How retirement insurance fights fraud

Capital: what are the main frauds you detect?

Patrizia Coste: The main right, namely the basic pension, is extremely difficult to cheat because the statements do not come from the beneficiary but from a third party (like the company, ed). Rather, the risk is on the side of rights subject to conditions that change over time, such as the survivor’s pension and the minimum old age. Fraud can concern identity, family situation, level of resources or even career, regularity of stay and residence.

Capital: what means have been put in place to combat these frauds?

Patrizia Coste: As for the payment of the pension, we are in the budget. We ask for a series of supporting documents and check them before paying the pension. For example, in the case of a person who has provided us with a fake paycheck, we will check their employer’s records to see if it matches. On the regularity of stays we have access to the list of residence permits of the Ministry of the Interior and therefore we can verify that the person is in good standing. Each time, we try to have information provided by a third party and not by the insured.

Capital: What aspects are you particularly vigilant about?

Patrizia Coste: One of the most common fraud risks concerns residence. For some benefits such as the solidarity allowance for the elderly, it is necessary to reside legally in France to receive it. However, some people don’t tell us they moved overseas. The symmetrical of this risk is the risk of death. A family does not report the death of one of its members in order to continue receiving the pension. This fraud is almost impossible in France because we receive the deaths of the day every night. For a number of European countries, this data is reported to us on a monthly basis. But there are some countries for which we don’t have access to their marital status. There is significant fragility there, because documents cannot be sent to us by third parties. For example, for the certificate of existence (document proving the existence of a pensioner residing abroad and which must be sent every year, ed) it is a town hall that certifies its existence, but we have no connection with it. direct.

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Capital: In this case, what are you doing to limit fraud?

Patrizia Coste: We focus our actions in places where we know we do not have the means to verify with certainty the information provided by the policyholder. We are working on this issue, in particular with Algeria, which has 600,000 pensioners, representing one billion in paid benefits. To verify the existence of pensioners, since last year we have a partnership with an Algerian bank so that an insured person for whom we have doubts, for example because he has not answered for 6 months and returns, goes to his counter to have his identity controlled. Those for whom there is a real suspicion, from this year we will summon them to the consulates.

Capital: Do you plan to implement this system in other countries?

Patrizia Coste: Yes, this will not be reserved for Algeria. For example, in Morocco we are experimenting with a fairly similar system which goes through the Moroccan pension fund. This fund undertakes to verify the existence of pensioners in its local offices. We try to follow local regulations every time. The idea is to have progressively more and more policyholders whose existence we can verify by exchanging their marital status. Out of 1.2 million pensioners residing abroad, today this exchange of marital status takes place for 400,000 of them. Our goal is to reach 600,000 within 2 to 3 years. Which frees us from the capacity and time to be more attentive to the other 600,000.

Capital: do you also rely on biometrics to strengthen controls?

Patrizia Coste: In 2021, we pioneered biometrics to verify that the policyholder is alive and well using their smartphone. 200 retirees volunteered. Before generalizing this principle, the authorization of the National Commission for Informatics and Freedoms is awaited to award a public contract. The use of biometrics will remain for voluntary retirees. This will be as robust in our eyes as civil status exchanges.

Capital: What Happens When You See Established Fraud?

Patrizia Coste: When we have grouped the material elements that can be qualified as fraud, we question the policyholder so that he can explain himself and present his arguments. If the fraud is proven, the insured must reimburse the unduly collected fees but also pay a penalty that can reach up to 12,000 euros. If we find that there is organized fraud that has benefited several people, then we go to a criminal case.

Capital: Does the CNAV have a department dedicated to these questions?

Patrizia Coste: The 10,000 agents who process settlement files are trained in fraud detection. Then there are the controllers who verify these liquidations. And we have a team of about a hundred detectives who are sworn in in court and do just that. It is in some ways the equivalent of the judicial police. They have broad access rights, for example, they can ask a bank to provide all account statements of an insured within a certain period.

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