Employment Injury Insurance - Social Security Fund Nepal

Social Security Fund Nepal

The Social Security Fund (SSF) of the government of Nepal was founded in the year 2011 and launched four social protection schemes in the year 2018: health and maternity insurance scheme, old age pension scheme, life insurance scheme, as well as accident and disability insurance scheme, all targeted towards formally employed workers. The current benefit package within the Employment Injury Insurance scheme offers full coverage of the medical expenses incurred in the treatment following the employment related accident, together with salary compensation until the beneficiary can return to work. Additionally, a maximum coverage of Rs. 700,000 (EUR 5500) is also offered to beneficiaries for medical expenses following a non-employment related accident.

Standard Operating Procedures

The scheme was launched from July 2019 and 11,852 employers, with a total of 133,111 employees are currently enrolled into the scheme (end of 2019). However, a lack of Standard Operating Procedures and a Management Information System to systematically process the claims coming in has made it difficult for the SSF to serve their beneficiaries effectively.

A team from the Hochschule Bonn-Rhein Sieg and Deutsche Gesetzliche Unfallversicherung (DGUV) are currently supporting the SSF Nepal in the design of the Standard Operating Procedures(SoP) of the Employment Injury Insurance Scheme.

Presented below are some of the SoPs that have been developed till date.

SOP

 

SOP

 

Employer Registration

 

Employee Registration

 

Claims Management - Accident

 

Claims Management - Occupational Disease

 

Record Keeping

 

Medical Treatment - Accident Insurance

 

Financial compensation - Inability to Work

 

Financial Compensation - Surviving Dependents

 

Complaints Management