India has quietly rolled out one of the most ambitious occupational health reforms in its history: under the four consolidated labour codes that replaced 29 archaic laws, every employer (government, private, factory, or establishment) is now legally bound to provide completely free annual medical examinations to all employees aged above 40, a move designed to catch the silent epidemic of non-communicable diseases before they become fatal or crippling.

The cornerstone provision is embedded in the Occupational Safety, Health and Working Conditions (OSH) Code 2020, which explicitly mandates “free annual health check-up of the workers” along with tests prescribed by the central government. With hypertension, diabetes, heart disease, and cancer driving nearly two-thirds of all deaths in the country and costing the economy an estimated $6 trillion by 2030 according to some studies, this single clause transforms preventive screening from a corporate perk into an enforceable statutory right for tens of millions of ageing workers across formal and semi-formal sectors.

For the first time, fixed-term employees, contract labourers, seasonal workers, and even gig-economy personnel (delivery agents, drivers, and freelancers on digital platforms) have been brought under an expanded social security umbrella. The Code on Social Security 2020 ensures near-parity with permanent staff on medical benefits, while aggregators are required to divert 1-2 per cent of annual turnover into a dedicated welfare fund that will finance health coverage, accident insurance, and maternity benefits, effectively extending ESI-like protection to the unorganised digital workforce.

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Compliance has been deliberately streamlined through a unified digital portal that replaces dozens of old registers and returns with a single annual filing, single registration, and single licence. This removes the bureaucratic nightmare that earlier discouraged small and medium enterprises from offering structured health programmes, making it feasible for factories in Tiruppur, construction sites in Gurugram, and IT campuses in Bengaluru to organise systematic screenings without drowning in paperwork.

While the exact battery of tests (blood sugar, lipid profile, ECG, cancer markers, etc.) will be notified soon, and the age threshold of 40 currently excludes younger employees, the reform plugs a glaring gap: fewer than one in five Indian companies previously offered routine preventive check-ups despite over 70 per cent of the workforce showing lifestyle-disease risk factors. Early evidence from similar programmes elsewhere and Indian pilot studies indicates that systematic screening can reduce mortality risk by up to 48 per cent and slash long-term treatment costs dramatically, promising healthier lives and a more productive economy.

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