Questionnaire for Studying Effectivenes of Esi Benefits

1. District –
2. Category – Factory Establishment Personal Profile
3. Sex – Male Female 4. Age – Below 25years 25 – 35 35 – 45 Above 45years 5. Marital Status- Single Married 6. Number of Dependants- Less than 2 2 – 4 Above 4

7. Educational Qualification-
Below SSLC SSLC Plus Two/PDC Degree PG Technical/Diploma 8. Nature of Employment – Temporary Permanent 9. Period of Service – Less Than 1 year 1 – 10 10- 20 Above 20 years 10. Nature of Pay – Piece rate Daily Wages Monthly Salary 11. Monthly Income from Employment – Less than 2000 2000-6000 6000-10000 10000-15000

Effectiveness of ESI Benefits
12. Are you aware of the ESI benefits – Fully aware Partially aware Not at all 13. If you are aware of the benefits .specify the source of awareness – ESI Publications ESIC Officials Employers Co-workers/Friends Others, Specify 14. Do you regularly get the informative publications of the Corporation? YES NO 15. Are you satisfied with the measures taken by the corporation for providing information on the ESI Scheme? Extremely Satisfied Satisfied Not Satisfied No Opinion 16. Are you aware of the formalities for claiming various benefits provided by the Corporation? Fully aware Partially aware Not at all 17. Why do you prefer ESI Hospital for treatment when you are sick? Good Treatment Free Medical Care No other option 18. Are you satisfied with the following services & facilities provided in ESI Hospital for medical care? Service of Doctors – Extremely Satisfied Satisfied Not Satisfied No opinion Specialists’ Service- Extremely Satisfied Satisfied Not Satisfied No opinion Availability of Medicine- Extremely Satisfied Satisfied Not Satisfied No opinion Laboratory Services- Extremely Satisfied Satisfied Not Satisfied No opinion In-patient Treatment

& other hospital facilities- Extremely Satisfied Satisfied Not Satisfied No opinion Health Improvement Services- Extremely Satisfied Satisfied Not Satisfied No opinion 19. If any time, have you availed medical reimbursement from ESI Corporation. YES NO

20. If yes, is there any delay in getting the reimbursement? High delay Moderate delay No delay No Opinion 21. If any time, have you availed the following cash benefits provided by the Corporation. Sickness Benefit-

Maternity Benefit-
Disablement Benefit-
Other Benefits –
22. Are you satisfied with the amount of the following Cash Benefits provided by the Corporation? Sickness Benefit – Extremely Satisfied
Satisfied Not Satisfied No opinion Maternity Benefit – Extremely Satisfied Satisfied Not Satisfied No opinion

Disablement Benefit – Extremely Satisfied Satisfied Not Satisfied No opinion Other Benefits – Extremely Satisfied Satisfied Not Satisfied No opinion 23. Is there any delay in getting the payment of Cash Benefits? Sickness Benefit – High delay Moderate delay No delay No Opinion Maternity Benefit- High delay Moderate delay No delay No Opinion Disablement Benefit- High delay Moderate delay No delay No Opinion Other Benefits- High delay Moderate delay No delay No Opinion 24. Are you satisfied with the services of the Administrative Staff for claiming the ESI Benefits? Extremely Satisfactory Satisfactory Not Satisfactory No opinion 25. Please give suggestions, if any to improve Benefits provided through ESI Scheme.