Centre for Excellence

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

Centre for Excellence

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

Error, Evasion and Fraud in Social Security Systems -
Structure of the ISSA Guidelines on Error, Evasion and Fraud in Social Security Systems

These Guidelines, drawn up by practitioners from various schemes, comprise seven parts:

A. Governance: concerns the definition of the mandate, purpose and organizational structure of a social security system to address EEF.

B. Strategy: helps define aspects of a strategic nature to fulfill the aims of addressing EEF.

C. Operational Processes Common to All Social Security Branches and Risks: discusses the features and implementation of the main processes needed to perform the functions involved in addressing EEF in any branch of social security.

D. Error, Evasion and Fraud Risk Management in the Contribution Collection Process: this is a common process to all social security schemes, but can be seen as a vital and differentiated function.

E. Operational Processes Specific to Addressing Fraud in the Various Risks Covered by Social Security: identifies the different mechanisms specific to certain branches.

F. Promoting the Proper Use of Social Security Systems and the Results of Addressing Fraud: identifies the different techniques that can have a positive impact on public opinion in support of this aim.

G. Coordination with Other Institutional Actors: addresses the partnerships that should be developed in each country, and relations with the institutions of other countries to reduce the risks of evasion and fraud associated with benefits and contributions.

Within each part, guidelines are grouped according to how particular elements of the process may be applied. They are presented as follows:

Guideline. The guideline is stated as clearly as possible.

Structure. A structure is developed for each guideline. Such structure concerns each specific aspect of the fight against EFF, which promotes the application of the guideline and the promotion of the related principle. This involves defining the principles and objectives of each guideline so that it works effectively. This structure must ensure an adequate delineation of operational and control responsibilities, as well as the individual capacity and responsibility of the persons concerned.

Mechanism. A guideline may be implemented in a number of ways. The methods advocated for combatting EEF and compliance have been designed to ensure that appropriate actions are taken in terms of controls, procedures, communication and incentives, in order to promote good practices. Decisions, their execution according to the criteria and deadlines, ensuring convincing results, as well as regular follow-up for good evaluation.