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FUNERAL EXPENSES FORM EMPLOYEES’ STATE INSURANCE CORPORATION (Regulation 95E) Claim arising out of death on _____of _____ s/w/d of _____ aged _____ years, having Insurance No._____ and last employed as _____ by M/s _____ Code No. _____

Under Employee State Insurance Scheme the dependents of deceased ESIC member can get 15000 Rs amount as funeral expenses (W.E.F 1 March 2019). The family members need to claim ESI funeral expenses within 6 months from the date of the death of the insured person. Here can know how to fill ESIC form 22 and also find sample filled ESIC form 22.

The ESIC Form-22 for making the Funeral Expenses Claim is available. The form is provided by the Employee’s State Insurance Corporation (ESIC), Ministry of Labour and Employment, Government of India.

2023年3月6日 · ESIC Form 23 - LIFE CERTIFICATE FOR PERMANENT DISABLEMENT BENEFIT size:(40.63 KB) . 2023-03-06: 399/2023: 2: ESI Corporation : ESIC Form 22- Funeral Expenses Claim size:(32.81 KB) . 2023-03-06: 398/2023: 3: ESI Corporation: ESIC Form 37- Application for acceptance for medical treatment size:(20.27 KB) .

ESIC - 32 – Wage contributory Record. ESIC - 142 – Claim for Conveyance Allowance. Form - 11 Accident Book. Form - 12 Accident Report. Form - 14 Claim for PDB. Form - 15 Claim for DB. Form - 22 Funeral Expenses. Form - 23 Life Certificate PDB. Form - 24 Life Certificate DB

Download the Form 22 ESIC in PDF format using the link below. This application form is essential for claiming funeral expenses and is issued by the Employee’s State Insurance Corporation (ESIC), which operates under the Ministry of Labour and Employment, Government of India.

Form 22 ESIC is a medical acceptance card issued by the Employees’ State Insurance Corporation (ESIC) in India. It serves as an identity card for insured persons and their family members to avail of medical benefits under the ESIC scheme.

Sl. No. CLAIM FORMS FORM NO. 01. Life certificate for permanent disablement ... SCMB 06. Confinement expenses CE 07. Conveyance allowance ESIC-141 08. Unemployment allowance UA1 09. Atal beemit vyakti kalyan yojana (ABVKY) AB-1 10. COVID-19 relief scheme (CRS) CRS-I, CRS-II, CRS-III, CRS-IV & CRS-V 11. Funeral expenses REG-22 ...

ESIC form 22 is used to claim funeral expenses for ESIC members who have passed away. ESI provides a payout of an amount to dependents of deceased members.