December 19: The server of Social Security Fund has started becoming problematic.   

As the number of beneficiaries of the state-sponsored scheme is increasing, the problem has started to appear in recent days.

This has started affecting the contributors while making claims for refund after visiting the hospital for treatment.

On Monday, Bijay Nepal reached Old Baneshwar-based Frontline Hospital for treatment. He tried to purchase medicine as recommended by the doctor at a discount rate as guaranteed by the Social Security Fund but failed to get the service. The pharmacy staff said there was a problem with the SSF served and asked him to take the medicine without any discount. He returned empty-handed saying that he would take the medicine later.

Other contributors who went to the National Trauma Center last Thursday also faced a similar problem. Contributor Ramesh Sharma said that the center refused to give medicine after treatment saying that there was a problem with the server. Like him, many others have also complained of facing the same predicament.

Hospitals have been saying that the server of the SSF is having frequent problems in the last few days. Sometimes, the problem lasts throughout the day. Beneficiaries have been affected by the malfunctioning of the SSF server.

According to the fund, about 466,000 workers in the formal sector working in 18,504 establishments have been listed in the social security scheme of the SSF as of December 16. Likewise, the number of contributors who have gone for foreign employment as well as those from the informal sector and self-employed has reached 985,000.

The Social Security Act has a provision that formal and informal sector workers and self-employed persons can be included in the social security scheme of the government. This has broadened the scope of the fund.

According to the details kept by the fund on its website, the contributors of the social security scheme get treatment services from 71 hospitals across the country. The SSF has signed agreements with Bir Hospital, Tribhuvan University Teaching Hospital, Shahid Gangalal National Heart Center and other hospitals in Kathmandu.

When taking services from those hospitals, the beneficiary has to pay only 20 percent of the cost of the treatment. Although the fund claims that the contributors will be free from the hassle of making claim for the medical treatment, health and maternity protection plan and accident and disability protection plan provided by the fund by taking benefit directly from hospitals that operate online services, the contributors are now facing problems due to the malfunction of the SSF server.

According to Section 10 of the Social Security Act, the SSF facilitates its contributors under various schemes such as drug treatment and health protection scheme, maternity protection scheme, accident protection scheme, disability protection scheme, old age protection scheme, dependent family protection scheme, unemployment assistance scheme, as well as other social security schemes specified by the fund.

There is a scheme to cover all treatment expenses under OPD and IPD services under the facility of drug treatment, health and maternity protection scheme. Under this scheme, the contributor can claim the doctor's consultation service and all the treatment expenses, the expenses according to the medicine bill, the regular pregnancy test of the female contributor or the contributor's wife and the maternity treatment up to 6 weeks, the treatment expenses of a child up to 3 months after birth.

Similarly, there is a provision to claim money for maternity leave (facility), claim money for sick leave (facility), maternity care expenses. Limits have been fixed within this scheme. There is a provision that OPD service recipients can receive 80 percent of the funds from the SSF’s treatment expenses which covers up to a maximum of Rs 25,000 in a fiscal year. The remaining 20 percent of the amount has to be borne by the contributor.

There is also a provision that 80 percent of the hospital admission expenses up to a maximum of Rs 100,000 in one fiscal year for those taking IPD services will be paid directly from the fund to the hospital where they are admitted and the remaining 20 percent should be borne by the contributors. All these services should be taken online.

When the increase in the number of contributors, the service seekers have started to suffer due to weakness in the server. Officials of the Social Security Fund say that there are occasional problems with the servers and they resolve them as soon as possible.

According to Bivek Panthi, deputy executive director of the fund, they resolve the problem immediately.

"Another reason for the interruption of the service is the problem in the server of the hospital," he said.