Page 62 - KDU Law Journal Volume 4 Issue 2

KDU Law Journal Volume 04 Issue II
September, 2024
gaps, mainly between the Labour Act, 2017, CBSSA, 2017, and also
other concerned legislations to a certain extent which are addressed
and discussed in the following paragraphs;
Medical Treatment, Health & Maternity Protection Scheme:
36
This scheme activates after contributing for at least three consecutive
months, and the contributor is provided till three months from
discontinuing such contribution. The scheme covers the general
medical expenses, including the medical expenses during the
pregnancy of the contributor or contributor’s wife, hospital
admission, surgery, expenses related to the treatment of delivery for
up to a period of six weeks, and for treatment of the child up to three
months.
However, the scheme does not have an unlimited ceiling for
cover-up for medical treatment, health, and maternity protection.
It has a financial threshold of up to NRs. 100,000/- in a year for
a medical referral case where the contributor is not required to be
hospitalized. The amount equivalent to one month’s basic salary is
provided during the delivery of each child or if a child is aborted
after twenty-four weeks of pregnancy. The scheme’s benefit is
limited to only a single spouse, even though both husband and wife
are contributors to the SSF.

Similarly, the scheme does not apply to cosmetic medical treatment
such as plastic surgery, dental treatment, or bariatric surgery.
Also, the SSF can suspend the scheme during the epidemic if
the recommendation is received from the board. This provision
seems to demotivate the contributors to become members of SSF.
As discussed in subtitle four, the legal gap under this scheme
has further demotivated the aspirant contributors. No doubt, the
initiative taken by the Government of Nepal (GON) for this scheme
is appreciable, but still, more reforms have to be done to motivate
36 Annex 2, Sections 3,4,5,6,7, and 8 of Social Security Scheme Operating Procedure, 2018
(2075)
law.faculty@kdu.ac.lk
55