Standard Operating Procedure (SOP) for settlement of claims in EPFO

This Standard Operating Procedure (SOP) of EPFO, for settlement of claims, has been prepared as per the existing procedure in Manual of Accounting Procedure (MAP) and other instructions/ circular issued by the Head Office from time to time.

Standard Operating Procedure for Claims Settlements
Purpose: The purpose of this document is to delineate the procedure from the receipt of claims from members to settlement of claims & transfer of claim amount to member account.

Authority and source of SOP:
(i) The Employees Provident Funds and Miscellaneous Provisions Act, 1952.
a) The Employees Provident Funds scheme, 1952
b) The Employees' Pension Scheme, 1995
c) The Employe,es' D_ep_osit-Linked Insurance scheme, 1976.
d) Manual of Accounting Procedures
e) Claims Software user Manual.
f) Various circulars issued from time to time

PROCEDURE FOR SETILEMENT OF CLAIMS
Receipt of claim forms in EPFO's Field Offices:
1. Received through Post.
2. Brought by member or by his representative
3. Brought by Employer's representative.
4. Received through online mode for transfer claims (Form 13)
5. By drop box being maintained in the Office.

PRO/Receipt counter
DA receipt/PRO to follow the check points prescribed for scrutiny of various claim forms:
Composite Claim Form (Aadhar)/Composite Claim Form (Non-Aadhar):
Forms No. 19, lOC and 31 has been replaced with Composite Claim Form
(Aadhar) and Composite Claim Form (Non-Aadhar). 

1. For the purpose of PF part withdrawal (Advances/withdrawal), the purpose of advance & documents required includes as under:
1. Housing Loan/Purchase of site/house/flat or for construction/Addition alteration in existing house/ Repayment of Housing loan: No document is required. New Declaration Form/Utilization Certificate required earlier has been discontinued.
2. Illness of member/family:
• Certificate of doctor and
• Certificate by employer that ESIC facility is not available to the member may be submitted by the member.
3. Marriage of self/son/daughter/brother/sister: No document/Marriage Card is required.
4. Post Matriculation education of children: No document is required. 
5. Lockout or closure of factory/Cut in supply of electricity: No document is required
6. Natural calamity: No document is required.
7. Purchasing equipment by physically handicapped: Medical certificate is required.
8. One year before retirement: 90% of total PF balance can be withdrawn. No document is required.
9. Investment in Varistha Pension Bima Yojana: 90% of total PF balance can be transferred to UC. No document is required.
2. Copy of cancelled cheque/self-attested copy of first page of Pass Book clearly showing member's name printed on it.
3. No Revenue stamp (Re. 1/-) is required to be affixed by the member.
4. The Composite Claim Form (Aadhar) is applicable in cases where a - member's complete details in Form-11.(New), Aadhar number and bank account details are available on the .UAN Portal and UAN has been activated. Such members can submit this form directly to the concerned EPFO office, without attestation of claim form by the employers.

(Source: Circular No. Manual/ Amendment/2011/Pt/31792 dated 20.02.2017)

Pension Cl aim Form (Aadhar)- 10D

1. The Aadhar number and bank account number of the employee are seeded as and digitally verified by the employer 
2. All the details of the employee are available in Form No.-11 (New)
3. A cancelled cheque containing name of the employee, bank account number and IFSC Code is attached with the claim form. iv) Attestation of employer on Pension Claim Form (Aadhar) is not required.

(Source: Circular No. Pension-1(7)96/2017/Forms/32614 dated 03.03.2017)

Composite Claim Form in Death Cases:

Composite Claim Form in Death cases only has been replaced the existing Forms No. 20, 5 IF & 10-0. In case of death of the member, a claimant/nominee/legal heir/surviving member may apply for claim of provident fund, insurance fund and the monthly pension in a single form.

Following enclosure should be attached with the Composite Claim Form in Death case:
i) Death Certificate

ii) JJint photograph of all the claimants

iii) Date of Birth certificate of the children claiming pension

iv) Scheme Certificate (if applicable)

(Source: Circular No. Manual/Amendment/2011/Pt/163 dated 03.03.2017)

In addition to the above, DA receipt/PRO to check whether all the following data is to be properly filled in the claim form.

(a) Member's Name
(b). Father's/Husband's Name
(c). Date of Birth
(d) Date of Joining
(e) Date of exit - To ascertain completion of two months cooling off period
(f) Bank details - From the bank A/c statement or cancelled cheque or first Page of the Bank Pass Book duly attested by the authorized signatory enclosed with claim form.
(g) Stamp of Company - Showing name of employer/establishment (only in case of Non-Aadhar claim form)
(h) Availability of member's signature
(i) PAN No./lSG/lSH (>60 years age) - in case member's service is <5 years and the amount payable is >Rs. 50,000 w.e.f. 1st June, 2016.

Segregation & Forwarding of claim to Accounts Section:

Receipt Section segregates the applications relating to advances/withdrawals, final settlement, benefits and transfer [Form 13(R), 14, Composite Claim Form (Aadhar), Composite Claim Form (Non-Aadhar), Composite Claim Form in Death cases and Pension Claim Form {Aadhar), Accounts Section-wise with date stamp on each application received during the day.
The segregated/sorted claim forms are forwarded to the concerned Section. Supervisor with duplicate copies of the Receipt Report/ list for settlement under the respective Schemes on same day itself or at most next working day.

PROCESSING OF CLAIM IN ACCOUNTS SECTION:
•!• ROLE OF DEALING ASSISTANT (D.A):

Composite Claim form (Aadhar/Non-Aadhar)/FORM 19:

1. On receipt of the claim by the concerned Accounts Groups DA, preliminary checks as provided in para 10.15 of the MAP. Vol-II has to be followed. The check points are as under:

a) The accumulations have become payable under the scheme; b) That the form-is received through the 'dak-in-ward' section in computer prepared inward sheet;
c) That the form is correctly filled in and either signed or affixed with the impression of the left hand thumb

d) That the form has been attested and dated by the employer (Non-Aadhar Form) or any of the authorised officials and that the official seal of the attesting officer is affixed on the application.
e) That the signature of the employer or his authorised official tallies with the specimen signature card in the custody of the dealing hand. /J That the claim form need not be returned if the signature of the member does not agree exactly with the signature in the nomination form provided the of aims are attested by the employer· or his authorised official over their official seal. However, any serious observation brought out by the Section Supervisor should be examined

g) That the application is supported by the relevant certificates, wherever necessary according to the 'instructions' to the member.

h} That the claim form has been submitted after completion of two months from the date of leaving service, wherever necessary.

i) That the name, father's name (Husband's name) account number, date and reason for leaving service tally with the particulars available on records such as Form-9 and Form-2.
j) That the postal address given in the claim form is complete so as to send payment intimation to the member; that the overwriting or corrections in this portion is duly attested by the claimant.

k) That the particulars of bank account number and full address of the bank, IFS Code are furnished in the form.

J The check point No. {XI) of para 10.15 of MAP Vol-II has been amended vide circular letter No. WSU/17(2)2000/7637 dated 15th June, 2012 whereby the mode of payment through joint bank account with spouse shall be acceptable henceforth.

m} The date of joining and date of exit from the establishment are mandatorily to be updated with reference statuary return Form No. 5 & 10 or from the claim form received by the office from the establishment.

n) The dates of exit from employment and reason for leaving the employment should be checked by the concerned DA.
o) The correspondence address as per claim application of the member is required to be entered in the application.

p) The Mode of remittance opted by the member is entered. The Bank details provided in the application are verified through cancelled cheque/copy of passbook enclosed with the claim form duly attested by the authorized signatory.

Composite Claim Form in Death cases/FORM 20, 5 IF and 10-D

In addition to the check points prescribed for Composite Claim Form (Aadhar/NonAadhar)/Form-19, the following should also be verified:
a) Whether the claimant is valid nominee (S) as per Form No. 2 (Revised) verify with the nomination data in the application. The details in this respect should be updated first.

b) Whether the claimant is guardian on behalf of minor. If so, guardianship certificate is enclosed. The details in this respect should be updated first.

c) Death Certificate is enclosed, whether death occurred after leaving the service?

d) In case of absence of Form 2, payment may be released on the basis of succession certificate (within the provisions of para 70 of EPF scheme). However in order to deal with nominations and family members cla imants in normal course succession certificate may not be insisted upon. Only in cases where there is doubt or dispute, succession certificate may be called for. (Pension/ A&C/Widow pension//00/333499 dated 21st Dec2015.

e) Whether the claimant, not being a nominee, falling under 'family' of the member as per the family certificate enclosed.

f) If the claim forms are in order then the input data sheet is prepared by the DA checked 100% by Section supervisor/AO and along with the claim forms is sent to Pension Section for further processing and generation of PPO.

FORM 10 C/10 D/10 D (SPL.)

a) On receipt of the above mentioned Forms by the concerned Accounts Groups DA, preliminary checks as provided in Para 9.4 of the MAP. Part-Ill has to be followed.

b) It is mandatory to furnish Aadhar number for settlement of Pension (100) cases and not in withdrawal lOC cases. (Pension 1-17(10) 2016-17/Jeevan Praman/32049 dated 28/02/2017.)

c) If the claim forms are in order then the input data sheet is prepared by the DA checked 100% by Section supervisor/AO and along with the claim forms is sent tq .
Pension Section for further processing and generation of PPO.

d) The particular in the claim is to be verified for its correctness with reference to Form 9.

e) The application has to be carefully examined to ensure whether the member has opted for scheme certificate or withdrawal benefit. Where the eligibility is 10 years and above the member is eligible only for Scheme certificate accordingly, the same should be issued irrespective of his option against the Scheme certificate.

f) The input sheet (IDS-input data sheet after AO authorization) as received from accounts section is re-checked for correctness, from the available data and a pension worksheet is generated which is again approved at AO/ APFC level.

g) If any details/enclosures are found missing/not matched in IDS, the case is returned to Accounts Section with reasons of return mentioned thereof after the approval of -AO.

Further for all types of claims the dealing assistant to ensure that before processing the claims the forms are duly filled up and no column is left blank. The incomplete daim/ineligible claim be submitted to Accounts Offices through Section Supervisor duly indicating the deficiencies such as incomplete form, wrong details filled
in the form, missing enclosures etc. The AO would authorize return of claims for rectification to the members.