Before You Claim — 3 Rules to Know

🏥 Go to an empanelled hospital first SSF has 100+ empanelled hospitals across Nepal. Treatment is cashless — SSF settles directly with the hospital. No upfront payment beyond your 20% co-pay.
Find empanelled hospitals → [Source: ssf.gov.np]

🚨 Emergency exception If you go to a non-empanelled hospital in an emergency: get treatment first. Then notify SSF within 7 days (01-4529149 or info@ssf.gov.np). Submit your reimbursement claim with all bills within 30 days. [Source: Operating Procedure 2075]

✅ Check your contributions are active Your employer must be depositing your SSF contributions for coverage to apply. Log in at sosys.ssf.gov.np before any planned procedure to verify. Missing months = coverage gap.

Scheme 1 — Medical & Maternity Claim

OPD coverage starts: After 3 months of contributions
Annual limit: NPR 25,000

IPD coverage starts: After 3 months of contributions
Annual limit: NPR 1,00,000

Maternity coverage starts: After 12 months within previous 18 months
98 days paid leave

Medical cover continues for up to 2 years after you stop contributing

OPD & IPD — Steps at an Empanelled Hospital

Visit the SSF-empanelled hospital — show your SSFID card or number at reception
Hospital verifies coverage with the SSF portal online — takes a few minutes
You pay 20% co-payment — SSF covers the remaining 80%
Hospital sends claim to SSF directly — no paperwork required from you
For fatal diseases (cancer, kidney failure): up to NPR 1,00,000 additional; board-approved critical cases up to NPR 7,00,000

Emergency at a Non-Empanelled Hospital

Get treatment first — your health is the priority
Within 7 days: notify SSF by calling 01-4529149 or emailing info@ssf.gov.np
Within 30 days: submit reimbursement claim with all hospital bills, discharge summary, doctor's prescriptions, and your SSFID

Maternity Claim

Confirm eligibility: 12 months of contributions within the previous 18 months
Visit an SSF-empanelled hospital for delivery
Mother receives 98 calendar days paid maternity leave — employer pays salary, claims reimbursement from SSF
Newborn lump sum: 1 month minimum wage — employer claims through SSF portal
Father: 15 working days paternity leave

Documents for medical claims: SSFID number, citizenship copy, hospital bills/receipts, doctor's prescription or discharge summary, bank account details (for reimbursements)

[Source: Operating Procedure 2075, Sections 8–10]

Scheme 2 — Accident & Disability Claim

⚡ Accident coverage starts Day 1 — NO waiting period. You are covered from your very first day at work, regardless of how many months you have contributed. [Source: Operating Procedure 2075]

Workplace Accident — Steps

Get immediate treatment — go to any hospital in an emergency
Notify your employer immediately after receiving first aid
Employer notifies SSF within 7 days — this is the employer's legal obligation
At an SSF-empanelled hospital: 100% of costs covered, no co-payment
At a non-empanelled hospital: SSF reimburses up to NPR 7,00,000 after deducting any other insurance paid

Temporary disability
SSF pays 60% of your basic salary per month while you recover. Employer submits claim with your medical certificate and latest salary slip. [Source: Operating Procedure 2075]

Permanent disability
SSF medical subcommittee assesses your disability percentage. Full permanent disability = lifetime monthly pension. Partial = proportional monthly pension. [Source: Operating Procedure 2075]

⚠️ July 2025 Rule — Employer Personally Liable: If your employer had NOT deposited SSF contributions when you were injured, the employer personally pays your full treatment costs from their own funds. SSF does not cover the gap. Section 9(6), Act to Amend Some Nepal Acts 2082 (Nepal Gazette 2082/04/14). [Source: Act to Amend Some Nepal Acts 2082]

Documents for accident claims: SSFID + employer's ERN, accident report or police FIR (if applicable), medical certificate showing injury and treatment, hospital bills, disability assessment form (for permanent disability), citizenship copy

Scheme 3 — Dependent Family (Death) Claim

Waiting period matters: Day 1 coverage for work-accident or occupational disease deaths. For all other deaths (illness, non-work accident): 12 months of contributions required. But the NPR 25,000 funeral grant is available immediately in ALL cases — even on Day 1. [Source: Operating Procedure 2075]

Steps for Family / Nominee to Claim

Report the death to the employer and to SSF within 7 days
Gather all required documents (listed below)
File the claim in person at SSF Head Office — Naxal, Bhagwati Marg, Kathmandu — or via sosys.ssf.gov.np
SSF processes the claim and begins payments within 15–30 working days

What Eligible Family Members Receive

Beneficiary	Benefit	Conditions
Spouse	60% of last basic salary, monthly, for life	Forfeited on remarriage or own employment income
Each child (max 2)	40% of last basic salary monthly	Until age 18
Funeral grant	NPR 25,000 lump sum	Always — from Day 1, all cases
Foreign worker heir	NPR 7,00,000 lump sum (optional)	In lieu of ongoing monthly benefits

Documents required: Death certificate (Ward Office certified), SSFID of deceased contributor, nominee registration document or marriage/birth certificates, citizenship of the claimant, claimant's bank account details, employer's verification letter confirming employment and last basic salary, accident/incident report (for work accident deaths)

[Source: Operating Procedure 2075, Sections 14–17]

Scheme 4 — Pension & Retirement Fund

Feature	Retirement Fund	Pension
When available	Any age on job termination	Age 60 + minimum 180 months (15 years)
Payment type	Lump sum (your balance)	Monthly payments for life
Minimum requirement	None	15 years of contributions
If resigned early	✅ Withdraw any time	Balance stays in your account until age 60

Retirement Fund Withdrawal (on resignation or termination)

Your employment ends (resignation, termination, or retirement)
Log in to sosys.ssf.gov.np and find the Retirement Fund withdrawal section
Submit the claim with required documents
Processing typically takes 15–30 working days

Pension Claim (age 60 with 180+ months)

Reach age 60 with at least 15 years (180 months) of contributions
File the pension claim at SSF Head Office or via the contributor portal
SSF calculates your pension amount based on your full contribution history
Monthly pension payments begin after approval

⚠️ Pension formula is unverified — two conflicting versions exist in official documents. Do NOT rely on any online estimate. Contact info@ssf.gov.np to request your personal projection directly from SSF. [Source: Research verification pending — May 2026]

Loan against Retirement Fund
After 36 months of contributions, borrow up to 80% of your Retirement Fund balance. Types: Housing, Education, Social Function. Below market interest rate. [Source: SSF Investment Procedure 2077]

Early access exceptions
Permanent disability: Retirement Fund accessible at any age.
Foreign workers: Retirement Fund withdrawable any time after leaving Nepal. [Source: Operating Procedure 2075]

Documents for Retirement Fund: SSFID, citizenship certificate, bank account details, employment termination/resignation letter

Documents for Pension: SSFID, birth certificate or citizenship (proof of age 60), bank account details, contribution history statement from sosys.ssf.gov.np

Where to Get Help & File Complaints

SSF Head Office

Naxal, Bhagwati Marg, Kathmandu
📞 01-4529149 / 01-4529150
✉️ info@ssf.gov.np

Toll-Free Lines

📞 1116 (NTC network)
📞 1660-01-55555 (all networks)
Free from any Nepal number

Online Portals

sosys.ssf.gov.np ↗ — check contributions, file claims
employer.ssf.gov.np ↗ — for employers

Migrant & Foreign Workers

✉️ migrantworker@ssf.gov.np
📞 +977 9851345815

Complaint About Employer

File at your district Labour Office or email info@ssf.gov.np — under the Labour Act, the Labour Office can investigate and enforce.

Error on This Site?

Found incorrect information? Email ssf@latticenepal.com with your source — we verify and correct within 48 hours.

Important: If your employer is not depositing contributions, your claims may be delayed or denied. Check your contribution history at sosys.ssf.gov.np before any planned medical procedure. Missing months = file a complaint immediately.