Excellence in administration

  • ISSA Guidelines:
  • Error, Evasion and Fraud in Social Security Systems

Excellence in administration

  • ISSA Guidelines:
  • Error, Evasion and Fraud in Social Security Systems

Error, Evasion and Fraud in Social Security Systems -
Compliance Risk Management Model: A Six-Phase Continuous Loop Process

The risk management model comprises six phases:

  • Identifying risks

This phase involves a general risk review. It involves sequenced steps:

  • Collect and analyse data;
  • Produce information on the basis of such data;
  • Analyse risks;
  • Map risks.
  • Prioritizing risks

This phase involves analysis of:

  • The frequency of different risks;
  • The consequences of risks (financial and immaterial, such as the public image of social security).
  • Analyse the causes of risks

This phase should make it possible to distinguish between:

  • The complexity of administrative processes;
  • The lack of clarity in rules;
  • The existence of grey zones, gaps or unsupervised areas;
  • The efficiency of existing controls;
  • Problems related to skills and the lack of adequate resources to detect, prevent and address EEF;
  • Lack of communication with beneficiaries and contributors;
  • Conflict with other public policies and initiatives.
  • Defining initiatives to address and correct EEF

This relates specifically to:

  • Prevention;
  • Detection;
  • Deterrent actions that may result in sanctions.
  • Planning and implementing

This phase involves implementing, in a planned manner, prevention, detection and deterrent actions.

  • Monitoring and evaluating

This phase involves evaluating the measures taken to inform an update of the risk assessment strategy. The strategy as a whole should be revised.