Protecting Social Welfare Systems

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Welfare fraud is common to all developed countries and costs governments billions.

Preventing welfare fraud has therefore become essential in order to protect tax payers and citizens who really need benefits.

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Protecting Social Welfare Systems

  1. 1. Global Public Sector the way we see itProtecting Social Welfare Systemsfrom Fraud and ErrorCapgemini works with welfare agencies to implement flexible approaches totackling fraud, supported by cutting-edge business intelligence solutions.A CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS
  2. 2. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTA Contemporary Issue Previous | Next
  3. 3. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTThe Struggle Against FraudA social issue in the spotlightWelfare fraud is common to all developed French Minister for Work, Employment proportion of total welfare recipients,countries and costs governments and Health Xavier Bertrand reported that and that some who overclaim do sobillions. Preventing welfare fraud has €458m of welfare fraud was detected in through genuine need. Nonetheless,therefore become essential in order to France in 2010, twice as much as in 20061. welfare fraud represents a cost whichprotect tax payers and citizens who really British Prime Minister David Cameron stated many governments forced to reduceneed benefits. that ‘Welfare and tax credit fraud and error public spending and deficitsThe objective of most governments around costs the taxpayer £5.2 billion a year’ in cannot afford.the world is to reduce the welfare gap 2010, though administrative error accountsby 30% every year. But although for a large proportion of this at £1.6bn2.anti-fraud cells exist in most public Most fraud occurs when claimants withholdsector organizations, control methods information, or provide misleadingand detection strategies are not optimally or inaccurate data about their statusstructured to tackle evolving practices of and income to government agencies.fraud, and achieve only limited success. Demonization of benefit fraudsters by theAccurate figures on the sums lost to welfare media and politicians can obscure the factfraud are naturally difficult to obtain. that they account only for a very small1 http://www.budget.gouv.fr/files/bilan-dnlf-2010.pdf Previous | Next2 http://www.number10.gov.uk/news/pm%e2%80%99s-article-for-manchester-news/, Published 10th August 2010.
  4. 4. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTRoot Causes of Fraud and Error Previous | Next
  5. 5. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTSegmentation of the Social Welfare DomainHow to strengthen the system’s defenses?Multiple agencies – responsible for social welfare claims under scrutiny.insurance, family allowances, healthcare Although success in tackling welfare The fraud typology adds further complexityprotection or pensions – have their own fraud and error varies between countries, to the anti-fraud struggle: It can either beoperating models and use different certain barriers are common to many accidental or intentional. The gravity ofprocesses to allocate the right resources administrations. A disjointed approach by offences usually depends on the fraudster’sto the right recipients. central government to managing welfare profile and network, with professionalFraudsters often exploit the boundaries and provision across multiple agencies, and at fraudsters taking most from the system.lack of information sharing between these a local level, makes the system easier to Individuals can deliberately omit to reportorganizations. Australia’s social security exploit. The technology solutions, training income but fraud can also be due to errors,agency Centrelink uncovered and reversed and resources required to tackle fraud are especially administrative errors withinfraudulent payments totaling $112.5m in often weak. Cultural factors also impose the social welfare organization itself or2008-9 through matching data on claimants constraints, as in many countries staff submission of false information without theacross government agencies to identify motivated by an ethic of public service declaring individual being aware.inconsistencies in data about incomes, may feel reluctant to place the legitimacy ofpayments and personal identities.33 http://www.aic.gov.au/publications/current%20series/tandi/401-420/tandi418.aspx Previous | Next
  6. 6. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTOur Offer to Social Welfare Agencies Previous | Next
  7. 7. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTOur Offer to Social Welfare AgenciesPrevention and CureIn order to tackle the fraud problem, allows inter-agency cooperation to prevent surveillance and social network analysis.governments need to adopt a targeted fraudsters caught in one particular regionand holistic approach which combines operating in another. • Detecting inconsistencies. Analysiscure and prevention. Successful management of fraud depends often reveals claimants who presentOn one hand, the cure has a quick impact on effective gathering and analysis of data. different sets of information about theirand removes fraudsters who are already in We have worked with social welfare agencies circumstances or identities to differentthe system. On the other, prevention is less to put in place fraud detection systems and parties, possibly in order to commitcostly and ensures a progressive reduction of processes based on four stages of activity: fraud. This demands cross-detectionthe welfare gap. Technology combined with among different sources of data. Thiscontinuously improving business processes • Accumulating data on claimants. analysis usually reveals administrativecan provide solutions to detect fraud and This can often be migrated from the errors which can then be rectified.act on both prevention and cure. It can systems of multiple agencies intoevolve constantly to fight fraudsters who a central repository which enables • Targeting. As the human resourcesare increasingly skilful and well-informed. business analysis. Other sources of data available to investigate cases areA holistic approach at a national level can include bank statements, mobile necessarily limited, agencies must weigh Previous | Next
  8. 8. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACT up the likely cost of an intervention rules. Social welfare organizations need against the probable value of the fraud processes which make it easy for citizens to in order to maximize results. Using understand their obligations and comply estimates, we develop a business case for with the rules, and difficult for them not to. intervening in each possible instance of Above all, systems must be flexible enough fraud. to allow prevention and detection strategies and business rules to change regularly,• Intervention, with the aim of so that agencies are not outmaneuvered investigating the claim, recovering any by the constantly evolving tactics of the money lost to fraud and prosecuting fraudsters. This kind of flexible approach those responsible. allows governments to tackle the roots of the problem and significantly reduce the costAt the same time, upstream measures should of welfare fraud; it is what we define as abe built around multiple independent mature anti-fraud protection system.defences against fraud, including identitymanagement, risk profiling, watchlists,and advanced business and transaction Previous | Next
  9. 9. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTCapgemini’s Unique Solutions Previous | Next
  10. 10. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTCapgemini Develops Unique Solutions for WelfareAgencies at Different Levels of Maturity.Capgemini has experience in providing Our offer to social welfare agencies typically combined with a small pilot initiativegovernment agencies with business consists of: to trial the solution and demonstrate itsinformation, data management analysis value to stakeholders.and anti-fraud intelligence system • Fraud and Error Assessment – Aintegration. three to six-week assessment of existing • Solution Implementation – A largerWe have applied a combination of technology and processes for fraud proof of value with a broader scope,consulting and technology expertise to detection and prevention to identify the followed by the design and build of atransformational projects with social key areas for improvement, and what the full-scale fraud management system withwelfare agencies in the US, France, Norway, priorities are. options for fraud management as an ITGermany, the UK and Netherlands. We managed service or as Business Processhave a proven ability to run projects which • Solution Design – A design phase of Outsourcing.deliver a rapid return on investment, and approximately three months to produceoperate with an ecosystem of partners well- the blueprint for a holistic fraudplaced to provide the business analytics management approach, underpinned bysoftware products required as part of a fraud best of breed technology. This is oftenmanagement solution. Previous | Next
  11. 11. Global Public Sector the way we see itA CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS HOME CONTACTThree distinctive elements of ourapproach are:• Collaboration with Social Welfare Department directors and leaders to define business priorities for anti-fraud and error protection. This allows a program to achieve rapid RoI by tackling the easiest cases first, and strengthening compliance to reduce errors.• A strategic approach to targeting specific, high-risk segments which offer the strongest business case for the Capgemini offers demonstrations and administration to intervene. discussions tailored to the unique environment of each organization.• Implementation of a medium to long- term fraud and error prevention solution For more information or to request a which works in tandem with the business meeting please contact: intelligence analytical system. publicsector.global@capgemini.com Previous | Next
  12. 12. HOME ­About Capgemini ® With more than 120,000 multicultural organization, Capgemini has people in 40 countries, developed its own way of working, the Capgemini is one of the world’s foremost Collaborative Business ExperienceTM, and providers of consulting, technology and draws on Rightshore®, its worldwide delivery outsourcing services. The Group reported model. 2011 global revenues of EUR 9.7 billion. Together with its clients, Capgemini creates Learn more about us at and delivers business and technology www.capgemini.com solutions that fit their needs and drive the results they want. A deeply Rightshore® is a trademark belonging to CapgeminiContact our experts:Ian Prettyian.pretty@capgemini.comAlexandre Negadialexandre.negadi@capgemini.com Copyright © 2012 Capgemini. All rights reserved.

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