10 [via online payment; Reference No.: [Payment Ref]].

I request the above information within 30 days as required under Section 7(1) of the RTI Act, 2005.

Yours sincerely,

[Your Full Name]
[Your Complete Address]
Phone: [Your 10-digit Mobile Number]
Email: [[email protected]]
Date: [DD/MM/YYYY]

Replace all text in [square brackets] with your actual details before filing. Do not include the brackets in your submission.

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