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 -
E.2. Health Benefits

The financing of health benefits is an important element of social security expenditure.

Addressing error, evasion and fraud in health benefits should focus on several specific risks:

  • In terms of error and evasion, to ensure the correct enrolment of individuals and the compliance with healthcare regulations;
  • In terms of fraud, the diversion of monetary payments, instigated by employers or employees;
  • Fraud related to in-kind payments, instigated by health providers and patients.