The Employees’ Provident Fund Organisation (EPFO) claims to have enhanced the claim settlement processes, leading to a lower ratio of claim rejection and return. In its X post, EPFO writes, “The EPFO has significantly enhanced its claim settlement processes! As of 26 November 2024, the combined rejection and return ratio was 21.59 per cent. This includes 13.77 per cent inadmissible claims, and Returns (deficiency in claims) stood at 7.82 per cent. The final withdrawal claims reflect 11.92 per cent rejections and 13.44 per cent return cases.”

According to EPFO, claims are rejected mainly when the claimant is not eligible for the type of withdrawal or advance or when there is a discrepancy in information or member details. These requests are rejected, but members can resubmit them after corrections for processing.  

While EPFO claims to have improved the claim settlement processes, several dissatisfied members are waiting for a timely and satisfactory resolution of their complaints. As EPFO is one of the largest social security schemes in the country and has around 27.7 crore members, it is essential to have robust and agile IT systems and streamlined processes in place to run things smoothly. 

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What Is The Main Reasons Of Complaints?

Although there are various categories to file complaints, the highest complaints raised are regarding final settlements, withdrawals, and transfers. This is because of the higher rejection of these claims. 

EPFO can reject claims for reasons, such as incomplete information, information mismatch, or wrong information among other reasons. Usually, it is a mismatch of personal information with Aadhaar, incomplete KYC or bank details, and sometimes even the wrong form submitted for the claims. As members now fill up claim forms themselves online, chances are that they miss out on some information. The claims are then rejected, and members make complaints. In the manual systems, the help desk would assist members when needed. 

Another important reason has been a complete shift to online mode for updating details, filing claims, etc., which the EPFO’s outdated IT systems could not pace up with.

However lately, the retirement body has been focusing on making the IT infrastructure better to resolve the issue.

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Where Can One Register The Complaint?

There are various platforms through which one can raise a grievance to EPFO for resolution. These are:

• CPGRAMS

• EPFiGMS

• X and Facebook account of the EPFO and Ministry of Labour & Employment (MoL&E)

• Facilitation Centres

• Whatsapp Business Helpline

• Call Centres 

Measures Taken By EPFO To Enhance Services:

As per a previous notification from the government, the claims settlement rate improved by 7.8 per cent during financial year 2022-23. EPFO settled 4.45 crore claims in FY2022-23 compared to 4.13 crore in the previous year. Of the total 4.45 crore claims, around 60 per cent of the claims (2.84 crore) were advance claims (withdrawal of funds for reasons like illness, marriage, and education). 

Notably, EPFO has expanded auto claim settlement, which was introduced in 2020 only for illness claims, to education, marriage, and housing claims for faster claim processing and reducing operational formalities. Additionally, it has increased the withdrawal limit from Rs 50,000 to Rs 1 lakh for advance claims for illness. Of the advanced claims settled in FY2022-23, 89.52 lakh claims were settled through auto mode. 

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In the recent EPFO committee meeting, among various issues, IT systems, administration, and operational issues were discussed for better management as well as how the claims process can be improved and made easier for members.