Fraud and error in the field of EU social security coordination.
Date: 2015-02-11
Institutions: Directorate-General for Employment, Social Affairs and Inclusion
Subjects: EU Member State, administrative cooperation, electronic government, exchange of information, fraud, simplification of formalities, social-security benefit, social-security harmonisation

Fraud and error in the field of 
social security coordination 

Written by Yves Jorens, Dirk Gillis and Joyce De Coninck 
November 2015 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
        
        
      
      
 
 
 
EUROPEAN COMMISSION 

Directorate-General for Employment, Social Affairs and Inclusion 

Unit D/2  

European Commission 
B-1049 Brussels 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EUROPEAN COMMISSION 

Fraud and error in the field of 
social security coordination 

Directorate-General for Employment, Social Affairs and Inclusion 
Network Statistics FMSSFE (Contract No VC/2013/0301 ‘Network of Experts on intra-EU mobility –
Lot 2: Statistics and compilation of national data’) 

2015 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Network Statistics FMSSFE 

This report has been prepared in the framework of Contract No VC/2013/0301 ‘Network of Experts on intra-
EU mobility – social security coordination and free movement of workers / Lot 2: Statistics and compilation 
of national data’. This contract was awarded to Network Statistics FMSSFE, an independent research 
network composed of expert teams from HIVA (KU Leuven), Milieu Ltd, IRIS (UGent), Szeged University and 
Eftheia. Network Statistics FMSSFE is coordinated by HIVA.  

Authors: 

Prof Dr Yves Jorens, professor of social security law and European social law, Director of IRIS|international 
research institute on social fraud, Ghent University 

Dirk Gillis, academic assistant, Coordinator of IRIS|international research institute on social fraud, Ghent 
University 

Joyce De Coninck, researcher, Ghent University 

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ISBN: 978-92-79-69762-3 
doi: 10.2767/585086 
Catalogue number: KE-02-17-739-EN-N 

© European Union, 2015 
Reproduction is authorised provided the source is acknowledged. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Fraud and error in the field of social security coordination 

TABLE OF CONTENTS 

EXECUTIVE SUMMARY .................................................................................................. 7 

1. 

2. 

INTRODUCTION ................................................................................................... 9 

IDENTIFYING FRAUD AND ERROR ACROSS MEMBER STATES .................................... 11 

2.1.  Defining fraud and error in the field of social security coordination ................... 11 
2.2.  Treatment of fraud .................................................................................... 14 
2.3.  The prevalence of fraud in social security coordination ................................... 15 

2.3.1.  General observations .................................................................... 15 

2.3.2. 

Limited data available ................................................................... 16 

2.3.3.  Data available ............................................................................. 17 

2.3.4. 

Findings ...................................................................................... 19 
2.4.  Data concerning cases of fraud and recoverable amounts ............................... 19 
2.5.  Undetected fraud ...................................................................................... 21 
2.6.  The prevalence of error in social security coordination .................................... 22 

2.6.1. 

Lacking data concerning the prevalence of error ............................... 22 

2.6.2. 

Available data concerning the prevalence of error ............................. 23 

2.6.3. 

Findings ...................................................................................... 25 
2.7.  Data concerning cases of error and recoverable amounts ................................ 25 
2.8.  Undetected error ...................................................................................... 26 

2.8.1.  No available estimations ............................................................... 26 

2.8.2. 

Available estimations .................................................................... 26 
2.9.  Preventing and curbing fraud ...................................................................... 27 

2.9.1.  Generalised findings ..................................................................... 28 

2.9.2.  Overview of additional Member State initiatives ................................ 31 

3. 

IMPLEMENTING THE COORDINATION PROVISIONS ................................................. 36 

3.1. 

Issues pursuant to the implementation of the coordination provisions ............... 36 

3.1.1. 

Prevalent issues ........................................................................... 36 

3.1.2.  Overview of Member State-specific issues ........................................ 37 

3.2.  Measures  directed  at  preventing  and  curbing  fraud  and  error  pursuant  to  the 

coordination provisions .............................................................................. 40 

3.2.1. 

Prevalent initiatives ...................................................................... 40 

3.2.2.  Overview of Member State-specific initiatives ................................... 41 

3.3.  Promoting  compliance  by  institutions  and  healthcare  providers  in  the  field  of 

benefits in kind and awareness-raising amongst citizens ................................. 43 

3.3.1. 

Awareness-raising directed at claimants .......................................... 43 

3.3.2. 

Awareness-raising directed at providers .......................................... 44 
3.4.  Remaining issues ...................................................................................... 45 
3.5.  Recommendations .................................................................................... 47 

4.  DATA EXCHANGE IN THE FIELD OF FRAUD AND ERROR ........................................... 47 

4.1.  Actions taken and measures implemented to enhance cross-border cooperation 

and information exchange .......................................................................... 47 
4.2.  Cross-border social security cooperation and privacy concerns ......................... 52 

4.2.1.  General Findings .......................................................................... 52 

4.2.2.  Overview of Member State-specific action ........................................ 53 
4.3.  Assessing potential conflicts vis-à-vis privacy legislation ................................. 55 

5 

 
 
5. 

CONCLUSION .................................................................................................... 58 

ANNEX .................................................................................................................... 60 

Czech Republic .................................................................................................. 60 
Denmark .......................................................................................................... 63 
Estonia ............................................................................................................. 67 
Germany .......................................................................................................... 69 
Hungary ........................................................................................................... 71 
Lithuania .......................................................................................................... 75 
The Netherlands ................................................................................................ 77 
Norway ............................................................................................................ 80 
Poland .............................................................................................................. 82 
Spain  84 

ANNEX 2 .................................................................................................................. 86 

Overview Sanctioning Fraud: Austria .................................................................... 86 
Overview Sanctioning Fraud: Belgium ................................................................... 87 
Overview Sanctioning Fraud: Portugal ................................................................... 90 

6 

 
 
 
EXECUTIVE SUMMARY1  

This  study  summarises  the  information  provided  by  Member  States  in  their  annual 
voluntary reports on their experiences and progress concerning cooperation on fraud and 
error,  as  provided  for  in  Decision  H5  of  the  Administrative  Commission  for  the 
Coordination of Social Security Systems. The Member States’ reports have been analysed 
with  the  aim  of  identifying  several  elements.  First,  particular  attention  goes  to  the 
definition  of  fraud  and  error  in  the  field  of  social  security  coordination  in  the  respective 
Member  States.  Secondly,  the  aim  of  the  country  reports  was  to  determine  the 
prevalence  of  fraud  and  error  as  two  conceptually  distinct  phenomena  in  the  Member 
States  concerned.  Next,  insight  was  sought  into  the  remaining  issues  associated  to  the 
implementation  of  the  European  coordination  provisions,  as  a  result  of  which  fraud  and 
error  may  arise,  and  the  steps  taken  in  this  respect  to  prevent  and  combat  fraud  and 
error.  Lastly,  an  overview  was  requested  of  the  measures  taken  both  internally  and 
externally by means of bilateral agreements with other Member States, in handling fraud 
and  error,  as  well  as  data  protection  concerns  associated  thereto.  The  report  at  hand 
provides  an  overview  of  these  findings,  allowing  several  conclusions  to  be  drawn 
concerning fraud and error in the Member States in the past year.  

The  report  summarises  the  responses  of  26  Member  States  for  2015:  Austria,  Belgium, 
Bulgaria,  Croatia,  the  Czech  Republic,  Denmark,  Estonia,  Finland,  Germany,  Greece, 
Hungary,  Iceland,  Ireland,  Italy,  Latvia,  Lithuania,  Malta,  the  Netherlands,  Norway, 
Poland,  Portugal,  Romania,  Slovakia,  Spain,  Sweden  and  the  United  Kingdom.  It 
attempts to distil some general practices, particular difficulties and remaining problems. 
These insights might subsequently be used to strengthen the prevention and tackling of 
fraud and error even more in the future. Decision H5 suggests four matters to be covered 
in these annual reports: first, the steps taken throughout the year by the Member States 
to  combat  fraud  and  error;  second,  the  specific  problems  connected  to  the 
implementation of the coordination rules which increase the risk of fraud and error; third, 
the agreements and cooperation agreements Member States conclude among each other 
for the  purposes  of  combating  fraud  and  error;  and  finally,  the  steps  taken  to  motivate 
institutions and health care providers to comply with the coordination rules as well as the 
steps  taken  to  provide  information  to  citizens.  These  four  issues  are  –  as  previously 
indicated  –  covered  below.  The  Member  States’  accounts  reveal  that  it  has  proven 
somewhat  difficult  to  detect  and  provide  all-encompassing  data  concerning  fraud  and 
error  within  the  realm  of  social  security  coordination.  What’s  more  –  a  number  of 
difficulties  remain  problematic  in  a  majority  of  Member  States  when  attempting  to 
combat  fraud  and  error  in  the  field  of  social  security  coordination.  These  shared  issues 
include,  amongst  others,  the  delayed  or  absent  cooperation  between  the  competent 
authorities  in  the  respective  Member  States,  the  determination  of  residence,  and  the 
prevalence  of affiliation to benefit schemes in more than one Member State for matters 
concerning unemployment benefits as well as healthcare benefits.    

Furthermore – concerning steps taken in dealing with fraud and error – the reports reveal 
that  Member  States  focus  on  prevention  of  fraud  and  error  as  well  as  tackling  it. 
Information dissemination towards the general public, in order to raise awareness to limit 
the occurrence of fraud and error, is vital in this respect, as demonstrated by the focus 
thereupon  by  Member  States.  In  addition,  information  exchange  with  other  relevant 
actors  is  just  as  important.  This  goes  for  information  exchange  both  intrastate  and 
interstate  between  institutions,  as  well  as  with  other  actors  such  as  but  not  limited  to 
insurance  companies.  Other  efforts  include  strengthening  the  teams  dealing  with  fraud 

1 The executive summary and the introduction were inspired by last year’s report - JORENS, Y., GILLIS, D. and 
PLASSCHAERT,  I.,  Fraud  and  Error  in  the  Field  of  Social  Security  Coordination,  Network  Statistics  FMSSFE, 
European Commission, December 2014, 55 p. 

7 

 
 
                                                 
and error cases, providing comprehensive training for the personnel, and putting in place 
bilateral meetings between institutions. Cooperation in this respect can be formalised, for 
example  by  concluding  a  Memorandum  of  Understanding  (MoU),  or  non-formalised,  for 
example by engaging in ad hoc meetings. 

Overall,  the  report  reveals  two  broad  conclusions.  First  and  foremost,  all  reporting 
Member States have undertaken efforts to fight fraud and error, albeit on different levels 
or  with  varying  intensity.  These  efforts  repeatedly  concentrate  on  strengthening  the 
information exchange and cooperation between internal competent authorities as well as 
the competent authorities in Member States. Secondly, one of the predominant concerns 
amongst  all  Member  States  concerned  relates  to  the  delayed  or  absence  of  cooperation 
between the competent institutions of the respective Member States. In turn this results 
in scenarios – amongst others - where illegitimate double affiliation occurs and/or undue 
payments. Improvement thus remains possible and necessary – both with regard to the 
prevention  and  early  detection  of  fraud  and  error  in  cross-border  situations  as  well  as 
concerning  cross-border  administrative  cooperation  and  information  exchange  between 
Member States.  

8 

 
 
 
1.  INTRODUCTION  

Restrictions  to  the  free  movement  of  persons  can  and  do  appear  in  many  different 
respects,  not  in  the  least  in  the  field  of  social  security,  where  both  fraudulent  and 
erroneous situations can put a strain on the free movement of persons. With respect to 
social  security  coordination,  fraud  is  defined  as  “any  act  or  omission  to  act,  in  order  to 
obtain  or  receive  social  security  benefits  or  to  avoid  obligations  to  pay  social  security 
contributions,  contrary  to  the  law  of  a  Member  State”.2  Error  on  the  other  hand  is, 
according  to  Decision  No  H5,3  “an  unintentional  mistake  or  omission  by  officials  or 
citizens”. Although both fraud and error often end up having the same effects, the capital 
difference between them is the fact that error is always unintentional.  

Strong  cooperation  between  Member  States  is  crucial  in  order  to  prevent  and  tackle 
fraudulent and erroneous situations in the realm of social security coordination. In order 
to  boost  and  strengthen  this  cooperation,  Regulation  (EC)  No  883/2004  on  the 
coordination  of  social  security  systems4  has  provided  for  the  establishment  of  several 
mechanisms.  The  Administrative  Commission  is,  in  accordance  with  said  Regulation, 
responsible  for  handling  questions  of  interpretation  concerning  the  Regulation’s 
provisions  or  concerning  agreements  or  accords  concluded  in  the  framework  of  the 
Regulation.  In  addition  to  the  Administrative  Commission,  there  is  a  Technical 
Commission,  which  among  other  things  assembles  technical  documents  and  studies;  an 
Audit  Board,  which  establishes  the  average  costs  for  the  reimbursement  of  health  care 
costs in Member States; and an Advisory Committee, which is responsible for preparing 
opinions and proposals for the Administrative Commission.  

At  the  307th  meeting  of  the  Administrative  Commission,  the  Member  States  decided  to 
create an Ad Hoc Group, in order to assist the Administrative Commission in its efforts to 
strengthen  the  cooperation  between  competent  institutions,  particularly  concerning  the 
combat  of  social  security  fraud  and  error.  This  Ad  Hoc  Group  produced  two  reports  on 
this  type  of  fraud  and  error  issues  and  identified  some  major  problem  areas.  The 
conclusions  and  recommendations  then  led  to  Decision  H5  in  March  2010.  As  stated  in 
that  Decision,  the  Administrative  Commission  discusses  cooperation  on  fraud  and  error 
issues  once  a  year,  based  on  the  voluntary  reporting  by  the  Member  States  of 
experiences and progress in the field. It is suggested that this voluntary reporting covers 
a number of matters:  

  First,  the  steps  taken  throughout  the  year  to  combat  fraud  and  error  in  cases 

determined under the Regulations;  

  Second, specific problems in implementing the coordination rules which may lead 

at least to risks of fraud and error;  

  Third,  agreements  and  bilateral  cooperation  agreements  with  other  EU  Member 

States entered into for the purposes of combating fraud and error;  

  Finally, the steps taken, in the field of benefits in kind, to promote compliance by 
institutions  and  health  care  providers  with  the  coordination  rules  and  to  provide 
information to citizens.  

2 Resolution of the Council of 22 April 1999 on a Code of Conduct for improved cooperation between authorities 
of the Member States concerning the combating of transnational social security benefit and contribution fraud 
and undeclared work, and concerning the transnational hiring-out of workers (OJ C 125, 6.5.1999, p. 1). 

3 Decision No H5 of the Administrative Commission for the coordination of social security systems of 18 March 
2010 concerning cooperation on combating fraud and error within the framework of Council Regulation (EC) No 
883/2004 and Regulation (EC) No 987/2009 of the European Parliament and of the Council on the coordination 
of social security systems (OJ L 149, 8.6.2010, p. 5). 

4  Regulation  (EC)  No  883/2004  of  the  European  Parliament  and  of  the  Council  of  29  April  2004  on  the 
coordination of social security systems (OJ L 314, 7.6.2004, p. 1). 

9 

 
 
 
 
 
 
                                                 
This  report  was  drawn  up  by  firstly  identifying  how  the  various  Member  States  have 
approached  and  defined  fraud  and  error  in  their  respective  territories.  In  addition,  an 
overview  is  given  as  to  the  prevalence  of  both  fraud  and  error  as  two  conceptually 
distinct  phenomena;  both  concerning  detected  and  undetected  cases.  The  foregoing  is 
subsequently complemented by an overview of the steps taken by the individual Member 
States  in  order  to  provide  solutions  to  the  respective  problems  pertaining  to  fraud  and 
error.  Subsequently,  the  problems  associated  to  the  implementation  of  the  coordination 
provisions  are  addressed  as  well  as  the  measures  taken  to  address  these  issues.    To 
conclude,  an  overview  is  given  of  additional  measures  taken  by  Member  States  to 
enhance cross-border cooperation and issues that may arise in this respect with privacy 
regulations.  

10 

 
 
2.  IDENTIFYING FRAUD AND ERROR ACROSS MEMBER STATES 

2.1.  Defining  fraud  and  error  in  the  field  of  social  security 

coordination 

Any assessment of fraud and error in the field of social security coordination requires an 
assessment of these notions from a national Member State perspective. An initial step in 
this respect is ascertaining to what extent the concepts of fraud and error are effectively 
defined in national legislation in view of social security coordination – if at all – and how 
these definitions are understood in a national context. Within this context it appears that 
a number of Member States (AT, BE, BG, HR, CZ, DK, EE, FI, DE, EL, HU, IS, IE, IT, 
LV, LT, MT NL, NO, PL, PT, SK, ES, SE and UK) have not defined fraud and error in the 
field  of  social  security  coordination  in  legislative  instruments  concerning  social  security. 
Rather, it appears that the definitions of these concepts are derived from other sources, 
including amongst others case law, administrative practice, other legislative instruments 
or  a  combination  of  the  foregoing.  In  the  Netherlands,  Slovakia,  Sweden  and  the 
United Kingdom the notions of fraud and error are defined in the respective legislative 
instruments  governing  social  security,  albeit  not  specifically  concerning  social  security 
coordination.  

In  Austria,  Bulgaria,  Denmark,  Estonia,  Iceland,  Ireland,  Italy,  Lithuania  and 
Spain  case  law  and  administrative  practice  have  served  as  an  invaluable  source  for 
defining what constitutes fraud and error. In Denmark in particular the different  social 
benefits  in  the  Danish  social  security  system  are  to  a  significant  extent  administered 
by  different  competent  institutions.  Moreover,  the  specific  conditions  for  each  type  of 
benefit are largely defined by private legislation. The conditions of recovery, which are 
general principles in Danish practice, however, guide the definition of fraud and error. 5 
Pursuant  to  Article  12  (b)  in  the  Consolidated  Act  on  Legal  Protection  and 
Administration in Social Matters, which states the conditions for punishment in severe 
cases. Moreover, fraud is defined as a deliberate misrepresentation of the authority by 
the  claimant  that  consequently  inflicts  loss  of  capital  onto  the  authority.  Generally, 
errors  in  Denmark  are  thus  defined  as  benefit  payments  transferred  accidentally  due 
to  an  error  made  by  the  competent  institution  or  by  the  beneficiary.  Fraud  is  defined 
as  benefits  received  by  the  beneficiary  against  better  judgment.  In  Ireland  fraud  is 
understood as a deliberate false representation of facts whether by words or by conduct, 
by concealment of what should have been disclosed — in order to obtain or receive social 
security  payments  or  to  avoid  obligations  to  pay  contributions.  Error  on  the  other  hand 
may  be  understood  as  either  customer  error  or  departmental  error.  Customer  error 
occurs  where  incorrect  information  is  provided  without  fraudulent  intentions,  whereas 
departmental  error  occurs  due  to  a  mistake  by  an  act  or  omission  by  staff,  which  a 
customer did not cause or materially contribute to and which the customer could not at 
the time they received payment or paid contributions reasonably have been expected to 
be aware of. Similarly, in  Lithuania, the concepts of fraud and error are understood to 
occur, amongst others, when incorrect information or documents are provided,  or when 
an  individual  does  not  inform  the  competent  authorities  about  a  pertinent  change  of 
circumstances.  Examples  of  fraud  and  error  include  the  non-reporting  of  employment, 
income  or  social  security  benefits  in  other  Member  States,  the  non-reporting  of  death, 
claiming  unemployment  benefits  whilst  employed  in  another  Member  State  or  claiming 
the  same  benefit  in  more  than  one  Member  State,  the  non-reporting  of  the  posting  of 
workers  or  presenting  incorrect  documents,  and  lastly,  fictitious  employment  contracts. 

5  Specifically  the  conditions  for  recovery  prescribe  that  both  the  social  benefit  has  to  have  been  wrongly 
received and the beneficiary has to have been acting in bad faith by, for instance, deliberately withholding 
information, in order for the competent institution to demand recovery of paid benefits.   

11 

 
 
 
                                                 
The main difference between fraud and error in Lithuania subsequently hinges upon the 
fraudulent  intent  of  the  act  concerned.  A  similar  approach  is  employed  in  Austria, 
Bulgaria, Estonia, Iceland, Italy and Spain.  

In  Croatia,  Finland,  Latvia,  Norway  and  Portugal,  the  notions  of  fraud  and  error  in 
social security coordination are defined by reference to other legislative instruments, not 
necessarily specifically governing social security. Fraud and error in Croatia are defined 
by criminal law as well as the Act on the System of Internal Financial Control. As a result, 
fraud and error in the realm of social security coordination is for a large part dependent 
upon  a  case-to-case  assessment  where  due  regard  is  given  to  the  types  of  benefits 
tainted by fraud and/or error. In Finland reference is made to the Finnish Criminal Code 
in determining what type of behaviour and/or actions constitute fraud, aggravated fraud 
and  forgery.  As  concerns  the  notion  of  error  in  Finnish  legislation,  reference  is  made  to 
the  Administrative  Procedure  Act,  which  regulates  the  concepts  of  material  error  and 
typographical  errors.  This  approach  is  also  applied  in  Latvia  where  fraud  is  defined  by 
reference to the Administrative Procedure Law as well as the Criminal Code. Similarly to 
the  aforementioned  definitions,  fraud  is  distinguished  from  error  due  to  the  fraudulent 
intent, as confirmed by the Administrative Procedure Law. The latter explains that error 
occurs due to clerical and mathematical calculation errors in an administrative act; or in 
situations  where  norms  of  law,  which  determine  the  procedure  for  issue  of  the  relevant 
administrative act, have not been observed in the course of the administrative procedure 
(procedural  error);  or  when  the  institution  has  incorrectly  applied  the  norms  of  law  (or 
has relied upon erroneous facts), or when it has not observed the hierarchy of the legal 
force  of  norms  of  law  or  has  erred  regarding  considerations  of  usefulness  (mistakes 
regarding  substance).  In  Norway  the  Penal  Code  describes  fraud  as  wilful  or  gross 
negligent action taken in order to obtain a benefit while the user must have realised he 
or she was not entitled to that benefit. Error, on the other hand, is described as occurring 
when payments are not completed correctly as the result of flaws in casework, negligent 
misinformation or omission of information by the users. Finally, in Portugal the notions 
of  fraud  and  error  are  defined  by  the  Basic  Social  Security  Act,  the  General  Tax 
Infringement  Rules,  the  Code  of  Contributory  Schemes  and  Law  No  133/88  concerning 
the reimbursement of unduly paid benefits.  

As  aforementioned,  a  number  of  Member  States  (MT,  NL,  SK,  SE,  UK)  have  adopted 
definitions  of  fraud  and  error  in  the  realm  of  social  security;  moreover,  the  same 
definitions apply with respect to social security coordination. Slovakia defines fraud and 
error  in  its  legislation  concerning  social  security,  i.e.  Part  Four  of  Act  No  461/2003  on 
social  insurance.  However,  it  solely  refers  in  general  terms  to  non-compliance  with  or 
violation of an obligation laid down by the act or other legislation, including coordination 
regulations,  i.e.  committing  an  offence  without  distinction  of  the  degree  of  fault.  The 
exact definition of fraud and error will thus in part and somewhat similarly to the practice 
in Belgium and Poland, be determined on a case-by-case basis and with due reference to 
the  benefit  concerned.  In  Sweden  fraud  and  error  in  social  security  are  defined,  albeit 
generally  and  not  specifically  related  to  social  security  coordination.  Benefit  fraud  is 
subsequently defined as occurring when a person provides false information or does not 
report  changed  circumstances,  thereby  causing  a  risk  that  financial  compensations  are 
being  wrongly  paid  or  payable  by a high  amount.  ‘Error’ on  the  other  hand  refers to  all 
errors  regardless  of  who  discovered  the  error,  if  they  are  caused  by  administrators  or 
recipients or whether they are accidental or unintentional. Similarly, legislation in Malta, 
the  Netherlands  and  the  United  Kingdom  define  fraud  and  error  within  the  realm  of 
social  security.  These  definitions  also  apply  to  social  security  coordination.  In  the 
Netherlands  in  particular,  fraud  is  distinguished  from  error  by  reference  to  intent. 
Moreover,  two  types  of  error  exist  –  claimant  error  and  official  error.  In  the  United 
Kingdom  on  the  other  hand,  fraud  includes  all  cases  where  the  following  three 
conditions apply: the basic conditions for receipt of the benefit, or the rate of the benefit 
in payment, are not being met; the claimant can reasonably be expected to be aware of 
the effect on entitlement; the benefit stops or reduces as a result of a  review. Similarly 
to the notion of error in the Netherlands, it is defined as being one of two types. Firstly, 
claimant  error  is  defined  as  occurring  when  the  claimant  has  provided  inaccurate  or 

12 

 
incomplete information, or failed to report a change in their circumstances, but there is 
no fraudulent intent on the claimant’s part. Official error on the other hand occurs when 
the benefit has been paid incorrectly due to inaction, delay or a mistaken assessment by 
the DWP, a local Authority or Her Majesty’s Revenue and Customs (HMRC). 

Belgian,  Czech  and  Polish  legislation  employ  a  similar  yet  specific  technique  whereby 
distinct definitions are given to fraud and error in particular circumstances and scenarios 
and by reference to particular benefits. In Belgium for example, the notions of fraud and 
error differ depending on whether the substance of the matter concerns family benefits, 
unemployment  benefits  or  healthcare  benefits.  Fraud  concerning  family  benefits  is 
defined  by  reference  to  fictitious  residences  and  fictitious  employers.  These  types  of 
fraud  are  divided  into  seven  types  of  fraud  concerning  family  benefits:  type  A  -  the 
make-up of the household which is indicated in the National Register of Natural Persons 
does  not  tally  with  the  real  situation  (false  declaration);  type  B  -  false  declaration  of 
household  income;  type  C  –  intentional  non-disclosure  of  a  situation  in  order  to  unduly 
obtain  social  advantages;  type  D  –  usurping  the  identity  of  another  person  with  or 
without his or her consent; type E – fictitious activity as an employee; type F – fictitious 
employers; and type G – others. Similarly, three types of errors can be observed: type A 
–  errors  occasioned  by  the  family  benefit  fund  itself  to  the  advantage  of  a  recipient  in 
good  faith  when  the  fund  pays  a  sum  which  is  different  from  that  to  which  the  insured 
person would normally be entitled under family benefit legislation; type B – error due to 
fraud,  negligence  or  omission  by  the  socially  insured  (undue  payment  is  occasioned  by 
this  type  of  error);  type  C  –  errors  referring  to  a  period  prior  to  1 July  2014  between 
family  benefit  bodies  that  were  not  included  in  the  financial  envelope  for  global 
management  or  national  distribution.  However,  fraud  and  error  in  the  field  of 
unemployment  benefits  are  determined  by  more  generalised  definitions  instead  of  by 
specific circumstances and situations. This is also the case for fraud and error concerning 
health  care.  As  indicated,  a  similar  approach  is  also  applied  in  Polish  legislation.  In 
addition  to  distinct  definitions  of  fraud  and  error  encompassed  in  criminal  and  civil  law, 
specific  scenarios with  respect  to  specific  benefits  have been  identified  as amounting  to 
fraud and error. For example, in the field of pension benefits, fraud and error is described 
as  occurring  when  benefits  are  paid  despite  circumstances  that  cause  the  cessation  or 
suspension  of  the  entitlement  to  benefits,  or  the  withholding  of  benefits  in  whole  or  in 
part if the beneficiary was informed about no entitlement to benefits; when benefits are 
granted  or  paid  on  the  basis  of  a  false  testimony  or  documents  or  in  any  other  case  of 
intentional  misleading  by  the  beneficiary;  or  when  benefits  are  paid  for reasons  beyond 
reasonable control of the pension institution to a person other than the one stated in the 
decision delivered by such authority. Within this same vein, the Hungarian approach to 
defining  fraud  and  error  with  respect  to  social  security  matters  is  two-fold.  Firstly,  the 
definitions will depend in part upon the particular benefits concerned – fraud in the realm 
of family benefits for example differs from the definition of fraud given in the field of old-
age  benefits.  In  addition  however,  the  notions  of  fraud  and  error  with  respect  to  these 
particular benefits also have differing legal bases. For example, fraud related to old-age 
benefits  is  determined  by  criminal  law  unless  it  fails  to  meet  a  given  threshold. 
Furthermore, fraud concerning old-age benefits is also defined in the Taxation act, whilst 
error  is  described  by  the  Act  IV  of  1991  on  the  promotion  of  employment  and  on 
unemployment  benefits.  This  approach  thus  combines  the  technique  employed  in 
Belgium and Poland as well as the technique employed by the Member States discussed 
below.   

In Denmark, Greece and Romania the definition(s) of fraud and error are subject to a 
predominantly  mixed  regime,  whereby  these  terms  are  interchangeably  defined  by 
reference  to  case  law  and  practice,  as  well  as  other  general  legislative  instruments.  In 
Denmark  for  example,  fraud  is  defined  by  reference  to  criminal  law,  the  Consolidated 
Act  on  Legal  Protection  and  Administration  in  Social  Matters  and  general  principles  of 
law,  whilst  the  definition  of  error  is  the  product  of  case  law  and  practice  (see  supra  p. 
10).  The  foregoing  approach  is  also  used  in  Greece  and  Romania  where  fraud  is  also 
defined  by  reference  to  the  criminal  code,  whilst  error  is  defined  by  case  law  and 
practice. 

13 

 
 
Sources of the Definition of Fraud and Error 

Member States 

Case law and administrative practice 

AT, BG, DK, EE, IS, IE, IT, LT, ES 

General legislative instruments (Administrative law, 
criminal law etc.) 

Social security legislation 

Per social security branch (via practice and/or 
legislation) 

Mixed Regime 

HR, FI, LV, NO, PT 

SK, SE, MT, NL, UK 

BE, CZ, PL 

DK, EL, RO 

2.2.  Treatment of fraud  

In the large majority of Member States (AT, BE, BG, HR, CZ, DK, EE, DE, HU, IS, IE, 
IT,  LV,  MT,  NL,  NO, PL,  PT,  RO,  SK,  ES,  SE,  UK)  fraud  in  the  field  of  social  security 
coordination  may  be  subject  to  both  criminal  prosecution  and  administrative  sanctions, 
albeit  subject  to  varying  intensity.  Conversely  thereto,  Greek  legislation  and  practice 
solely allows for administrative sanctions, including recovery with interest in case of fraud 
in the field of social security coordination.  

In  Austria,  Belgium  and  Portugal,  the  applicability  of  criminal  law  as  opposed  to 
administrative law,  is  determined by  legislation,  which  sets  forth  a number of  scenarios 
and/or conditions signifying whether a particular act is to be considered as administrative 
or  criminal.  In  Austria  in  particular,  the  level  of  sanction  from  both  an  administrative 
and criminal perspective, will be determined by the severity of the fraud (see infra Annex 
2  -  Austria).  Within  this  context  the  most  severe  cases  of  fraud  may  lead  up  to 
imprisonment of 1 to 10 years.  Similarly, in Belgium the type of consequences accorded 
to fraud in the field of social security coordination on the severity of act and is distinctly 
defined  in  the  applicable  legislation  (see  infra  Annex  2  –  Belgium).  Within  this  context 
four  levels  of  penalties  can  be  identified,  including  both  administrative  and  criminal 
sanctioning,  of  which  the  most  severe  fraud  can  lead  to  imprisonment  of  6  months  to 
three years, a criminal maximum fee of € 33,000, and/or a maximum administrative fine 
of  €  16,500.6  Also,  in  Portugal  a  number  of  scenarios  have  been  described  in  various 
pieces  of  legislation,  which  define  certain  acts  and  omissions  as  giving  rise  to  either 
criminal  and/or  administrative  sanctioning,  with  a  maximum  fine  for  the  most  severe 
cases  of  fraud  resulting  in  a  fine  between  €5,000  and  €25,000  (see  infra  Annex  2: 
Portugal).   

Somewhat similar to the foregoing, in Croatia and the Czech Republic, the criminal or 
administrative  nature  of  the  consequences  associated  to  fraud  are  determined  by  the 
type  of  benefit  concerned.  In  the  Czech  Republic  the  determination  of  criminal 
sanctioning as opposed to administrative sanctioning depends primarily upon the type of 
benefit  concerned  and/or  whether  the  fraud  concerns  the  determination  of  applicable 
legislation.  For  matters  concerning  the  determination  of  applicable  legislation  for 
example, fraud will result in criminal consequences, whereas for residence-based benefits 
(family benefits, death grants, care allowance) no use is made of criminal law provisions. 
Rather,  fraud  in  concerning  these  benefits  will  solely  result  in  administrative  offences. 
This  is  also  the  case  in  Croatia,  where  criminal  sanction  is  possible  for  matters 
concerning  pensions,  family  benefits  and  health  insurance,  whilst  only  administrative 
sanction is available for matters concerning unemployment insurance. 

In a number of other Member States (EE, HU, IS, MT, NL, UK) the predominant focus in 
combating  fraud  in  social  security  coordination  is  on  administrative  law  as  opposed  to 

6 For the levels of administrative and criminal sanctions, cfr. AnnexII, p. 87. For a translation of the applicable 
legislation,  cfr.  De  Coninck  M.,  Gillis  D.  &  Jorens  Y.,  The  Belgian  Social  Criminal  Code.  An  English 
Translation by IRIS|international research institute on social fraud, Die Keure, Brugge, 2013. 

14 

 
 
                                                 
criminal  law.    In  Estonia  criminal  prosecution  and  administrative  sanctions  may  be 
administered  in  case  of  fraud  in  the  field  of  social  security  coordination.  However,  for 
criminal sanctions to be administered, fraudulent intent must be explicitly demonstrated. 
Similarly, in Iceland, the Netherlands and the United Kingdom criminal sanctioning of 
fraud is predominantly reserved for the more severe cases, whilst criminal sanctioning of 
fraud  occurs  extremely  rarely.  Furthermore,  Dutch  legislation  in  particular  prescribes 
that criminal prosecution is envisaged for cases if the contested amount exceeds €50,000 
or  if  it  concerns  a  matter  of  recidivism  or  criminal  behaviour.  Hungarian  legislation 
provides  for both  possibilities,  albeit  necessary  to  note that  criminal  cases  pertaining  to 
family  benefits  have  yet  to  occur.  In  Malta  both  approaches  are  also  possible,  but  the 
predominant focus remains upon the recovery of the amounts as opposed to criminal and 
(other) administrative sanctioning. 

In Germany on the other hand, in case of social security fraud the predominant focus is 
on  criminal  law.  This  is  also  the  case  in  Sweden,  where  fraud  is  subject  to  criminal 
prosecution, albeit that no distinction is made with respect to social security coordination. 
This entails that all cases are sent to the police although not all – not inconceivably – go 
to trial. 

Interestingly, in Ireland a matrix with reference to nine characteristics is used in order 
to determine whether fraud in the field of social security coordination is to be addressed 
with criminal or administrative sanctions. These characteristics include, amongst others, 
the duration of the fraud, the amount of the overpayment, a false declaration at the time 
of  the  claim  and  failure  to  notify  a  change  in  circumstances  affecting  entitlements,  and 
previous  history  of  defrauding  the  Department  of  Social  Protection.  The  matrix  is  used 
predominantly  by  social  welfare 
for  vetting  cases  and  making 
inspectors 
recommendations for criminal prosecution. 

Treatment of Fraud 

Member States 

Defined (general) scenarios and distinctions in 
legislation  

Defined per social security branch 

AT, BE, PT 

HR, CZ 

Predominant focus on administrative sanctions 

EE, HU, IS, MT, NL, UK 

Predominant focus on criminal sanctions 

Other 

DE, SE 

IE 

2.3.  The prevalence of fraud in social security coordination  

2.3.1.  General observations 

In a number of Member States (AT, FI, DE, EL, IE, IT, LV, LT, MT, NO, PL, RO, SK) 
significant  statistics  concerning  cases  of  detected  fraud  in  the  field  of  social  security 
(coordination)  are  not  available.  In  particular,  Greece,  Ireland  and  Norway  provide 
general  statistics  concerning  fraud,  which  renders  it  impossible  to  distil  statistics 
concerning fraud in the field of social security coordination. Despite the lack of statistics 
it  appears  that  in  Finland7  and  Lithuania8  fraud  in  the  field  of  social  security 
coordination is extremely limited.  

7 Cases concerning fraud in the field of social security coordination amount to around 0.03 % of all benefits paid 
and 2/3 of these cases concern unemployment benefits. The number of cases has been stable during the last 
years. 

8 The Lithuanian report addresses an interesting phenomenon concerning possible posting fraud: The Lithuanian 
competent  institution  received  applications  to  issue  PD  A1  documents  for  Polish  nationals,  residing  in  Poland 
and  employed  in  several  companies  established  in  Lithuania.  All  these  employees  were  also  self-employed  in 
Poland. The mentioned persons were employed in Lithuania only for a few hours a week and according to the 

15 

 
 
 
                                                 
Conversely  to  the  foregoing,  statistics  concerning  social  security  fraud  in  the  field  of 
social  security  coordination  are  available  in  Belgium,  Bulgaria,  Croatia,  the  Czech 
Republic, Denmark, Estonia, Hungary, Iceland, the Netherlands, Portugal, Spain, 
Sweden  and the United  Kingdom. It need be noted, however, that even with respect 
to  those  Member  States,  which  have  such  data  available,  the  data  concerned  may  be 
fairly  limited  and  oftentimes  solely  pertains  to  a  single  benefit.  In  addition  thereto,  it 
need be noted that even with respect to the Member States, which have significant data 
available, this may be somewhat tainted as in certain examples the distinction between 
fraud and error is not made.   

2.3.2.  Limited data available  

As  indicated,  in  a  number  of  Member  States  (BG,  HR,  DK,  EE,  PT,  HU,  IS,  SE,  UK), 
data  is  available,  albeit  subject  to  the  nuance  that  it  is  limited  to  a  certain  extent.  The 
limited  nature  of  the  available  data  can  be  attributed  to,  amongst  others,  the  lack  of 
distinction  made  concerning  fraud  in  the  field  of  social  security  coordination  vis-à-vis 
fraud  in  social  security  generally,  or  alternatively  the  seemingly  lacking  prevalence  of 
fraud  in  said  Member  States.  Moreover,  in  certain  Member  States  the  determination  of 
fraud  has  been  limited  to  certain  specific  social  security  benefits,  which  in  turn  may  be 
attributed  to  different  authorities  being  competent  for  different  types  of  benefits.  As  a 
result however, the availability of relevant data is not all encompassing.  

In particular, in Bulgaria an approximated 469 cases of fraud concerning family benefits 
have  been  identified,  without  further  indications  as  to  the  types  and  intensity  of  the 
fraud. 

Concerning  pensions  in  Croatia  13  criminal  cases  were  identified  as  being  potentially 
fraudulent. Other forms of fraud concerning other benefits have not been documented. 

labour  contracts  their  salary  was  usually  less  then  100  euros.  These  employees  also  applied  for  documents 
proving their health insurance in Lithuania. The THIF in Vilnius received 78 applications from Polish residents to 
issue E104 forms confirming that people were covered by the compulsory health insurance in Lithuania during 
the year 2014. In 2015 the THIF has turned to the Ministry of Social Security and Labour, the Labour Inspection 
and  the  State  Tax  Inspectorate  with  the  request  to  investigate  these  cases  because  it  considered  the  labour 
contracts were possibly faked) and to the Polish authorities with the request to provide information about the 
labour  activities  of  the  Polish  residents  concerned.  Till  now  several  investigations  by  labour  inspectors  were 
conducted, however, no infringement of labour law was established as Lithuanian Labour Code does not forbid 
employing  a  person  only  for  few  hours  per  month  and  there  is  no  minimum  working  hours  per  month  or  per 
week  established  by  law.  Nevertheless,  Lithuanian  authorities  suspect  the  main  purpose  of  employment  in 
Lithuanian is to avoid payment of social security contributions in Poland. The Lithuanian competent institution 
refuses  to  issue  the  PD  A1  documents  for  the  mentioned  Polish  residents  on  the  grounds  the  activities  in 
Lithuania being only marginal. The persons applying for the PDA1s usually appeal against the decision refusing 
the  issuance  of  the  PDA1.  They  argue  that  there  is  more  then  only  marginal  activity  in  Lithuania  and  that 
Lithuanian  legislation  is  applicable.  The  employees  do  not  provide  information  about  their  self-employment 
activity  in  Poland  or  state  that  they  receive  no  income  in  Poland.  Lithuanian  competent  institution  faces 
difficulties to verify this information: on the one hand, Polish tax authorities refuse to provide information to the 
Lithuanian  competent  institution  about  the  activities  as  self-employed  by  the  Polish  residents  applying  for  the 
PDA1 in Lithuania and about the income of said Polish residents as there is no respective bilateral agreement. 
On the other hand, the Polish competent institution in the field of social security does not have any information 
about the activity of said Polish residents since said residents - are not registered as socially insured persons in 
Poland  !  The  Lithuanian  competent  institution  has  contacted  the  Polish  competent  institution  regarding  these 
cases and the institutions of both Member States are trying to solve this problem bilaterally. The main difficulty 
in  the  above  mentioned  situation  is  how  to  establish  and  prove  the  marginal  activity  in  a  Member  State.  The 
Practical guide defines marginal activities as activities that are permanent but insignificant in terms of time and 
economic  return.  It  is  suggested  that,  as  an  indicator,  activities  accounting  for  less  than  5  per  cent  of  the 
worker's regular working time and/or less than 5 per cent of his/her overall remuneration should be regarded 
as  marginal  activities.  The  question  is  how  to  compare  employment  activities  in  one  Member  State  and  self-
employment  activities  in  other  Member  State  when  no  exhaustive  information  about  the  activities  as  a  self-
employed  can  be  provided.  Furthermore,  it  is  not  always  clear  how  to  measure  e.g.  working  time  of  a  self-
employed  person  or  the  'evaluation  of  the  activity',  since  the  5  per  cent  mentioned  in  the  Practical  guide  can 
only be considered an indicative criterion. 

16 

 
                                                                                                                                                         
 
In Denmark, the National Board of Industrial Injuries receives an estimated two to three 
reported  cases  of  fraud  or  punishable  offences  in  relation  to  the  workers’  compensation 
per  year.  Not  inconceivably,  it  is  assumed  that  the  total  number  is  higher,  albeit  that, 
here  also,  no  account  of  the  total  number  is  available.  This  is  so,  as  the  compensation 
amounts  are  paid  out  by  the  insurance  companies,  who,  independently  of  the  National 
Board of Industrial Injuries, are able to report punishable offences to the police and take 
steps to  recover the  money  on  their own. Concerning pensions for former civil servants 
under the Civil Servants’ Pensions Act, fraud is extremely rare because of the extensive 
registration  of  pension  rights  by  the  former  state  employer  throughout  the  duration  of 
the employment. There have been no cases of fraud detected, reported or prosecuted by 
the Agency for Governmental Administration. Relating specifically to claimants of old-age 
pensions  and  anticipatory  pensions  from  Denmark  who  reside  outside  of  Denmark,  a 
control unit has focused specifically on claimants of Danish pensions residing in Spain. In 
2014, the control unit reported 56 cases of recovery. It need be noted, however, that no 
distinction  between  fraud  and  error  was  made  in  this  respect.  The  main  types  of  fraud 
and  error  relate  to  income,  residence  and  marital  status.  Finally,  the  Danish  Labour 
Market Supplementary Pension Scheme has an estimated 20,000 pensioners abroad and 
rarely discloses cases of fraud regarding the life certificate. Moreover, the very few cases 
per year where the Danish Labour Market Supplementary Pension Fund (ATP) suspected 
fraud concerned countries outside the EU. 

Within this same vein, Estonia seems to be confronted with cases of fraud in the field of 
social  security  coordination  only  to  a  limited  extent.  However,  whilst  no  cases  were 
reported  concerning  unemployment  insurance  and  social  insurance  generally,  an 
approximated  42 cases  were  detected  concerning  inappropriate  use  of  a valid  European 
Health Insurance Card (EHIC) by a person who was no longer insured.  

In Hungary limited data is available, primarily due to the fact that actions with respect 
to family benefits have remained limited to repayment procedures. In the field of old-age 
benefits,  however,  353  cases  were  reported,  of  which  157  concerned  forgery;  the 
majority  of  the  remaining  196  concerned  misuse  of  payment  cards  or  failure  to  comply 
with notification obligations. 

In Iceland the Social  Insurance Administration investigated 501 cases, in 226 of which 
payments were made. It need be noted, however, that in these cases no real distinction 
is made between fraud and error. 

Limited data is available in Portugal, where the Institute of Social Security investigated 
an approximated 360 cases of fraud.  

In Sweden, as aforementioned, all types of suspected cases of fraud are reported to the 
police.  However,  not  all  police  reports  go  to  trial.  Throughout  the  past  year,  the  Social 
Insurance  Agency  drew  up  1,061  police  reports.  Most  of  these  were  terminated  by  the 
police, but in other cases police reports resulted in some form of sanction. Again, it need 
be  recalled  that  no  distinction  is  made  in  this  respect  allowing  for  data  to  be  identified 
regarding fraud in social security coordination only. 

In the United Kingdom the following preliminary data has been gathered concerning the 
prevalence  of  data  on  cases  of  detected  fraud.  For  the  period  2014-2015,  estimates  of 
fraud and error amount to 1.9% of total expenditure, of which an approximated 0.7% is 
assumed to be attributable to fraud. This percentage, in turn, amounts to approximately 
£1.1 billion. 

2.3.3.  Data available  

For  Belgium,  the  various  competent  administrations  provided  the  following  information 
concerning the applicable legislation. In 2014, the National Social Security Office (NSSO) 
initiated 233 investigations in order to establish the applicable legislation. In addition, the 
Directorate-General of the Federal Public Service Social Security indicated that the social 

17 

 
 
 
inspectorate invoked Decision A1 in 150 cases (requests for information or requests with 
a view to withdraw PDs A1) between 1 January 2014 and 31 December 2014 with regard 
to  the  applicable  legislation.  Concerning  family  benefits,  258  cases  were  initiated  for  a 
total  amount  involved  of  €  977.144,  53.  With  respect  to  unemployment  insurance,  the 
competent  institution  (National  Employment  Office  or  NEO)  noted  that  it  keeps  figures 
and  statistics  on  ‘non-compliant  situations  and  findings’.  These  are  exclusively  non-
compliant situations occasioned by beneficiaries. Within this context it need be noted that 
no  distinction  is  made  between  non-compliant  situations  resulting  from  ‘fraud  or  wilful 
misconduct’  or  non-compliant  situations  resulting  from  a  purely  material  error  or  an 
anomaly. Mindful of the foregoing, 29, 402 cases were found to be non-compliant out of 
120,  601  effectuated  investigations.  Finally,  with  respect  to  healthcare  insurance,  the 
statistics  by  SECM  (Service  d’évaluation  et  de  controle  médicaux  –  Medical  Assessment 
and Monitoring Service) do not allow for a distinction to be made between cross-border 
healthcare within healthcare as a whole, entailing that there are no figures as such. 

Overview Belgium  

Types of fraud 

Results 

Applicable Legislation  

PDs A1  

Family Benefits  

Unemployment Insurance  

Healthcare  

233 cases 

150 cases 

258 cases  

29,402 cases  

No available data  

Concerning  the  determination  of  applicable  legislation  and  sickness  benefits  in  cash,  no 
conclusive  data  exists  on  the  detected  and/or  prosecuted  cases  of  fraud  in  the  Czech 
Republic.  However,  in  the  field  of  pensions  limited  data  is  available.  Pensions  are 
exported abroad retroactively upon presentation of a certificate. As a result there cannot 
be  any  overpayments  with  the  exception  of  payments  to  Slovakia,  where  pensions  are 
paid  out  on  a  monthly  basis  upon  quarterly  presentation  of  a  living  certificate.  In  the 
latter  case,  overpayments  occur  as  a  result  of  the  death  of  beneficiaries.  See  the  table 
below.  In  addition  to  the  foregoing,  an  approximated  956  cases  were  registered 
concerning sickness benefits in kind. 

Overview Czech Republic  

Types of Fraud  

2014 

CZK 

Number of Cases 

Total payments Slovakia 

1,592,842,627 

288,841 

  Overpayments total 

 

Reimbursed 

  Outstanding 

  Out of the abovementioned reimbursed 

from the survivors´ pensions 

  Write-offs 

Sickness Benefits  

1,405,770 

771,706 

629,238 

206,362 

4,781 

N/A 

205 

118 

86 

33 

1 

956 

18 

 
 
 
 
 
Whilst statistics are available in the Netherlands, it is crucial to note that the data below 
only  concern  social  security  fraud,  not  health  care  fraud  (see  infra  Annex  –  the 
Netherlands). 

Overview the Netherlands 

Types of fraud 

Results 

Applicable Legislation  

Determination of Residence  

Sickness Benefits in cash 

Invalidity Benefits  

Old-age Benefits 

Survivors’ Benefits 

698 cases 

172 cases 

1,170 cases  

9,499 cases  

899 cases  

127 cases 

The cases of fraud detected or pursued by the Spanish National Social Security Institute 
(INSS)  under  EU  rules  are  shown  in  the  table  below.    Within  this  context,  the  General 
Treasury  for  Social  Security  (Tesorería  General  de  la  Seguridad  Social)  took  action 
against  two  types  of  fraud  in  financial  year  2014:  businesses  that  are  enrolled  in  the 
Spanish social security system, but post their workers to another country and should be 
subject  to  the  legislation  of  the  country  in  which  they  operate;  and  conduct  detected 
involving fictitious businesses and fraudulent worker enrolments. 

Overview Spain  

Types of fraud 

Results 

Fictitious businesses  

Worker  enrolments  declared  fraudulent  on  account  of 
being fictitious  

1,320 

25,182 

Businesses  declared  fraudulent  on  account  of  the 
posting of workers  

32 businesses 

Enrolments of posted workers declared fraudulent  

335 workers 

2.3.4.  Findings  

Clearly,  as  can  be  derived  from  the  foregoing,  the  data  available  is  somewhat 
unsystematic. As indicated, this is, in part, due to the fact that Member States approach 
the data collection of cases concerning fraud in social security (coordination) – if done at 
all – in various different manners.  

Furthermore, whilst some Member States do make a distinction between the concepts of 
fraud  and  error,  others  do  not,  which  furthermore  may  taint  the  perception  of  the  data 
collected.  In  addition,  as  can  be  derived  from  the  Member  States  that  do  provide  a 
substantial amount of data in this respect, discrepancies nevertheless persist as various 
authorities in various Member States do or don’t gather relevant data per social security 
branch. Within this vein, it appears that currently, in the Netherlands, the most extensive 
approach  to  data  collection  in  this  field  can  be  identified.  However,  due  to  lacking 
uniformity  in  data  collection  in  this  context  –  insofar  it  is  undertaken  at  all  -,  it  is 
extremely difficult to decipher general tendencies with respect to fraud in social security 
coordination, as well as to determine differences and similarities in this respect, between 
Member  States.  Finally,  a  comparison  with  respect  to  previous  years  is,  equally  so, 
difficult to make, as data as such was not asked for previous reports.   

19 

 
 
 
 
 
 
 
2.4.  Data concerning cases of fraud and recoverable amounts  

As  a  preliminary  observation,  it  need  be  noted  that  a  majority  of  Member  States  (AT, 
BG,  DK,  FI,  DE,  EL,  IS,  IT,  LV,  LT,  MT,  NO,  PL,  PT,  RO,  SK)  simply  do  not  have 
specific data with respect to fraud in the area of social security (coordination).  

In Belgium, with regard to family benefits, the information requested is not available, as 
the  competent  institution  does  not  break  it  down  per  period.  With  regard  to 
unemployment  insurance  on  the  other  hand,  the  competent  institution  notes  the 
following: 

The type of check 

Declarations and conditions for granting 

Unauthorised combination of income 

Employment situation – checks on paid workers 

Temporary unemployment – checks on paid workers 

Family situation 

Amounts to be recovered (ascertained in 
2014) 

- 

€ 11,897,572.28 

- 

- 

€ 36,786,331.57 

In 2014, the NEO provided findings accounting for €139,735,910.35. This represents the 
sum of new claims and the increases in claims already ascertained. This includes a sum 
of €23,948,363 to be recovered from service voucher enterprises. After deducting this, it 
is  calculated  that  €116,787,547  are  to  be  recovered  from  recipients  of  unemployment 
benefits.  In  2014,  €34,550,416  was  reimbursed  voluntarily  by  beneficiaries.  Finally,  as 
regards  healthcare  insurance,  the  competent  institution  specifies  that  SECM  statistics 
cannot be broken down to identify cases of cross-border health care.  

In Croatia and concerning pension benefits in particular – as no other data is available – 
the  recoverable  amount  was  estimated  at  HRK  4,535,447,82.  Data  concerning 
recoverable  amounts  due  to  fraud  in  the  Czech  Republic  is  limited  to  data  concerning 
pension benefits and sickness benefits in kind. Concerning the sickness benefits in kind, 
the  956  cases  resulted  in  a  recoverable  amount  of  €1,060,620.  In  Estonia,  as 
aforementioned, no cases were detected concerning unemployment insurance and social 
insurance.  With  respect  to  health  insurance  on  the  other  hand,  the  total  amount  was 
€16,663,61,  of  which  five  cases  were  brought  to  court.  Furthermore,  in  some  of  the 
cases concerned, the Estonian Health Insurance Fund entered into extrajudicial voluntary 
agreements  to  facilitate  payment  by  instalments.  Recalling  that  the  number  of  cases 
concerning old-age benefits amounted to 353, the recoverable amount associated thereto 
amounted  to  HUF  242,676,243.  It  need  be  noted,  however,  that  this  figure  cannot  be 
broken  down  by  reference  to  various  categories  of  fraud  related  to  old-age  benefits. 
Concerning  sickness  benefits,  invalidity  benefits  and  unemployment  benefits  in  the 
Netherlands the objective is to recover 80% of the wrongfully accorded amounts within 
a  timeframe  of  three  years.  Moreover,  concerning  family  benefits  the  focus  is  on 
prevention.  

In order to facilitate the compilation of data in this respect, Spain is currently developing 
a  model  to  combat  social  security  fraud.  The  model  takes  a  comprehensive  approach 
aimed at improving the monitoring of the principal sources of fraud, prevention of fraud 
throughout  the  administration  of  social  security  relationships,  contributions  and  their 
collection, early detection to avoid and correct wrongful access to social security benefits, 
and strategic planning of all of these actions, together with their constant follow-up and 
the monitoring of the results.  

Over the course of the past year,  the Swedish Social Insurance Agency  recovered SEK 
285  million,  which  generated  savings  of  SEK  680  million.  However,  here  also,  this 
amount is not limited to coordination only. 

20 

 
 
In  the  United  Kingdom,  the  competent  authority  recovered  £387  million  of 
administered benefit overpayments in 2014-15, of which £61.9 million was estimated to 
be due to fraud. 

2.5.  Undetected fraud  

Again,  in  a  predominant  number  of  Member  States  (AT,  BE,  BG,  HR,  CZ,  EE,  DE,  EL, 
HU, IS, IT, LV, LT, MT, PL, PT, RO, SK) no estimations have been established as to the 
cases  of  fraud  not  detected.  Lastly,  methodological  and  practical  issues  hinder  the 
capacity  to  collect  such  data  Despite  the  overwhelming  lack  of  statistics  in  this  respect 
however, it need be noted that in the Czech Republic it is nevertheless estimated that a 
significant  number  of  cases  concerning  intentional  double  health  insurance  exist. 
Conversely to  the  foregoing,  in  Denmark,  Ireland,  Norway  and to  a certain  extent  in 
Sweden, estimations have been made as concerns undetected fraud.  

An  analysis  performed  by  an  external  consulting  company  in  Denmark  in  2015 
extrapolated  existing  data  on  detected  cases  of  fraud  and  error  in  order  to  indicate  the 
economic  potential  for  enhanced  efforts  of  control  in  the  area  of  social  security 
coordination. The analysis was limited to sickness benefits in cash, which are subject to 
coordination under Regulation (EC) No 883/2004, and welfare benefits in cash, which are 
not  subject  to  the  aforementioned  social  security  coordination  rules.  Moreover,  the 
estimate of undetected cases was limited to include an estimate as regards EEA citizens 
(not  including  Danish  citizens  living  abroad).  The  analysis  indicates  that  there  are  445 
cases  of  fraud  and  error  to  be  found  concerning  sickness  benefits  and  welfare  benefits 
each year. It is, however, not possible to provide data on the number of detected cases 
within  the  context  of  these  445  cases,  entailing  that  it  is  also  not  possible  to  provide  a 
clear estimate of the number of undetected cases. Nevertheless, the number of detected 
cases is expected to be lower than 445. 

In Ireland the Department of Social Protection has a broad-ranging and comprehensive 
control strategy, which aims to keep fraud and abuse to a minimum. A key objective of 
the  Department’s  control  strategy  is  to  ensure  that  the  right  person  is  paid  the  right 
amount  of  money  at  the  right  time.  The  emphasis  is  to  minimise  risks  of  fraud  and 
eliminate  incorrect  payments.  Where  fraud  is  discovered  appropriate  sanctions  apply. 
However, to prove fraud requires a careful investigation of the case, the establishment of 
the  facts  (often  under  a  cautioned  interview),  often  resulting  in  a  disallowance  of 
payment by the deciding officer and the setting up of the recovery of any overpayment in 
respect of the historical period (whenever this is possible; sometimes the evidence only 
allows the payment to be stopped from a certain date, making a full recovery of unduly 
paid  amounts  impossible).  According  to  the  Department,  the  level  of  overpayments 
recorded  in  the  social  welfare  system  is  the  only  true  measure  of  fraud.  In  2013,  the 
total overpayments recorded amounted to €127.2 million in respect of just over 84,702 
overpayments.  €70.7  million  was  the  amount  recovered  in  2013.  The  2014  figures  are 
subject to audit and are not available. Total overpayments in 2013 accounted for 0.61% 
of  Departmental  expenditure.  Overpayments  recorded  as  suspected  fraud  account  for 
0.3% of total expenditure.  

As  concerns  Norway,  an  independent  research  institution  has  estimated  the  amount  of 
undetected  fraud  to  be  an  average  5%  of  gross  payments  across  the  six  cash  benefits 
most subject to fraud. The figures are encumbered with considerable uncertainty, as they 
are based on qualitative methods and analysis.  

The  latest  overall  assessment  of  the  extent  of  irregular  payments  within  the  welfare 
system  in  Sweden  was  made  in  2010.  As  estimated,  incorrect  payments  in  total 
amounted  to  approximately  16.5  billion.  The  uncertainty  in  the  estimate  is  however 
large.  Moreover,  as  aforementioned,  these  estimations  are  not  limited  to  social  security 
coordination  only.  The  method  used  to  generate  such  estimations  is  called  the  “Expert 
Elicitation”.  Experts  analyse  the  existing  checks,  audits  and  investigations  that  are 

21 

 
 
 
available  and  complement  its  expertise  in  the  field.  Experts'  individual  assessments  are 
then weighed together resulting in a final assessment. 

Estimations Undetected Fraud 

Member States 

No available estimations 

AT, BE, BG, HR, CZ, EE, DE, EL, HU, IS, IT, LV, LT, 
MT, PL, PT, RO, SK 

(Limited) available estimations 

DK, IE, NO, SE, NL 

2.6.  The prevalence of error in social security coordination 

Whilst  fraud  –  as  aforementioned  (see  supra  2.1)  –  presupposes  a  fraudulent  intent, 
error  is  distinguished  therefrom  by  reference  to  the  absence  of  fraudulent  intent.  In  a 
number of Member States  (AT,  DK,  EE, DE,  EL,  HU,  IS,  IE,  IT,  LV,  MT,  NL,  PT, SK, 
SE)  there  is  no  or  extremely  limited  data  available  concerning  the  number  of  cases  of 
error  detected  in  the  field  of  social  security  coordination  per  respective  branch.  Again, 
this  is  due  to  various  reasons.  In  Denmark,  Iceland,  Lithuania  and  Sweden  (see 
supra) this is to be attributed to the fact that the distinction between fraud and error is 
not  made  in  data  collection.  In  Estonia,  Germany,  Greece,  Ireland,  Italy,  Latvia, 
Malta,  the  Netherlands,  Portugal  and  Slovakia  on  the  other  hand,  reliable  data  as 
such  is  simply  not  collected.  Unlike  the  foregoing,  data  is  available  in  Belgium, 
Bulgaria,  Croatia,  Czech  Republic,  Finland,  Norway,  Poland  and  the  United 
Kingdom.  

2.6.1.  Lacking data concerning the prevalence of error  

Despite the lacking data in a large number of Member States (AT, DK, EE, DE, EL, HU, 
IS,  IE,  IT,  LV,  MT,  NL,  PT,  SK,  SE),  a  number  of  observations  need  nevertheless  be 
made.  In  Hungary  data  with  respect  to  error  in  social  security  coordination  is  not 
available.  However,  it  need  be  noted  that  undue  payments  are  estimated  to  represent 
less than 1% of all cases concerning family benefits.  

The  German  statutory  pensions  body,  the  Deutsche  Rentenversicherung,  is  unable  to 
provide  reliable  data  for  reporting  year  2014.  Nevertheless,  it  is  assumed  that  cases  of 
error  caused  by  employees  or  benefit  recipients  in  cross-border  situations  are 
significantly  more  relevant  than  cases  of  fraud.  In  the  area  of  insurance,  the  main 
problem in cross-border situations is failure to communicate multiple employments to the 
authorities in the place of residence, which leads to individuals being wrongly insured and 
to  contributions  not  being  paid.  The  difference  compared  to  fraud  can  be  seen,  for 
example,  in  the  case  of  seasonal  workers,  who  are  often  completely  unaware  of  their 
duty  to  report  their  multiple  employments  to  their  country  of  residence  in  order  to 
receive  an  A1  certificate.  On  the  benefits  side,  the  main  problems  are  a  lack  of 
information  about  deaths  of  people  entitled  to  pensions,  failure  to  communicate 
employment,  erroneous  statements  about  the  level  of  any  income  to  be  taken  into 
account, and – in relation to orphan pensions – failure to communicate that an education 
or  training  has  ended  prematurely.  Likewise,  there  is  no  reliable  data  for  accident 
insurance, though it is assumed that there are a significant number of people in multiple 
employments  who  are  unknown  and  will  not  become  known  to  the  social  security 
institutions.  The  reasons  for  this  are  usually  that  the  individuals  concerned  and  their 
employers  are  unaware  of  the  legal  provisions  of  the  coordination  Regulations,  or  that 
employers  deliberately  fail  to  report  the  situation,  in  order  to  avoid  the  administrative 
effort  connected  with  a  registration  in  the  social  security  system  of  another  Member 
State,  when  that  State  is  responsible  for the  multiple  employment.  Lastly, no statistical 
data  can  be  given  for  the  area  of  family  benefits.  A  frequent  source  of  error  by 
competent  institutions  in  this  respect,  is  the  application  of  Article 60(3)  of  Regulation 
(EC)  No 987/2009.  The  current  benefit  rates  applicable  in  the  Member  State  which  has 
priority  are  frequently  not  known.  As  a  result,  incorrect  benefit  amounts  are  paid 
(sometimes  to  the  advantage  and  sometimes  to  the  disadvantage  of  the  recipient), 

22 

 
 
calculated  for  the  purpose  of  the  provisional  decision  as  the  difference  between  the 
German child benefit and the expected benefit entitlement in the other Member State.  

Despite  the  lacking  statistics  on  the  number  of  cases  of  error  in  Latvia  in  the  field  of 
social security coordination per branch of social security, a number of prevalent sources 
of  error  have  nevertheless  been  identified.  The  main  types  of  error  on  the  side  of  the 
competent institution are – similarly to Germany – the determination of a person’s death 
in  the  case  of  long-term  services,  errors  concerning  the  contributions  to  be  paid,  and 
decisions  taken  based  upon  incorrect  information  and  thus  incorrectly  executed.  On  the 
claimant’s side the main types of error are due to a lack of understanding of the situation 
and legislation and errors due to lacking attention.  

In Slovakia, the Social Insurance Agency has not recorded overall statistical data on the 
number  of  detected  errors  for  calendar  year  2014.  Checks  carried  out  in  the  period 
covering  2014  included  the  granting  of  invalidity  pensions  pursuant  to  the  coordination 
Regulation  (32  errors  were  found  in  201  checked  cases;  i.e.  16  %  or  1  in  6!)  and 
entitlements  to  a  Christmas  allowance  in  relation  to  foreign  countries  (no  errors  were 
found).  However,  the  Social  Insurance  Agency  does  not  keep  statistics  with  respect  to 
such cases. 

2.6.2.  Available data concerning the prevalence of error 

Contrary  to  the  foregoing,  a  number  of  Member  States  do  have  some  data  available 
concerning  the  number  of  cases  of  error  detected  in  the  field  of  social  security 
coordination.  

On the one hand, in Belgium, with respect to the applicable legislation, the emphasis is 
placed  on  the  correct  application  of  the  legislation  in  the  field  of  social  security  without 
deciding whether the case in question constitutes fraud or error. Often a choice is made 
in  favour  of  rectifying  the  situation  by  invoking  (or  imposing)  the  applicable  national 
legislation,  which  results  in  (retroactive)  payments  of  social  security  contributions 
complying with the rules on social security. Concerning family benefits on the other hand, 
the  competent  authority  provides  that  161,  275  cases  of  error  have  been  detected. 
Furthermore,  regarding  unemployment  insurance,  it  need  be  recalled  that  the  available 
data  does  not  distinguish  between  fraud  and  error,  which  thus  also  renders  the 
compilation of data concerning error difficult (see supra 2.3). 

Types of Error 

Applicable Legislation  

Family Benefits 

Unemployment Insurance 

Cases 

N/A 

161, 275 cases 

N/A 

The National Health Insurance Fund in Bulgaria disputed an approximated 105 claims by 
other  Member  States  for  reimbursement  of  costs  on  the  ground  that  the  individuals 
concerned  were  not  insured  in  Bulgaria  or  that  duplicate  claims  had  surfaced.  Data 
pertaining to error in other fields of social security is not available.   

Types of Error 

Health Insurance 

Cases 

105 

In  Croatia  276  cases  concerning  error  were  detected  in  the  realm  of  pension  benefits. 
However,  within  this  number  of  cases  no  distinction  has  been  made  between  error 
resulting  on  behalf  of  the  claimant  or,  alternatively,  error  resulting  on  behalf  of  the 

23 

 
 
 
 
 
competent authority. Data concerning error in other fields of social security coordination 
is not available.  

Types of Error 

Pension Benefits 

Cases 

276 

Error  in  the  Czech  Republic  as  indicated  (see  infra  Annex  –  Czech  Republic),  is  solely 
limited to error on the claimant side and does not take into consideration error on behalf 
of the competent authorities.  

Types of Error 

Survivors’ Benefits 

Unemployment Benefits  

Cases 

1 case 

17 cases 

In  Finland  during  2014,  approximately  800  cases  were  detected  where  a  person  had 
been  simultaneously  insured  by  the  respective  social  security  legislation  of  two  States. 
The employees concerned had typically worked in two States for two different employers, 
and  were  covered  by  the  lex  loci  laboris  principle  in  both  States.  The  employees 
concerned  had  not,  however,  received  double  benefits  nor  had  they  acted  on  purpose. 
Furthermore,  to  minimise  error  on  behalf  of  Kela,  the  decision-making  by  the 
administration  is  regularly  monitored  based  on  risk  evaluations.  Based  on  the  results 
from such monitoring, case handlers are trained and processes are improved if needed.  

Types of Error 

Simultaneous Insurance 

Cases 

+/- 800 cases 

As  concerns  the  available  data  for  Norway  (see  infra  Annex  –  Norway)  the  figures  on 
recovered  amounts  are  encumbered  with  uncertainty  due  to  shortcomings  in  the 
accounting  systems.  Figures,  which  specify  whether  the  error  was  on  the  side  of  the 
competent institution or on the side of the claimant, are not available. 

Types of Error 

Sickness Benefits  

Maternity and Paternity Benefits 

Invalidity Benefits 

Unemployment Benefits 

Family Benefits 

Cases 

3,912 cases 

1,839 cases  

13,410 cases  

10,190 cases  

14,157 cases  

Concerning social  insurance  in  Poland  generally,  no  data  is  available  on  the  number of 
cases  of  error  detected  in  the  field  of  social  security  coordination.  However,  as  regards 
KRUS  –  the  agricultural  social  insurance  –  there  have  been  a  number  of  cases  of 
overpayment,  which  were  caused  by  simultaneous  insurance  in  Poland  and  in  the  other 
Member State. In particular there have been 17 cases concerning invalidity benefits, 20 
cases concerning old-age benefits and 2 cases concerning survivors’ benefits.  

Types of Error 

Invalidity Benefits 

Cases 

17 cases 

24 

 
 
 
 
 
Old-age Benefits  

Survivors’ Benefits 

20 cases  

2 cases  

In  the  United  Kingdom  preliminary  data,  as  previously  indicated,  estimates  that  an 
approximated  1.9%  of  benefit  overpayments  is  to  be  attributed  to  fraud  and  error,  of 
which  an  approximated  0.7%  is  due  to  claimant  error  and  0.4%  due  to  official  error. 
Despite  the  available  percentages  however,  it  is  unclear  how  many  cases  in  particular 
these figures relate to.  

2.6.3.  Findings 

As was the case with respect to the prevalence of fraud, the data available is somewhat 
unmethodical.  As  aformentioned,  this  is,  in  part,  due  to  the  fact  that  Member  States 
approach the data collection of cases concerning error in social security coordination – if 
done at all – in various different manners. Whereas certain Member States do attempt to 
undertake data collection in this respect, others are less focused thereupon. Again, this is 
attributable to a number of factors. Whereas some Member States do make a distinction 
between the concepts of fraud and error, others do not, which furthermore may taint the 
perception of the data collected. In addition, as can be derived from the Member States 
that do provide a substantial amount of data in this respect, discrepancies nevertheless 
persist, as various authorities in various Member States do or don’t gather relevant data 
per social security branch. Within the context of error, it appears that Norway provides 
the  most  extensive  and  thorough  overview  data  concerning  cases  of  error  per  social 
security branch. However, it is crucial to reiterate that it is extremely difficult to decipher 
general  tendencies  with  respect  to  fraud  in  social  security  in  view  of  the  absent 
comparable approach by Member States to data collection in this particular field.  

2.7.  Data concerning cases of error and recoverable amounts 

In view of the extremely limited number of Member States which effectively gather data 
on  the  cases  of  error  detected  in  the  field  of  social  security  coordination,  it  is  not 
surprising  that  data  concerning  the  amounts  awarded  in  error  and  the  amounts 
recovered are not easily ascertainable. In particular, only Belgium, Bulgaria, Denmark 
and Poland report to have such data available, whilst a number of Member States (AT, 
HR, CZ, EE, DE, EL, HU, IS, IT, LT, MT, NO, PT, RO, SK) do not or do but to a limited 
extent  (e.g.  NL).  In  Lithuania  in  particular  this  is  due  to  the  fact  that  there  is  no 
possibility to determine which of the amounts claimed for recovery are related to claims 
in  2014.  Moreover,  it  is  not  possible  within  this  context  to  determine  whether  the 
amounts are to be recovered due to error or fraudulent behaviour.  

In  Belgium,  concerning  applicable  legislation,  the  competent  social  inspection  services 
note  that  for  the  period  between  1  January  2014  and  15  December  2014,  the  amount 
recorded  is  €  17,364,965.50,  according  to  the  investigations  conducted  by  the  social 
inspection services and the withdrawal of PDs A1, for Belgian social security contributions 
payable  on  a  voluntary  basis.  It  need  be  recalled,  however,  that  for  what  concerns  the 
applicable  legislation  it  is  uncertain  whether  this  amount  is  to  be  attributed  to  fraud  or 
error, as the distinction was not made in the compilation of this data. Between 1 January 
2014 and 15 December 2014, the amount recorded by the NSSO following investigations 
inspection  services  was  €7,784,002.88  (ex  officio: 
conducted  by 
€5,793,721.60).  With  respect  to  family  benefits,  the  competent  institution  FAMIFED 
specifies  that  it  distinguishes  between  error  and  fraud.  As  a  result  no  fraud  due  to  an 
‘error’ by the socially insured (which is actually an attempt at fraud) is included in unduly 
paid amounts resulting from error. Finally, with respect to the unemployment insurance 
the recoverable amounts are indicated (see supra 2.4) albeit subject to the nuance that 
no explicit distinction has been made between fraud and error.  

the  social 

25 

 
 
 
Types of Error 

Recoverable Amounts 

Applicable Legislation  

€ 17,364,965.50 

Similarly to Belgium, it need be noted that Danish authorities rarely distinguish between 
fraud and error when registering detected cases (see infra Annex – Denmark).  

Types of Error 

Recovered Amounts 

Unemployment Benefits 

Pre-retirement Benefits 

9,5 million 

3,9 million 

In  Bulgaria,  with  respect  to  the  amounts  requested  to  be  refunded  by  other  Member 
States for health services, an amount of €2,264,288.17 was effectively refunded. Of this 
amount, €2,197,237.47 (97.04%) concerned benefits in kind provided to persons with a 
valid EHIC and €67,050.70 (2.96%) concerned benefits provided against valid certificates 
for  registration  in  the  Member  State  of  residence.  The  persons  not  entitled  to  health 
insurance  coverage  due  to  interrupted  health  insurance  rights  did  not  reimburse  these 
amounts to NHIF. 

Types of Error 

Health Services  

Recovered Amounts 

€2,264,288.17 

Polish statistics concerning social insurance have generally not been collected. However, 
concerning KRUS, the following amounts have been recovered.  

Benefits 

Invalidity benefits 

Old-age benefits 

Survivor’s benefits 

Recovered Amounts 

€ 1113.38 

€ 2487.15 

€ 149.55 

In  Sweden  over  the  course  of  the  past  year  the  Swedish  Social  Insurance  Agency 
recovered 285 million SEK, which generated savings of 680 million SEK. However, it need 
be  recalled  –  as  aforementioned  –  that  within  this  context  no  distinctions  are  made 
between  fraud  and  error,  and  the  foregoing  amount  is  not  limited  to  social  security 
coordination. 

Finally, the competent authority in the United Kingdom recovered £1.334 billion of debt 
in 2014-2015, of which £61.9 million was due to fraud and £265.5 due to claimant error, 
a slight increase vis-à-vis 2013-2014. 

2.8.  Undetected error 

2.8.1.  No available estimations 

Similarly  to  the  estimation  of  undetected  cases  of  fraud,  the  large  majority  of  Member 
States (AT, BG, HR, CZ, EE, DE, EL, HU, IS, IT, LV, LT, MT, NL, NO, PL, PT, RO) do 
not  have  estimations  concerning  the  number  of  cases  of  error  in  the  field  of  social 
security  coordination.  Furthermore,  in  view  of  the  fact  that  no  distinctions  are  made 
between fraud and error, and relevant data is not confined to social security coordination, 
no reliable data can be given with respect to error in Sweden. 

26 

 
 
 
 
 
2.8.2.  Available estimations 

In  Belgium,  Denmark  and  Ireland  such  estimations  are  available,  although  this  is 
subject to nuance. As indicated above, in Belgium for example, certain estimations are 
available  for  family  benefits,  whereas  no  reliable  estimations  are  available  concerning 
cases  of  error  with  respect  to  the  applicable  legislation  and  unemployment  insurance. 
Nevertheless,  concerning  family  benefits  the  competent  institution  (FAMIFED)  specifies 
that  it  detects  errors  by  monitoring  the  correct  and  uniform  application  of  the  relevant 
legislation.  It  therefore  verifies  whether  the  quality  standards  recommended  are 
complied with. Via this approach, FAMIFED guarantees the efficiency and effectiveness of 
the family benefits system whilst helping to prevent error. In 2013, a certain number of 
errors  were  detected  in  a  random  sample  of  files  audited  at  14  family  benefit  funds  (in 
2013).  It  emerged  that  1.62%  of  undue  payments  which  had  not  been  accounted  for 
were detected in this sample. 

As  concerns  Denmark  a  nuanced  approach  is  also  requisite.  Recalling  that  estimations 
have been made by an external consulting company claiming that there are 445 cases of 
fraud  and  error  to  be  found  within  sickness  benefits  and  welfare  benefits  each  year,  it 
need  be  noted  that  this  estimation  does  not  distinguish  between  fraud  and  error.  Yet 
again,  this  entails  that  no  definitive  data  can  be  provided  for  concerning  cases  of  error 
specifically.  

The  competent  Irish  department  carries  out  detailed  fraud  and  error  surveys  on 
individual schemes, which provide evidence-based indicators for levels of fraud and error 
for those schemes at that particular time. ‘Fraud and Error Surveys’ have not been used 
to identify the total cost of amounts lost through fraud or error in schemes. The purpose 
and  value  of  fraud  and  error  surveys  is  to  identify  the  exposure  to  risk  of  irregular 
payments  to  enable  necessary  improvements  to  be  implemented.  Fraud  and  Error 
Surveys  have  been  used  as  an  indicator  of  the  level  of  fraud  and  error  in  schemes  and 
fraud  on  most  schemes  examined  is  very  low.  Under  the  Compliance  &  Anti-Fraud 
Strategy  2014-2018,  the  Department  of  Social  Protection  is  furthermore  committed  to 
undertaking  at  least  two  fraud  and  error  surveys  each  year  up  to  the  end  of  2017. 
Results are presented in terms of the ‘net rate of fraud and error’. The net rate refers to 
the position after account is taken of decreases in weekly rate, increases in weekly rate, 
terminations  of  payment,  transfers  to  other  payments  and  the  position  following  appeal 
of  any  cases  affected.  The  following  are  the  results  of  the  most  recent  fraud  and  error 
survey: 

Benefit 

Child benefit - 
Published 2013 

Jobseekers allowance 
– Published 2014 

Widow(er)’s/survivors 
and civil partners 
contributory pension – 
Published 2014 

Total cost of fraud and 
error  

The net cost of fraud and 
error was found to be 
0.5% of expenditure 

The net cost of fraud and 
error was found to be 
3.1% of expenditure 

The net cost of fraud and 
error was found to be 
0.7% of expenditure 

Cost related to fraud 

Cost related to error 

0.5% related to 
suspected fraud 

1.4% related to 
suspected fraud 

0.2% related to 
suspected fraud 

0% related to error 

1.7% related to error 

0.5% related to error 

SWA – (rent 
supplement) – 
Published 2014 

The net cost of fraud and 
error was found to be 
5.0% of expenditure 

2.9% related to 
suspected fraud 

2.1% related to error 

2.9.  Preventing and curbing fraud  

Not  inconceivably,  Member  States  have  various  different  ways  of  preventing  fraud  and 
error  in  a  national  context  not  exclusively  limited  to  social  security  coordination. 

27 

 
 
 
 
Nevertheless,  certain  techniques  are  particularly  predominant  across  various  Member 
States. In a number of Member States (BE, DK, FI, DE, IS, IE, IT, LV, NL, SE, UK) the 
techniques  of  data  exchange,  data  matching  and  data  mining  are  frequently  used. 
Croatia, Denmark, Estonia, Finland, Malta, the Netherlands and Sweden also make 
frequent use of bilateral agreements with other Member States in order to limit fraud and 
error in the field of social security coordination. 

2.9.1.  Generalised findings  

As  indicated  above,  data  exchange,  data  matching  and  data  mining  are  particularly 
popular  tools  in  combating  fraud  and  error.  In  Belgium  for  example,  these  techniques 
are  used  in  a  purely  national  as  well  as  international  context  and  serve  the  purpose  of 
isolating inconsistencies or irregularities in social security. These methods are frequently 
adopted in combating social dumping and seek to put an end to the fraudulent posting of 
workers. To that end data matching and data mining techniques (especially in the Limosa 
database but also other databases) are to be increased. This involves making a selection 
on  the  basis  of  a  risk  assessment  with  scenarios  developed  and  tested  by 
multidisciplinary  teams.  Feedback  from  these  activities  will  be  managed  in  a  structured 
manner  so  that  data  mining  activities  can  be  refined  in  an  iterative  process.  Data 
matching is furthermore also used in the field of unemployment insurance.  In casu, the 
competent  institution  (NEO)  states  that  databases  are  cross-referenced  with  others 
including  with  other  social  security  databases  such  as  the  databases  of  the  NSSO,  the 
National Institute for the Social Security of the Self-employed and the National Institute 
for  Health  and  Disability  Insurance  (INAMI/RIZIV).  Data  matching  is  conducted  in 
compliance  with  the  principles  concerning  the  protection  of  privacy  and  the  provisions, 
which govern the electronic exchanges of personal data in the field of social law. Via the 
means  of  the  cross-referencing  of  relevant  databases,  the  NEO  conducts  both 
preventative checks and a posteriori checks.  

In the fields of unemployment insurance and a range of other benefits, Denmark is also 
particularly keen on the use of data matching techniques. In the field of unemployment 
benefits,  members  are  informed  that  the  information,  which  they  provide  to  the 
Unemployment  Insurance  Fund,  will  be  subject  to  control,  amongst  others  by  means  of 
data  matching.  In  addition,  several  Unemployment  Insurance  Funds  have  carried  out 
information  campaigns  to  raise  awareness  amongst  members  that  the  Fund  concerned 
will conduct data matching through the income register in order to check the correctness 
of  their  respective  information.  Data  matching  is  carried  out  in  relation  to  data  on 
income,  the  amount  of  working  hours,  independent  business  and  holiday  payment. 
Moreover,  related  specifically  to  claimants  of  old-age  pensions  and  anticipatory  pension 
from Denmark but for individuals who reside outside of Denmark, a control unit has been 
established,  which  focuses  particularly  on  claimants  of  a  Danish  pension  residing  in 
Spain.  In  addition  to  this  initiative,  Denmark  engages  in  information  exchange  with, 
among  others,  Norway  and  Sweden.  Within  this  context  one  of  the  main  strategies  for 
the control of fraud and error in this respect is – equally so – the increased use of data 
matching.  

At  a  national  level  the  Estonian  authorities  have  developed  a  better  exchange  of  data 
between  different  databases  and  are  enhancing  the  cooperation  with  other  national 
competent institutions. Similarly thereto, in Finland Kela envisages an increased use of 
data matching amongst various competent authorities in order to detect fraud and error 
at a far earlier stage.  

In  Germany,  data  matching  and  data  mining  is  carried  out  pursuant  to  § 119(3)(1)  of 
Volume VI of the German Social Security Code (SGB VI), allowing the pensions service of 
Deutsche Post AG to regularly conduct automated cross-checking of data on deaths with 
various  EU  Member  States  and  third-party  countries  on  behalf  of  the  Deutsche 
Rentenversicherung. In reporting period 2014, numerous comparisons took place of data 
on  deaths.  These  covered  approximately  845,700  pensions  paid  to  various  Member 
States  (AT,  BE,  CH,  ES,  FI,  IT,  LU,  NL,  SE).  In  2014,  the  sending  of  820,000  life 

28 

 
certificates  was  rendered  unnecessary  because  of  the  automated  crosschecking  of  this 
data  in  place  for  these  people.  As  stressed  in  reports  in  earlier  years,  the  Deutsche 
Rentenversicherung  is  much  in  favour  of,  and  is  working  hard  towards,  enhancing  this 
cooperation.  In  accordance  with  its  statutory  duty  under  § 150(3)  SGB  VI,  the  Data 
Centre  of  the  Pensions  Institutions  (Datenstelle  der  Träger  der  Rentenversicherung) 
maintains  the  so-called  'A1  database'.  Saved  in  this  database  is  data  on  all  posting 
certificates  (A1  forms)  to  which  German  regulations  do  not  apply.  Routine  checks 
performed  at  the  time  the  data  is  captured  reveal  errors  in  the  certificates,  which  are 
then returned to the issuing authority for correction. This database is used by the audit 
authorities  principally  to  expose  cases  of  abuse  of  the  posting  process  and  to  combat 
undeclared  work.  Under  § 150(5)  SGB  VI,  an  automated  data  retrieval  process  is 
available for these purposes. The accident insurance institutions in Germany have in the 
past made efforts to agree on procedures with the liaison bodies of other Member States, 
to ensure that pension payments are made to recipients in those countries only where an 
entitlement  exists.  Regrettably,  nearly  all  these  procedures  have  come  to  a  standstill. 
Accident insurance institutions which make payments abroad via the pensions service of 
Deutsche  Post  AG  are  going  to  endeavour  to  become  included  in  the  automatic  cross-
checking  of  data  on  deaths.  The  remarks  on  the  Deutsche  Rentenversicherung  and  the 
A1 database apply equally for accident insurance.In the area of family insurance, a yearly 
comparison  with  data  from  the  residence  registration  authorities  is  used  to  check 
whether  minors  still  exist  and  are  living  in  the  household  of  the  person  drawing  a  child 
benefit.  

Lastly, the Irish Department of Social Protection’s emphasis is to minimise risks of fraud 
and  eliminate incorrect  payments,  which  is  achieved amongst  others,  by  means  of  data 
matching  and  mining  techniques.  This  involves  appropriate  checks  at  the  point  of 
claiming, strengthened by systematic reviews of claims in payment  and verification that 
the  conditions  for  entitlement  continue  to  be  met,  including  means,  residency  and 
medical reviews. The Department of Social Protection has an extensive legal structure to 
support the sharing of data for the purpose of controlling the entitlement and payment of 
benefits.  The  legislative  provisions  that  allow  for  the  specific  sharing  of  data  are 
contained  in  section  261(1)  of  the  Social  Welfare  Consolidation  Act  2005.  Information 
held by the Department (Minister) for the purposes of the  Act (including the purpose of 
collection  by  the  Revenue  Commissioners  of  employment  and  self-employment 
contributions)  may  be  transferred  by  the  Department  to  the  Revenue  Commissioners. 
Similarly, information held by the Revenue Commissioners for the purposes of this Act or 
the  Income  Tax  Acts,  relating  to  employers,  the  reckonable  earnings  of  employed 
contributors  or  reckonable  income  or  reckonable  emoluments  of  self-employed 
contributors or of any payments made under this Act may be transferred by the Revenue 
Commissioners  to  the  Minister.  Under  the  provisions  of  section  261(2)  information  held 
by  the  Department  (Minister)  for  the  purposes  of  this  Act  or  the  control  of  schemes 
administered by or on behalf of the Minister or the Department of Social Protection may 
be  transferred  by  the  Minister  to  a  Department  or  a  specified  body.  The  inverse  also 
applies.  The  Department  undertakes  a  number  of  existing  data  matches  with  other 
Government  Departments  and  Agencies  on  a  systematic  basis,  including  with  the  Irish 
Prison  Service,  Third  Level  Institutions,  the  General  Register  Office,  the  Commission  on 
Taxi  Regulation,  Revenue  Commissioners,  the  Department  of  Work  and  Pensions  (UK) 
and  the  Probate  Office.  The  Department  recognises  that  fraud  investigation  and  control 
can  be  assisted  through  the  application  of  a  range  of  new  technologies.  Within  this 
context,  the  Department  recently  commenced  a  project  utilising  analytics  technology  to 
predict which claims are more likely to be fraudulent. When this technology is in place, it 
is hoped that this will enable the Department to target higher risk cases for investigation 
and to do so faster. Existing customer information will be used to build analytics models 
which will enhance fraud and error detection. 

Finally, as concerns cooperation techniques regarding data at a national level seeking to 
combat  fraud  and  error,  mentioned  need  be  made  of  the  plethora  of  national  data 
exchange  agreements  that  have  been  enacted  in  Latvia  with  this  exact  purpose,  as 
indicated below.   

29 

 
 
Data exchange agreements in Latvia 

 

 

 

 
 

 

 
 
 
 
 

 

 

Agreement  on  cooperation  between  the  State  Social  Insurance  Agency  (SSIA)  and  the  State  Medical 
Commission for the Assessment of Health Condition and Working Ability (16.04.2007).  
Agreement  on  cooperation  between  the  SSIA  and  the  State  Medical  Commission  for  the  Assessment  of 
Health  Condition  and  Working  Ability  on  the  exchange  of 
information  via  the  state  portal 
http://www.Latvija.lv  e-services (15.12.2014).  
Agreement between the SSIA and the Constitution Protection Bureau on the exchange of information (the 
CPB) (15.04.2008). 
Agreement between the SSIA and the Ministry of Defence on the exchange of information (09.06.2008).  
Agreement between the SSIA and the Office of Citizenship and Migration Affairs on supplying of information 
to the SSIA in online data transmission regime (27.02.2009).  
Agreement between the SSIA and the Office of Citizenship and Migration Affairs on the use of the software 
package “Personal Data Database” of the Office of Citizenship and Migration Affairs (14.04.2009).  
Agreement between the SSIA and the Ministry of Education and Science (28.10.2009).  
Agreement between the SSIA and the Information Centre of the Ministry of the Interior (07.07. 2010).  
Agreement between the SSIA and the State Revenue Service (02.08.2011).  
Agreement between on cooperation between the SSIA and the State Employment Agency (18.01.2012).  
Agreement on cooperation between the SSIA and the  State Labour Inspectorate  on data exchange of the 
act of accident at work (05.08.2013).  
Agreement between the SSIA and the Administration of the Maintenance Guarantee Fund on exchange of 
data using the state information system (13.10.2013).  
Agreement between the SSIA and the National Health Service on supplying of information (08.04.2015).  

In addition to the frequent use of data matching and data mining,  life certificates are 
often  used  to  facilitate  the  fight  against  fraud  and  error  in  the  particular  field  of  social 
security coordination. In particular Denmark, Finland, Sweden and Norway make use 
of  such  certificates.9  Regarding  the  Danish  Labour  Market  Supplementary  Pension 
Scheme specifically, pensioners residing abroad have to fill in a life certificate once a year 
in order to  continue receiving supplementary pension. Furthermore, the  Finnish Centre 
for  Pensions  exchanges  life  certificates  electronically  with  Sweden  and  Norway. 
Changes  to  the  living  conditions  deduced  from  life  certificates  are  forwarded  to  the 
Finnish  pension  providers  in  order  to  save  costs  in  pension  handling  and  to  avoid  long-
term  excess  payments  of  pension.  Exchanges  of  information  concerning  deaths  with 
Germany  and  Spain  are  also  under  negotiations.  Not  entirely  like  the  foregoing,  yet 
nevertheless noteworthy – in Hungary steps have been taken to automate the transfer 
of  mortality  data  on  a  national  level  and  steps  have  been  taken  to  conclude  bilateral 
agreements in this respect.  

As  previously  indicated,  bilateral  agreements  covering  various  topics  such  as  life 
certificates and data exchange, have furthermore proven to be very fruitful in combating 
fraud  and  error.  In  Croatia  a  number  of  data  exchange  (bilateral)  agreements  have 
either  been  established  or  are  being  prepared.  Such  bilateral  agreements  have  already 
been  concluded  with  Slovenia  and  Montenegro  and  negotiations  are  underway  with 
Germany, Bosnia and Herzegovina and Serbia. In Malta a data exchange agreement was 
negotiated with the United Kingdom, as a large share of the Maltese pensions are paid 
in the UK.  

Furthermore,  in  addition  to  the  bilateral  agreements  between  Finland,  Norway  and 
Sweden  concerning  the  use  of  life  certificates,  mention  need  be  made  of  the  joint 
information  campaign  between  Estonia  and  Finland.  In  2014  Finland  and  Estonia 
organised a joint campaign called “You should not pay double”. The objective of the latter 
was to inform workers moving between the two countries of their respective social rights 
and  obligations  with  an  emphasis  on  the  applicable  legislation  and  the  avoidance  of 
double insurance. 

A particularly noteworthy initiative in the context of bilateral and multilateral cooperation 
concerns a Danish initiative. Denmark has enhanced its efforts of combatting fraud and 

9 Recall in this respect that the use of data matching and data mining have rendered the use of life certificates 

in Germany unnecessary.  

30 

 
 
 
 
                                                 
error under the Regulation (EC) No 883/2004 coordination rules by establishing a central 
unit for international administrative cooperation in 2014 under the auspices of Udbetaling 
Danmark, which is the competent institution for a range of social benefits, such as family 
benefits,  maternity  benefits  and  old-age  pensions.  The  central  unit  works  to  establish 
close relations with other Member States as well as with countries outside the EEA area, 
aiming at enhancing cooperation and information exchange. A central task of the unit is 
to examine the possibilities of concluding bilateral agreements with other Member States, 
aiming  at  information  exchange  on  a  larger  scale.  In  addition,  the  unit  facilitates 
information  exchange  between  the  Danish  municipalities  and  other  Member  States  in 
concrete cases under the administration of the municipalities. These initiatives relate to a 
range  of  different  social  benefits  –  e.g.  family  benefits  and  sickness  benefits  – 
administered  by  different  central  and  local  national  authorities.  Hence,  the  unit  also 
contributes  to  strengthening  cooperation  and  coordination  across  different  national 
authorities. The central unit is closely connected to a newly established section dedicated 
to working with data and data matching (see supra) as part of the strengthened efforts 
of combatting fraud and error. By matching data from various public registers, the data 
section is able to identify patterns of fraud and is therefore able to identify possible cases 
of  fraud  and  error,  which  are  forwarded  to  the  competent  institutions  for  further 
inspection.  This  section,  hence,  also  contributes  to  strengthening  cooperation  and 
coordination  across  different  national  authorities.  In  the  initial  phase,  the  data  section 
focused on data matching on the basis of Danish public registers, which has accordingly 
resulted  in  a  focus  on  national  cases  of  fraud  and  error.  However,  there  have  been 
examples of cross-border cases that have been detected using the data-matching tool. In 
order for the data-matching tool to be effective in detecting cross-border cases of fraud 
and  error,  the  data  unit  is,  nevertheless,  dependent  on  access  to  data  from  other 
Member  States’  registers.  In  the  long  term,  it  is  therefore  the  ambition,  in  cooperation 
with  the  central  unit  for  international  administrative  cooperation,  to  conclude  bilateral 
agreements on information exchange with other Member States’ competent institutions. 
The current data matching system is based on experience with patterns of fraud, but for 
the purpose of the stepped up efforts, it is the ambition to increase the use of statistical 
data analyses.  

2.9.2.  Overview of additional Member State initiatives  

Clearly, as can be derived from the foregoing, the varying initiatives taken by the various 
competent  authorities  in  the  respective  Member  States  are  not  to  be  regarded  as 
conceptually  distinct  and  isolated  from  each  other.  The  establishment  of  the  Danish 
central  unit  (see  supra  p.  30)  for  administrative  cooperation  for  example,  serves  as  an 
umbrella facilitating cooperation from a bilateral perspective with varying other (Member) 
States, as well as the effective and enhanced use of data matching and data mining on a 
national  scale,  but  equally  so  on  an  international  scale.  Mindful  of  the  foregoing,  an 
overview follows of the various additional and individual initiatives taken by the Member 
States.  

In  2014,  Austrian  Social  Security  began  building  up  specialised  competence  in 
combating  fraud  at  both  national  and  international  levels.  The  current  fact-finding 
exercise  was  taken  as  the  basis  for  laying  the  foundations  of  a  common  anti-fraud 
strategy  and  standard  guidelines  for  fraud  monitoring.  Furthermore,  there  was  an 
increased focus on the possibilities of computer-assisted risk analysis, particularly on the 
employer  side,  to  enable  suspicious  cases  to  be  identified  early  on  and  targeted 
verification systems introduced. 

In addition to the use of data matching and mining, since 2014 Belgium provides for the 
Checkin@work application at construction sites. It registers all persons working on sites 
(Act of 08 December 2013 amending Article 30bis of the Act of 27 June 1969 and the Act 
of  04  April  1996)  in  order  to  prevent  fraud  and  to  make  other  data  available  for  data 
mining. Also in the construction sector, QR codes are provided for in compulsory LIMOSA 
documents  in  order  to  make  it  easier  to  register  foreign  employees  and  self-employed 
workers at construction sites and the two sides of the construction industry have agreed 

31 

 
 
 
upon  photo  identification  for  all  construction  workers  (albeit  that  the  latter  was 
accomplished without a distinct legal basis). In addition, the new State Secretary for the 
Fight against Social Fraud has set up (round table) meetings with all the stakeholders in 
the  construction  and  transport  sector  to  discuss  possible  measures  and  possible 
cooperation  in  order  to  combat  fraud  more  effectively.  Concerning  family  benefits  a 
number of initiatives have been taken, including amongst others, the establishment of an 
electronic  flow  system  for  authentic sources  coordinated  by  the  Crossroads  Bank  for 
Social  Security  was  developed  so  that  each  of  these  IPSSs  which  grant  social  benefits 
depending  on  the  socio-professional  situation  of  the  socially  insured  may  automatically 
have  the  information  they  require  to  manage  the  file  correctly.  Each  IPSS  may  thus  be 
authorised  by  the  Social  Security  Sectoral  Committee  to  benefit  from  access,  free  of 
charge,  to  the  data,  which  are  relevant  to  it  and  are  legally  justified.  In  addition,  with 
respect  to  family  benefits,  for  the  purpose  of  preventing  error  and  fraud,  FAMIFED 
developed  and  introduced  the  Register  of  Family  Benefits  (Cadastre  des  allocations 
familiales  /  Kadaster  van  de  kinderbijslag)  in  July  2004.  This  tool  registers  all  family 
benefit  files  with  all  the  beneficiary  children,  the  recipients  of  family  benefits  and  the 
contributors  whom  the  rights  to  the  benefits  stem  from.  This  register  permits  a  flow  of 
electronic data and is a tool, which streamlines administration and helps to combat family 
benefit  fraud.  It  rejects  any  attempt  to  encode  a  double  payment  for  the  same 
beneficiary  child  for  the  same  period  and  is  therefore  a  tool  for  preventing  a  certain 
number of errors and (attempts at) fraud. 

In Bulgaria  the National Revenue Agency undertakes measures to prevent and combat 
fraud by strict verification of the conditions for the issuance of A1 certificates, by use of 
electronic  means  and  the  statistical  data  available,  by  providing  forms  for  applications 
online  and  by  incorporating  relevant  changes  and  adaptations  in  national  insurance 
legislation.  

Croatia has implemented a plethora of measures to combat and prevent fraud and error 
in the field of social security coordination. In particular use is made of regularly updated 
databases  in  the  field  of  pensions.  Moreover,  such  databases  are  used  to  facilitate 
cooperation  between  the  competent  Croatian  authorities.  The  foregoing  has  been 
complemented  with  data  exchange  agreements  between  said  authorities.  Furthermore, 
and  in  addition  to  the  aforementioned  bilateral  agreements  (see  supra),  since  March 
2014  an  agreement  on  electronic  data  exchange  on  the  occurrence  of  death  has  been 
concluded and a three-year obligatory medical check-up has been imposed with respect 
to pension benefits and fraud within the respective field.  

In  the  Czech  Republic  focus  has  been  on  the  composition  and  conclusion  of  internal 
regulations  for  the  competent  authorities  and  their  respective  staff  members,  in 
conjunction  with  vocational  training  of  said  employees  and  a  system  of  controls. 
Furthermore, use is made of regularly updated databases as well as a centralised system 
for  the  purpose  of  determining  the  applicable  legislation.  In  order  to  handle  the 
difficulties arising in the determination of residence, a questionnaire has been established 
which may facilitate an easier determination thereof.  

fraud  and  error  need  be  mentioned.  Regarding 

In addition to the initiatives in Denmark concerning data matching and mining as well as 
the  use  of  life  certificates  and  bilateral  agreements,  an  additional  initiative  intended  to 
curb 
to 
spouses/cohabitants  and  children  under  21  upon  a  member’s  death  under  the  Danish 
Labour Market Supplementary Pension Scheme, the relatives must make a claim for the 
lump sum, if the deceased member resided outside Denmark or if the surviving relatives 
reside  outside  Denmark.  Within  this  context,  a  surviving  spouse  must  send  a  marriage 
certificate, and confirm that they have not divorced.  

lump  sums  paid 

In Estonia the data of electronically transmitted invoices from health care providers are 
automatically  verified  (electronic  invoices  must  meet  the  size/format  of  the  shipment, 
which  is  approved  in  contract  for  financing  medical  treatment  between  the  health  care 
providers and EHIF).  

32 

 
Complementing  the  Finnish  use  of  data  matching  and  mining  as  well  as  bilateral 
agreements,  insurance  numbers  are  exchanged  electronically  with  Sweden,  Norway 
and  Germany.  The  Finnish  Centre  for  Pensions  also  has  access  to  the  German  EAO 
service, which includes German insurance history periods and the amounts of pensions. 
Secure  e-mail  connections  with  Estonia  and  Sweden  are  established  (Finnish  Centre  for 
Pensions)  and  negotiations  for  establishing  secure  e-mail  connections  with  other  Nordic 
pension institutions are on-going. The Finnish Centre for Pensions also registers all of the 
PDs A1 received from the other Member States. The Employees Pensions Act entitles the 
authorities to gain access to information which can be used in the fight against fraudulent 
behaviour as well as erroneous situations. This access to information functions between 
for  example  the  tax  authorities  and  the  authorities  in  charge  of  social  security 
coordination  in  Finland.  The  act  also  enables  the  authorities  to  grant  access  to 
information in order to solve offences or irregularities (Sections 198, 199 and 200). 

to  persons  who  are  no 

A  number  of  initiatives  to  prevent  fraud  and  error  have  also  been  taken  in  Greece. 
Firstly, fraud related issues may be reported, anonymously or otherwise, to the Financial 
Police Directorate, by telephoning 11012 or sending an email to 11012@hellenicpolice.gr. 
In addition to the foregoing and by virtue of the ARIADNE programme (Law No 4144/13), 
information  is  shared  between  the  databases  of  all  the  Greek  social  security  bodies, 
under  the  responsibility  of  IDIKA  Α.Ε.  (eGovernment  Social  Security),  and  the  TAXIS 
database  (the  electronic  system  used  by  the  tax  offices  –  DOY),  so  that  changes  in 
pensioners’  personal  situations  (marriages,  deaths,  divorces)  are  detected  in  good  time 
so  they  can  be  immediately  deleted  from  the  social  security  bodies’  files  where 
appropriate. Based on the data from ARIADNE, a whole series of actions are carried out 
to prevent infringements. Specifically, upon notification of a death, payment of pensions 
and  other  benefits  and  allowances  by  the  social  security  body  or  bodies  is  immediately 
suspended. Furthermore, these benefits can no longer be collected by non-beneficiaries, 
the  use  of  the  deceased’s  insurance  booklets  is  cancelled,  ensuring that  they cannot  be 
used by third parties, and significant financial losses to the EOPYY (National Organisation 
for Healthcare Provision) are avoided. The DOY (tax offices) are immediately informed of 
the death and assess the new situation from a tax point of view and also in terms of the 
assets  register.  Similarly,  upon  notification  of  a  marriage  (or  registered  partnership), 
insurance  benefits  to  those  who  were  considered  as  dependants  are  suspended, 
assistance 
is  suspended,  and 
widow’s/widower’s benefits are suspended following remarriage. Finally, upon notification 
of  divorce,  insurance  cover  of  non-dependants  and  payment  of  family  benefits  are 
suspended.  Complementing  the  foregoing  initiatives,  the  ILIOS  (Integrated  Control 
System for Payment of Pensions) was established, electronically connecting 93 different 
pension  payment  systems,  which  support  the  disbursement  of  4,407,288  (main, 
supplementary  and  other)  pensions  to  2,714,034  pensioners.  ARIADNE  interconnects 
with  ILIOS,  to  enable  greater  use  of  computerised  cross-referencing.  Finally,  a  National 
Register  of  Pensions  and  Pensioners  was  established  through  the  ILIOS  system,  the 
database of which is already being used by social security bodies to address and detect 
abuse. In the field of tackling contribution evasion and contribution avoidance, the Social 
Security  Debt  Collection  Centre  (KEAO)  was  created  within  IKA-ETAM  (Law 
No 4172/2013).  The  purpose  of  the  KEAO  is  to  establish  uniform  procedures  and 
mechanisms  for  the  timely  collection  of  debts  and  arrears  owed  to  social  security 
organisations, with the aim of improving the sustainability of the social security system. 
It is the first step within a broader reform that aims to integrate the revenue collected by 
the  social  security  bodies  into  the  tax  administration  system  and  merge  the  procedures 
for  collecting  taxes  and  social  insurance  debt  by  1 July  2017.  Setting  up  this  Centre  is 
expected  to  resolve  problems,  which,  in  the  past,  rendered  the  recovery  procedure  and 
enforced recovery measures complex and time-consuming, preventing the social security 
bodies  from  collecting  their  projected  revenues.  Lastly,  the  Sample-based  Audit 
Department  has  been established  within  the  Directorate for Incomes  Policy  of  the  State 
General Accounting Office, which is the pension institution for former civil servants. The 
main  purpose  of  this  department  is  to  carry  out  external  audits  on  interdepartmental 
discrepancies,  but  also  to  carry  out  sample-based  audits  on  acts  issued  by  the 

longer  beneficiaries 

33 

 
 
Directorate  for  Regulation  and  the  Directorate  for  Pension  Payment  Orders  (Article 5  of 
Law No 4002/2011). 

In Ireland, the Public Services Card (PSC) is furthermore provided for to enable citizens 
to  gain  access  to  public  services  more  efficiently  and  with  a  minimum  of  duplication  of 
effort, while at the same time preserving their privacy to the maximum extent possible. 
The PSC is designed to replace other cards used by the Department of Social Protection 
such  as  the  free  travel  pass  and  the  Department’s  social  services  card,  and  to  make  it 
easy for providers of public services to verify the identity of persons. Towards the end of 
April  2015,  a  total  of  1.34  million  cards  were  produced,  including  just  below  700,000 
PSCs produced in 2014. The PSC also provides a higher and enhanced level of assurance 
as  to  identity  and  it  therefore  acts  as  a  key  tool  in  the  prevention  and  detection  of 
identity  fraud.  Taken  in  conjunction  with  the  face-to-face  registration  process,  the  new 
PSC  seeks  to  offer  significant  new  protection  against  welfare  fraud.  To  strengthen  the 
PSC  registration  process,  the  Department  uses  facial  image  matching  software  to  help 
detect  and  deter  duplicate  registrations.  During  the  course  of  the  registration  process, 
the software performs a search of the captured or imported customer photograph against 
existing photographs on the Department’s database to ensure that the individual has not 
already  been  registered  for  a  PSC  using  a  different  PPS  number,  or  a  different  identity 
dataset.  Where  a  match  or  a  potential  match  is  found,  it  is  referred  for  further 
investigation.  

In addition to the use of data matching and data mining, Italy has established a specific 
procedure in order to manage the phenomenon of fraud, to archive cases of fraud and to 
analyse  said  data  for  the  purpose  of  conducting  risk  analyses.  Furthermore,  a 
memorandum  of  understanding  has  been  established  with  the  Finance  Guard  for  the 
prosecution of offences in social assistance, pensions and social security contributions.  

In  tackling  fraud  and  error  in  Lithuania,  information  about  social  security  coordination 
rules  and  about  the  use  of  the  EHIC  is  published  on  the  web  pages  of  the  competent 
institutions.  This  information  is  updated  on  a  regular  basis.  In  addition,  information 
concerning social security coordination is consistently disseminated by means of different 
mass communication measures, information pamphlets and brochures. Upon the granting 
of  benefits  in  accordance  with  the  coordination  Regulations,  experts  of  the  competent 
institutions  verify  the  information  provided  in  SEDs,  PDs,  E  forms  or  other  documents. 
The  documents  are  consistently  verified  to  ensure  that  they  are  properly  filled  out  and 
signed. In the event of suspicion concerning the credibility of the information presented, 
the  relevant  EU Member State  competent  institution  is  contacted.  Lithuanian  competent 
institutions  also  verify  information  about  the  employer  made  available  by  different 
registers and other institution databases (e.g. tax authorities information, the register of 
Lithuanian  residents).  Lastly,  meetings  are  organised  with  competent  institutions  and 
experts to discuss individual cases and to share best practises.  

Complementing  the  Maltese  agreement  with  the  UK  concerning  data  exchange,  IT 
infrastructure in the field of social security has become interconnected with that of other 
entities  allowing  for  enhanced  cooperation  between  the  various  national  authorities  and 
institutions.  In  addition,  verification  of  the  identification  of  foreign  nationals  has  been 
enhanced, entailing that original pieces of identification are now required.  

In the Netherlands a plethora of measures have been taken to prevent fraud and error 
on  a  national  level.  In  particular  –  concerning  sickness  benefits,  invalidity  benefits  and 
unemployment benefits, preventative measures have been taken, as well as control and 
compliance measures and corrections and sanctions. The preventative measures include 
promoting and maintaining risk and fraud awareness of employees by organising training 
programmes and protocols for staff, verification of the identity of clients,  administrative 
keys  (Civil  Service  Number)  and  DigID  (pin-code  for  services  provided  by  the  whole  of 
the public sector), and informing clients properly on their rights and obligations, including 
mass  media  campaigns  in  cooperation  with  the  Department  of  Social  Affairs  and  other 
organisations. The control and compliance measures include administrative and electronic 

34 

 
controls, entailing data comparisons and exchange when applying for a benefit as well as 
electronic  payment  controls.  In  addition  thereto,  such  control  and  compliance  measures 
encompass  statistical  means  of  risk  profiling,  risk  management  and  risk  targeting  in 
combination  with  checklists  for  front-office  officials  such  as  work-coaches,  doctors  and 
intermediaries.  Lastly,  as  concerns  corrections  and  sanction  measures,  recovery  of 
unjustly  claimed  benefits  is  employed  as  well  as  the  use  of  fines  and  possibly  criminal 
prosecution.   

Prevention  of  fraud  and  error  in  Norway  is  currently  ascertained  by  manual  measures 
established  as  compulsory  checks,  which  are  instituted  in  key  operations  by  case 
handlers  before  the  benefits  are  paid  out.  These  measures  are  undertaken  in  the 
processing  of  the  cash  benefits  most  subject  to  fraud  and  error,  such  as  sick  leave 
benefits and single parent benefits. In addition, red flag documents have been identified 
for  some  of  the  most  fraud-prone  benefits  as  a  means  to  support  case  officers  in  their 
daily handling of cases. 

It  is  noteworthy  to  mention  the  legislative  amendments  made  in  Portugal  in  order  to 
promote  the  coordination  of  various  databases  and  the  promotion  thereof  vis-à-vis 
various  competent  authorities.  In  addition,  Law  No  15/2012  established  an  Information 
System for Death Certificates.  

In  Poland  a  number  of  initiatives  have  been  taken  to  prevent  fraud  and  error,  albeit 
limited to pensions. These measures include identity verification allowed by access to the 
PESEL  register  (the  Polish  PIN),  the  adjustment  of  the  insurance  database  and  benefits 
database,  the  adjustment  of  data  from  various  benefits  databases  and  enhanced 
verification of the correctness of cases by the regional offices (concerning KRUS). 

In  Romania  the  following  initiatives  have  been  taken  as  part  of  the  fight  against  fraud 
and error:  

Prevention of fraud and error in Romania 

 

 

 

Efficient  cooperation  with  national  institutions  responsible  for  combating  fraud  and  error  in  the  field  of 
social security.  

Efficient cooperation with institutions from other Member States responsible for combating frauds and error 
in  the  field  of  social  security,  and  with  other  competent  institutions  in  the  enforcement  of  the  European 
coordination Regulations of social security systems  (especially with those from Belgium, Germany, France 
and the Netherlands).  

Regular exchange of databases between the national institutions responsible for combating fraud and error 
in the field of social security: the National Pension Office, the National Health Insurance Office, the National 
Agency  for  Employment,  the  Labour  Inspection,  the  National  Tax  Administration  Agency/Territorial  Tax 
Agencies and the Ministry of the Interior).  

 

Provision of databases related to PDs A 1 issued by the CNPP to CLEISS. 

Equally  so,  a  number  of  initiatives  have  been  taken  in  Slovakia.  As  a  measure  to 
prevent fraud and error in the field of pensions, two specific employees deal with cases 
which  have  a  cross-border  dimension.  Firstly  –  an  officer  (referent)  and  secondly,  an 
individual  who  approves  the  work  completed  by  the  former  (aprobant).  These  are 
subsequently  checked  –  on  an  interim  basis  –  by  the  competent  managers  and  the 
methodology  unit  for  pension  insurance.  The  amount  of  the  pension  is  determined 
automatically  by  software  wherever  possible.  Furthermore,  in  proceedings  concerning 
pensions,  the  Social  Insurance  Agency  cooperates  with  the  institutions  of  other  States 
that  are  parties  to  the  EEA  Agreement  and  with  Switzerland,  and  with  other  Slovak 
national authorities. It also cooperates in the reporting of the death of pension recipients, 
changes of address and other income. During 2014, the Social Insurance Agency carried 
out  checks  in  accordance  with  Section 242  of  Act  No  461/2003  and  was  obliged  to 
remedy  the  deficiencies  identified  by  these  checks  and  the  causes  of  such  deficiencies, 
and  to  take  disciplinary  action  against  the  responsible  employees.  With  respect  to 

35 

 
 
 
sickness and maternity benefits,  the Social Insurance Agency accepts – for the purpose 
of  claims  for  certain  sickness  benefits  –  domestic  certificates  of  a  treating  physician 
issued in another EU Member State. In order to prevent fraud and error, the competent 
institutions  of  the  Member  States  have  been  asked  to  provide  the  domestic  documents 
used  for  verification  of  sickness  and  maternity  cash  benefits.  Unfortunately,  not  all 
Member  States  responded  to  the  Social  Insurance  Agency’s  request.  It  need  be  noted 
that  the  most  effective  cooperation  with  the  Social  Insurance  Agency  has  been  with  its 
partner  institution  in  the  Czech  Republic.  If  an  insured  person  files  a  claim  using 
documents  for  which  the  Social  Insurance  Agency  does  not  have  a  sample,  the  Social 
Insurance  Agency  asks  the  competent  institution  in  the  Member  State  in  which  the 
treating  physician  issued  the  submitted  certificate  to  verify  whether  the  submitted 
documents are admissible for a claim for sickness and maternity cash benefits. The Social 
Insurance Agency assesses the claim for a sickness benefit only after receiving a positive 
response  from  the  competent  institution.  Lastly,  concerning  family  benefits,  databases 
have been installed which seek to warn for potential errors and pair data to avoid errors 
in the payment of benefits and facilitate cooperation between institutions. As a result, a 
single  officer  can  now  manage  the  registration  and  assessment  of  all  social  benefits  for 
an individual family. 

3.  IMPLEMENTING THE COORDINATION PROVISIONS  

3.1.  Issues  pursuant  to  the  implementation  of  the  coordination 

provisions 

3.1.1.  Prevalent issues 

A number of issues can be identified as a result of the implementation of the coordination 
rules  in  the  field  of  social  security  amongst  the  various  Member  States.  Grosso  modo 
three  issues  in  particular  can  be  identified  which  are  directly  related  to  the 
implementation of the aforementioned rules. Firstly, lacking and/or delayed exchange of 
information between the competent institutions has proven to be a significant obstacle in 
the implementation of said rules and may lead to an increase of fraud and error in a large 
number  of  Member  States  (BE,  BG,  HR,  DK,  EE,  FI,  EL,  IS,  IE,  LV,  NL,  PL,  PT,  RO, 
SK, ES). As a result thereof, issues arise such as intentional double health insurance, as 
well as scenarios whereby individuals are receiving unemployment benefits in one  State 
whilst being gainfully engaged in a second Member State. This can also result in incorrect 
payments  being  made  and/or  social  insurance  contributions  being  paid  to  the  wrong 
institutions  as  indicated  by  Ireland,  as  well  as  the  payment  of  pensions  despite  the 
claimant already being deceased as noted by Croatia. In Iceland the lacking or difficult 
cooperation 
in 
circumstances,  which  are  not  or  not  in  a  timely  fashion  notified  to  the  competent 
authority.  

is  considered  as  particularly  cumbersome 

in  case  of  changes 

Secondly,  lacking  individual  awareness  with  respect  to  the  applicable  rules  in  a  cross-
border  context  and  the  rights  and  obligations  associated  thereto,  has  also  proven  to 
significantly  hinder  the  effective  implementation  of  the  coordination  rules  in  certain 
Member States (FI, DE, ES) thereby increasing the risk of fraud and error. As has been 
indicated, however, and as will be elaborated upon below (see infra), a large majority of 
Member  States  have  acknowledged  the  necessity  of  updated  information  dissemination 
via a number of platforms.  

Lastly,  the  identification  of  an  individual’s  residence  has  proven  to  be  an  arduous  task 
(CZ,  EL,  HU,  IT,  LV,  MT,  NO,  PL,  PT).  This  can  in  part  be  attributed  to  the  fact  that 
free  movement  has  increased  as  a  result  of  the  steps  taken  to  facilitate  this.  For  now, 
however,  the  difficulty  in  determining  a  place  of  residence  may  ultimately  negatively 
affect  the  prevalence  of  fraud  and  error.  In  Lithuania  and  Slovakia  it  appears  that, 
respectively,  no  issues  and  limited  issues  (see  supra  Section  2.3)  have  arisen  or 
detected.  

36 

 
Prevalent Issues 

Member States 

Lacking/delayed information exchange 

BE, BG, HR, DK, EE, FI, EL, IS, IE, LV, NL, PL, PT, RO, 
SK, ES 

Lacking awareness of rights and obligations  

FI, DE, ES 

Identification of Residence 

CZ, EL, HU, IT, LV, MT, NO, PL, PT 

No Significant Issues 

LT, SK 

3.1.2.  Overview of Member State-specific issues  

In addition to the foregoing overarching issues observed in a number of Member States, 
a number of issues have been noted which are specific to a particular Member State. In 
what follows, an overview will be given of these issues.  

The  competent  Belgian  institutions  specify  that  in  some  cases  it  remains  difficult  to 
rapidly  verify  findings/doubts  as  to  the  applicable  legislation  (conditions)  in  the  host 
Member State with the data available to the posting Member State. Moreover, employers 
acting in bad faith exploit this weakness and/or lack of transparency (e.g. by organising 
insolvency).  As  regards  family  benefits,  the  competent  institution  (FAMIFED)  specifies 
that  the  problems  it  encounters  with  the  European  coordination  rules  arise  in  the 
exchange  of  information  with  European  institutions  with  which  it  has  not  signed  an 
agreement  on  combatting  social  fraud  in  general  and  which  have  very  restrictive 
standards  governing  private  data.  Lastly,  concerning  unemployment  insurance  in 
Belgium,  it  need  be  noted  that  the  U1  form  is  not  always  completed  with  sufficient 
accuracy  or  does  not  offer  any  response  to  all  the  questions  raised  by  the  National 
Employment Office (NEO) in order to establish the right to unemployment allowances. It 
is  important,  for  example,  for  the  NEO  to  know  whether  a  specific  person  has  been 
working  full-time  or  part-time,  exactly  how  many  hours  were  worked,  how  much  the 
person  was  paid,  what  the  type  of  employment  contract  was  and  under  what 
circumstances  it  was  terminated.  Dismayingly,  a  substantial  amount  of  time  may  pass 
before  the  competent  foreign  body  replies  to  the  questions  raised  in  order  to  verify  or 
authenticate certain forms, or to certain requests for information. 

A  particular  issue  arising  in  the  Czech  Republic  is  the  lacking  uniformity  in  the 
interpretation  of  certain  terms  within  the  context  of  the  coordination  provisions.  It 
suffices  for  example  to  refer  to  the  notion  of  parental  leave,  which  is  subject  to  some 
discussion  as  to  the  exact  meaning.  As  a  result  of  the  lacking  homogeneity  in  the 
definition concerned, uncertainty may potentially lead to fraud and/or error.  

In Denmark the degree of registered problems specifically related to the implementation 
of  the  coordination  rules  remains  limited.  The  National  Board  of  Industrial  Injuries 
nevertheless  reports  that  the  most  frequently  occurring  problem  in  respect  of  the 
application  of  the  coordination  rules  is  when  work  in  Denmark  is  performed  under  the 
pretence  of  posting  or  self-employment.  This  may  result  in  erroneous  decisions  to  the 
effect that an injured person is not covered by social protection in Denmark and is  thus 
not entitled to compensation. Udbetaling Danmark reports that limitations on information 
sharing – as is the case in Belgium – constitute the primary barrier in combatting fraud 
and error. 

Generally,  it  can  be  held  that  the  problems  associated  to  the  implementation  of  the 
coordination  rules  have  -  thus far  -  remained rather limited  in  Estonia.  It  appears  that 
double entitlement remains an issue in that individuals apply for unemployment benefits 
whilst  still  being  employed  in  another  Member  State.  As  previously  indicated  this  is  in 
part  attributable  to  the  delay  and/or  absent  cooperation  between  the  Member  States’ 
competent institutions.   

37 

 
 
 
 
 
Similarly  to  Belgium,  Denmark  and  Estonia,  the  Social  Insurance  Institution  of  Finland 
(Kela)  notes  that  the  main  problems  are  associated  to  the  difficulties  in  obtaining 
necessary  information  for  determining  whether  there  is  entitlement  to  a  given  benefit, 
which  again,  is  attributable  to  the  aforementioned  lacking  or  delayed  cooperation 
between the requisite authorities.   

Pursuant  to  German  practice,  it  appears  that  the  rules  on  the  determination  of  which 
legislation is applicable (Article 11 et seq of Regulation (EC) No 883/2004) are prone to 
error.  Working  out  which  legislation  applies  concerning  an  individual  in  a  cross-border 
setting depends on a multitude of factors. The different possible scenarios are described 
in the regulations; however, statements of circumstances can be manipulated or relevant 
facts covered up. It appears that the options available to control these factors effectively, 
are limited. If, for example, statements concerning the substantial business activity of a 
self-employed person who pursues several business activities in different Member States 
need  to  be  checked  in  the  Member  State  of  residence,  the  question  arises  as  to  what 
means  are  available  to  the  institution  for  doing  so.  Whether  a  business  activity  is  still 
being carried out is often relatively simple to establish or prove via the registered trade. 
However,  the  question  whether  this  activity  is  substantial,  within  the  meaning  of 
Article 14(8) of Regulation (EC) No 987/2009, in the country of residence at the time of 
posting  requires  more  extensive  examination.  The  need  for  a  sophisticated  examination 
as  such,  inherently  carries  a  greater  risk  of  manipulation  and  error.  Another  example 
concerns  the  prohibition  to  replace  another  posted  person  (Article 12(1)  of  Regulation 
(EC)  No 883/2004),  which  can  scarcely  be  effectively  monitored  in  large  businesses.  It 
need  also  be  noted  that  the  rules  governing  the  applicable  legislation  inevitably  lag 
behind new forms of employment that surface, thus entailing that there is a discrepancy 
between  legislative  provisions  and  factual  reality.  It  tends  to  take  too  long  to  make 
amendments  reflecting  such  new  developments  due  to  time-consuming  coordination 
processes.  In  the  area  of  family  benefits,  sources  of  error  and  risk  arise  particularly  in 
cases of subordinate competence under the coordination rules, in particular due to a lack 
of  knowledge  of  the  conditions  for  and  levels  of  family  benefits  in  the  Member  State 
whose  legislation  has  priority.  Lastly,  in  the  Administrative  Commission's  last  EHIC 
questionnaire  the  DVKA  (German liaison  body for health insurance  abroad),  attached  to 
the  GKV-Spitzenverband  (German  national  association  of  statutory  health  insurance 
funds),  pointed  out  the  non-acceptance  of  the  EHIC  in  some  regions  of  the  EU  when 
individuals avail themselves to services in another EU country – of which certain 'tourist 
centres' are typical examples. 

In  Hungary  mention  is  made  of  difficulties  surrounding  the  determination  of  the 
issue  concerning  the 
in  addition  to  the  aforementioned 
applicable 
determination of residence concerning pension benefits.  

legislation 

As  indicated,  delayed  and/or  lacking  cooperation  between  Member  State  authorities 
render it difficult to adequately implement the coordination provisions and facilitate fraud 
and error. In Italy a particular result of this issue is the fact that unemployment benefits 
are paid whilst the person concerned is nevertheless gainfully employed elsewhere. This 
is  further  aggravated due to  the fact  that  there  is  no  structured  system  which  counters 
this  tendency.  In  addition  to  the  foregoing,  Italy  notes  that  lacking  or  incomplete 
information  with  respect  to  family  benefits  renders  it  extremely  difficult  to  determine 
entitlement thereto, which is not inconceivably to the detriment of the claimant.  

The  difficulties  encountered  in  Latvia  with  the  implementation  of  the  coordination  rules 
are  numerous.  In  addition  to  the  aforementioned  issues  pertaining  to  Member  State 
cooperation  and  the  determination  of  residence,  particular  issues  arise  with  respect  to 
double  contributions,  linguistic  discrepancies,  paid  social  services  to  deceased  persons 
and problems to recover them from the foreign banks, and lastly, the lack of information 
on  a  person’s  employment  in  another  Member State  in  order to  determine  the  rights  to 
the  social  service  payments.  However,  the  issues  concerning  double  contributions,  and 
double insurance as well as incorrect and/or delayed mortality information are in part to 
be attributed to the earlier mentioned overarching issues (see supra Prevalent Issues).  

38 

 
 
 
As  previously  indicated,  the  Netherlands  report  that  it  often  proves  to  be  difficult  to 
fully  understand  the  organisational  structure  and  competence  of  the partner  institutions 
in other Member States and to find the right contact person at the competent institution. 
In  addition, 
issues  have  been  noted  as  detrimentally  affecting  the 
implementation  of  the  coordination  rules  as  well  as diverging  data  protection  legislation 
in  the  respective  Member  States.  Concerning  family  benefits  in  particular,  artificial 
agreements  within  the  context  of  posting  have  been  noted  as  being  detrimental,  whilst 
inappropriate  use  of  the  EHIC  in  border  regions  has  been  noted  as  troublesome 
concerning cross-border healthcare.  

linguistic 

In  addition  to  the  issues  concerning  the  determination  of  residence  particularly  in  the 
field of atypical employment, the Norwegian Health Economics Administration has noted 
that in the field of benefits in kind, issues have arisen as well. It appears that technical 
challenges  have  arisen  in  relation  to  the  issuing  of  healthcare  rights  determined  under 
the  EU  social  security  coordination  provisions.  The  challenges  are  mainly  linked  to  the 
EHIC and the fact that the EHIC can at present only be issued for a period of three years, 
regardless  of  the  expected  period  of  insurance.  This  may  increase  the  risk  of  fraud  and 
error. However, thus far no cases of fraud and error in this field have been detected.    

to 

the 

that 

entitlement 

circumstances 

Polish practice, in line with the foregoing, has illuminated a number of irregularities and 
issues  in  the  implementation  of  the  coordination  rules  as  well.  Concerning  pension 
benefits,  it  appears  that  there  is  a  failure  to  provide  the  requisite  data  for  the 
identification of individuals, a lack of contact information in social insurance institutions, 
a  lack  of  information  about  the  death  of  persons  entitled  to  benefits,  resulting  
in  overpayment  of  benefits,  a  lack  of  information  about  changes  of  address/place  of 
residence  (also  of  tax  service  and  health  insurance  contributions),  a  lack  of  information 
about 
and  
determine 
the  amount  of  the  benefit  (e.g.  foreign  income,  continuation  of  employment,  non-
exhaustion  of  the  benefit  period),  national  regulations  or  practice  preventing  the  return 
of  benefits  transferred  to  the  bank  account  of  individuals  entitled  to  benefits  after  their 
death, a lack of information on entities entitled in a given Member State to authenticate 
signatures  as  well  as  to  authenticate  submitted  copies  of  documents  as  true  
to the original – most of which are attributable to lacking or delayed cooperation between 
the  aforementioned  institutions.  It  appears  that  –  concerning  health  insurance  –  there 
have been cases where individuals received benefits on grounds of a valid EHIC, but were 
then  subsequently  excluded  from  the  insurance  retroactively.  Furthermore,  there 
seemingly  is  a  problem  associated  with  the  use  of  Decision  S6  and  in  particular  the 
cancellation  of  the  entitlement.  Lastly,  certain  incidents  have  erroneously  been 
recognised  as  accidents  at  work  in  the  territory  of  Germany.  From  May  2004  until  the 
end  of  the  first  quarter  of  2015,  out  of  33,827  forms  E125  DE  containing  recognised 
claims  of  the  German  institution  in  the  scope  of  accidents  at  work    (DGUV),  21,481 
claims  did  not  relate  to  benefits  in  kind  unrelated  to  an  accident  at  work  or  an 
occupational  disease.  In  these  cases  the  benefits  related  to  an  accident  at  work  were 
granted on the basis of forms E111, the EHIC or certificates replacing the EHIC issued by 
the Polish institution at the request of the German institution. Examples provided by the 
Polish  competent  institutions  indicate  that  the  main  reason  for  the  expenses  were 
patients’  visits  to  clinics  or  hospitals  due  to  illness,  injuries  sustained  in  a  place  of 
residence  or  accidents  during  time  off  work  and  non-working  life  of  the  person  whose 
form  E125  was  concerned.  In  80  cases,  the  Polish  institutions  did  not  issue  an 
authorisation  document  requested  by  the  German  side  for  individuals  receiving  the 
benefits within the territory of Germany. These were, in fact, people uninsured in Poland, 
mostly working in Germany. 

Slovakian  practice  has  not  encountered  any  significant  issues.  In  the  field  of  sickness 
and  maternity,  the  main  problem  felt  by  the  Social  Insurance  Agency  is  the  prevalent 
lacking  effective  communication  with  other  institutions  and  the  lack  of  familiarity  with 
national  documents.  As  regards  the  applicable  legislation,  the  Social  Insurance  Agency 
has encountered a problem within the field of posting of workers, whereby atypical forms 

39 

 
 
 
 
 
 
of employment and bogus self-employment are used as a means to circumvent the rules 
on the prohibition of replacing posted workers. Lastly, in the field of family benefits, the 
aforementioned lack of effective cooperation and data sharing with other (Member State) 
institutions, as well as the lacking support for institutions from courts and police forces in 
connection with benefit fraud are significant issues. 

In Spain, the administration of the right to benefits in kind continues to be problematic 
due  to  the  aforementioned  significant  delays  in  communication  with  other  institutions, 
which gives rise to fraud and error. Such anomalies are  also caused by non-compliance 
by  the  insured  individuals  themselves,  when  they  fail  to  communicate  changes  in  their 
personal  and/or  family  circumstances,  for  example  a  change  of  residence,  in  a  timely 
manner,  as  required  by  paragraph 3  of  Article 76(4)  of  Regulation  (EC)  No 883/2004. 
This  practice  is  further  aggravated  by  the  fact  that  no  financial  repercussions  are 
applicable to individuals not complying with the aforementioned obligations, whereas this 
is  the  case  for  both  the  competent  institutions  and  the  authorities  in  the  place  of 
residence. In addition, it appears that there are some issues concerning U1 forms issued 
in  France,  which  has  subsequently  resulted  in  individuals  being  able  to  draw 
unemployment benefits in more than one State.  

Unlike  other  Member  States,  Austria  additionally  notes  problems  and  issues  related  to 
the  application  of  the  relevant  legislation,  and  misuse  of  the  EHIC.  In  Sweden  on  the 
other  hand,  it  appears  that  the  main  concern  is  related  to  the  fact  that  individuals  are 
negligent in notifying relevant changes of circumstances.  

Finally, in Lithuania it appears that no issues have arisen.  

3.2.  Measures  directed  at  preventing  and  curbing  fraud  and  error 

pursuant to the coordination provisions 

3.2.1.  Prevalent initiatives 

As  can  be derived from the  foregoing,  numerous  issues  persist  in  the  application  of  the 
coordination  rules  enshrined  in  the  EU  social  security  coordination  Regulations. 
Consequently, it need not surprise that a myriad of initiatives have been taken in order 
to combat fraud and error as a result thereof.  

In  particular,  a  number  of  Member  States  have  increased  and  enhanced  training  of 
employees in the respective competent authorities and communication concerning fraud 
and  error  in  the  field  of  social  security  coordination  (BE,  CZ,  FI,  LV,  NL,  PL,  PT). 
Complementing the foregoing, a number of Member States (BG, DK, EE, FI, EL, IE, LV, 
NO,  RO,  ES)  (see  infra)  have  invested  in  greater  awareness-raising  and  information 
dissemination  not  only  amongst  their  employees  but  equally  so  with  respect  to  their 
claimants. In Portugal such training sessions are particularly noteworthy. Three sessions 
were organised in 2014, each of a duration of two days, which covered the 18 institute of 
Social Security district centres and involved a total of 255 staff members.  

In  conjunction  therewith,  Member  States  are  increasingly  making  use  of  bilateral 
agreements  between  each  other  or  have  taken  steps  to  facilitate  such  bilateral 
agreements (BE, DK, IE, IT, LV, MT, NL, NO, PL, PT, RO, UK). 

Initiatives Concerning Coordination-related 
Issues 

Member States 

Training and awareness-raising of employees 

BE, CZ, FI, LV, NL, PL, PT 

Training and awareness-raising of claimants 

BG, DK, EE, FI, EL, IE, LV, NO, RO, ES 

Bilateral Agreements 

BE, DK, IE, IT, LV, MT, NL, NO, PL, PT, RO, UK 

40 

 
 
 
 
 
 
3.2.2.  Overview of Member State-specific initiatives 

In  addition  to  the  foregoing,  a  number  of  Member  State-specific  initiatives  are 
noteworthy as indicated in what follows.  

Special  measures  have  been  taken  in  Austria  to  prevent  fraudulent  claiming  of  the 
Austrian  compensatory  pension  supplement,  which  is  a  special  non-contributory  benefit 
listed  in  Annex  X  to  Regulation  (EC)  No  883/2004  and  thus  payable  only  to  persons 
resident in Austria. Presenting a registration certificate is insufficient to prove permanent, 
regular  residence  in  Austria.  The  pension  insurance  institutions  apply  strict  checks  both 
with regard to applications and to continued payment of the compensatory supplement. 
In  suspect  cases,  i.e.  where  there  is  reason  to  believe  that  the  pensioner  does  not 
permanently  reside  in  Austria,  a  questionnaire  must  be  completed  routinely;  income  is 
verified  via  the  competent  authorities;  the  applicants  are  summoned  to  the  pension 
insurance establishment and questioned about the income they declared to the residence 
authorities;  and  the  authorities  check  whether  sickness  insurance  benefits  have  been 
claimed in Austria (if they have not been for an extended period, this could indicate that 
the  person  is  not  resident  in  Austria).  Also,  if  a  telephone  call  is  received  from  the 
applicant,  the  dialling  code  is  checked  to  ascertain  whether  the  call  was  made  from 
abroad  and  if  the  suspicion  that  the  pensioner  does  not  live  in  Austria  increases, 
payments  are  discontinued  immediately.  Furthermore,  measures  have  been  introduced 
by  the  4th  Social  Law  Amendment  Act  2009,  entailing  that  persons  with  pension 
entitlement  are  responsible  for  proving  that  their  usual  place  of  residence  is  in  Austria 
and  insurance  institutions  are  authorised  to  switch  to  cash  payment  of  benefits. 
Furthermore, in such cases the pension insurance institution must request re-notification 
of the essential information pertaining to the claim for compensatory supplement at least 
once  a  year  (instead  of  every  three  years).  Lastly,  the  pension  insurance  institutions 
were  also  called  upon  by  the  Federal  Ministry  for  Labour,  Social  Affairs  and  Consumer 
Protection,  as  the  supervisory  authority,  to  monitor  trends  among  these  categories  of 
persons. Any apparent irregularities are to be reported to the Ministry to enable further 
measures to be taken against abuse. 

In Belgium – in addition to the foregoing – in 2014 an operational plan was established 
to  fight  cross-border  fraud  by  the  competent  institution  for  unemployment  insurance. 
Also within the field of unemployment insurance, it need be noted that the presidency of 
the  Benelux  Working  Group  on  ‘Benefit  Fraud’  has  been  entrusted  to  the  NEO,  the 
competent institution in Belgium for unemployment insurance. 

In  Croatia  new  legislative  provisions  have  been  implemented  by  the  new  Pension 
Insurance  Act,  which  are  intended  to  reduce  the  risk  of  fraud  and  error,  including 
amongst others mandatory re-examination in case of disability entitlement.  

As  previously  indicated,  in  Denmark  a  unit  for  international  administrative  cooperation 
has been established with the aim, amongst others, to ameliorate and facilitate enhanced 
cooperation with institutions in other Member States and support the forging of bilateral 
agreements.  

Awareness-raising  with  respect  to  the  rights  and  obligations  associated  with  social 
security  coordination  has  become  a  focal  point  in  Finland.  This  is  attained  in  part  via 
dissemination  of  relevant  information  on  the  respective  and  pertinent  websites.  This 
awareness-raising initiative was furthermore complemented by a joint awareness-raising 
campaign  –  via  television  channels,  newspapers  etc  –  in  Finland  and  Estonia,  which 
required cooperation between the social security authorities in both States, as well as the 
labour unions and the pension insurance companies.  

In Germany the initiatives taken to curb fraud and error have resulted in the recording 
of  A1  documents  in  an  A1  database  to  which  audit  authorities  have  access  for  matters 
concerning  statutory  pensions  and  accident  insurance.  In  addition,  as  concerns  family 

41 

 
 
benefits  in  the  realm  of  social  security  coordination,  specialised  case  handlers  will  be 
responsible for handling such claims.  

Greek  practice  has  resulted  in  the  obligation  to  provide  annual  life  certificates  to  avoid 
erroneous payment of pensions to individuals who have deceased.  

In Ireland, efforts are continuously made to establish contact points with Member States 
and the anonymous reporting of cases of fraud has been facilitated.  

A  number  of  initiatives  have  been  identified  in  Latvia.  The  main  steps  to  combat  fraud 
and  error  in  2014  were  the  attempt  to  enhance  the  effective  exchange  of  information 
between  competent  institutions,  the  use  of  data  techniques  to  fill  out  e-documents,  the 
use  of  annual  life  certificates  (similarly  to  Greece)  and  an  increased  use  of  bilateral 
agreements  with  other  Member  States.  Furthermore,  Latvia  has  focused  on,  as 
aforementioned, training individuals with respect to the EU coordination Regulations and 
has - via the Internet - raised citizens’ awareness concerning their rights and obligations. 

A  notable  measure  in  Malta  is  the  establishment  of  a  fully-fledged  inspectorate  branch 
within  the  Ministry  for  the  Family  and  Social  Solidarity  for  the  purpose  of  identifying 
cases of fraud and performing necessary investigations in this respect.  

In  the  Netherlands,  as  aforementioned,  a  plethora  of  initiatives  and  measures  have 
been taken aimed at the prevention, control and detection as well as the correction and 
sanctioning of fraud and error in the field of social security coordination (see supra p. 34-
35) 

The  focus  in  Norway  has  predominantly  been  on  the  increased  exchange  of  data  with 
the Nordic states concerning registered deaths on a regular basis.  

In  Poland  in  the  area  of  pensions,  action  has  been  taken  to  introduce  electronic 
exchange of information about deaths in order to ensure that pensions are no longer paid 
to  individuals  who  have  deceased.  Within  this  context  cooperation  is  underway  with 
Germany and Australia as well as with the Netherlands, the UK, Spain, Italy and Croatia. 
Furthermore information has been obtained with respect to, amongst others, the national 
legislation  concerning  the  recovery  of  benefits  from  foreign  bank  accounts  following  a 
beneficiary’s death, on entities authorised to verify signatures and certificates of life in a 
given  Member  State  and  on  bilateral  agreements  executed  by  EU/EFTA  Member  States, 
providing  for  aggregation  of  the  insurance  periods  completed  in  third  countries  by 
persons concerned. In addition, several cross-area initiatives have been taken, including 
direct  meetings  with  representatives  of  liaison  bodies  and  appropriate EU/EFTA  Member 
States  in  the  scope  of  social  security,  exchange  of  information  concerning  changes  in 
Polish  legislation,  changes  in  institutional  structure,  procedural  questions  as  well  as  the 
appointment of contact persons in each institution for the purpose of making enquiries as 
to  the  coordination  of  social  security  systems,  and  inspections  conducted  by  a  liaison 
body in competent institutions in order to eliminate errors and fraud in the field of social 
security. 

In  addition  to  the  bilateral  agreements  in  posting,  as  well  as  the  training  sessions 
generally,  Portuguese  practice  has  come  to  include  inspections  carried  out  by  a  given 
national  authority  in  association  and  in  collaboration  with  different  authorities.  This  has 
effectively led to criminal investigations, which thus serve to limit and reduce the cases 
of fraud and error in social security coordination.  

In Romania, a network of experts has been established responsible for the combating of 
fraud  and  error  in  the  field  of  social  security.  In  addition,  attempts  have  been  made  to 
enhance cooperation with national institutions responsible for combating fraud and error 
in the field of social security, as well as cooperation with institutions from other Member 
States  responsible  for  combating  fraud  and  errors  in  the  field  of  the  social  security 
Regulations  –  in  particular  Belgium,  Germany,  France  and  the  Netherlands.  Lastly, 

42 

 
regular  exchange  of  database  information  between  the  national  institutions  responsible 
for combating fraud and error in the field of social security has been facilitated.  

In  Spain,  meetings  are  held  with  liaison  bodies  of  various  States  (CH,  BE,  NL,  SE,  NO, 
DK, FI and PL) to establish and draft agreements for the exchange of information to help 
in the monitoring of deaths, top-up benefits and health cover.  

In Estonia, Iceland and Sweden no specific steps have been taken over the course of 
the past year.  

3.3.  Promoting compliance by institutions and healthcare providers 
in the  field  of benefits  in kind  and awareness-raising  amongst 
citizens 

In Belgium, Hungary, Iceland, Italy, Poland, Slovakia and Sweden no noteworthy 
steps  have  been  taken  to  promote  compliance  with  the  coordination  provisions  by 
healthcare  providers  nor  have  measures  been  taken  to  provide  information  to  citizens 
concerning benefits in kind. Conversely, a number of Member States (BG, HR, CZ, DK, 
EE, FI, DE, EL, IE, LV, LT, MT, NL, NO, PT, RO, ES, UK) have indeed taken measures 
to  promote  compliance  in  the  field  of  benefits  in  kind  by  institutions  and  healthcare 
providers  with  the  EU  social  security  coordination  rules  and  to  provide  information  to 
citizens,  and  this  via  the  means  of  extensive  awareness  raising  (see  supra  “Measures 
directed  at  preventing  and  curbing  fraud  and  error  pursuant  to  the  coordination 
provisions”).  Within  this  context,  various  Member  States  (AT,  BG,  DK,  EE,  FI,  EL,  IE, 
LV,  NL,  NO,  RO,  ES,  UK)  have  directed  measures  at  the  users  of  the  social  security 
coordination  rules,  or  in  other  words,  the  EU  citizens  to  whom  the  rules  apply.  On  the 
other hand, various Member States (BG, HR, CZ, FI, DE, IE, LV, LT, MT, NO, PT, RO, 
UK) have taken steps specifically directed at the provider of benefits.  

3.3.1.  Awareness-raising directed at claimants 

Concerning  the  former  category  of  initiatives  directed  specifically  at  the  users,  the 
following  initiatives  have  been  taken.  The  National  Health  Insurance  Fund  in  Bulgaria 
organises  periodic  media  campaigns  for  the  particular  purpose  of  further  elaborating 
upon  the  rights  and  obligations  inherent  to  the  health  insurance  services.  Regarding 
information to citizens concerning the EHIC and the coverage of cost under the EHIC, an 
intensive  information  campaign  was  launched  in  Denmark  in  2014.  The  reasoning  for 
this was the repeal of the Danish public tourist health insurance as of 1 August 2014. The 
campaign  was  conducted  by  use  of  different  platforms  such  as  a  campaign  website, 
television spots, street events,  posters in streetscape, leaflets and information on social 
media.  Similarly,  in  Greece  the  dissemination  of  pertinent  information  for  users  of  the 
coordination rules and in particular healthcare in a cross-border context, is posted on the 
websites of the main social security bodies and of the EOPYY. Also in  Latvia awareness 
raising  is  accomplished  in  a  similar  manner.  Information  for  citizens  is  available  on  the 
official  Internet  website  of  the  competent  institution.  Furthermore,  information  can  be 
obtained by calling the customer call centre. Informative campaigns specifically related to 
cross-border health care issues have not been performed during 2014. However, in some 
informative  activities  on  health  care  issues,  information has  been  provided  about  cross-
border  health  care  (type  of  activities:  participation  in  seminars  concerning  health  care; 
publications in newspapers; television news; usually such activities are initiated by other 
interested parties (journalists, other governmental institutions, associations, NGOs etc.)). 
Lastly, in Austria, the Netherlands, Norway, Romania and Spain use is also made of 
the  Internet,  mass  media  and  leaflets/brochures  in  order  to  provide  citizens  with  up  to 
date  and  correct  information  regarding  their  rights  and  obligations  under  the  social 
security  coordination  rules.  In  both  Member  States  information  regarding  rights  is 
provided to citizens through different channels such as the Internet, social media as well 
as the national contact point.  

43 

 
 
In  Estonia  the  Unemployment  Insurance  Fund  raises  awareness  amongst  the  public 
mostly  by  means  of  the  internet  and  the  relevant  websites.  With  respect  to  the 
transposition of the Directive on Patients’ Rights and previous legislation, a questionnaire 
to  hospitals  was  furthermore  prepared,  which  is  to  be  completed  by  foreign  patients  in 
order to clarify which rules apply to the patient concerned. 

The  Finnish  Kela  provides  information  for  public  health  care  providers  on  its  webpages 
concerning  healthcare  for  foreigners.  Kela  also  provides  information  for  health  care 
providers  in  the  private  sector,  pharmacies  and  insurance  companies.  Furthermore,  in 
2014  Kela  trained  its  personnel  as  well  as  the  health  care  sector  within  the  context  of 
social  security  coordination.  Within  this  same  vein,  several  internal  instructions  have 
been  improved.  In  addition,  Kela  has  been  preparing  a  new  data  system  concerning 
rights  to  health  care  in  cross-border  situations.  The  system  will  comprise  for  example 
information  about  the  forms  issued  to  a  person  and  his  or  her  entitlements  to  health 
care. The system will also promote compliance with the rules as well as offering accurate 
information  for  customers.  The  estimated  launch  of  the  new  system  will  be  in  March 
2016.  Kela's  Centre  for  International  Affairs  was  established  on  1  January  2014.  Most 
international affairs are centralised there, which also promotes compliance with the rules. 
Lastly,  the  national  contact  point  for  cross-border  healthcare  within  Kela  provides 
information  on  issues  related  to  situations  where  people  go  from  Finland  to  another 
country  or  come  to  Finland  from  another  country  in  order  to  obtain  healthcare.  This 
contact  point  is  preparing  a  new  website  together  with  other  authorities  to  provide 
information  in  Finnish,  Swedish  and  English  about  the  use  of  healthcare  services  in 
Finland and abroad. The estimated launch of the website will be in September 2015.  

Citizens  granted  entitlement  from  Ireland  are  forwarded  information  when  they  are 
issued  the  EHIC.  This  information  advises  them  on  their  responsibility  if  they  are  no 
longer resident or insured in Ireland. The processing of reimbursement claims from other 
Member States promptly leads to withdrawal of entitlement documents where a person is 
no  longer  insured  in  Ireland.  This  ensures  that  the  Irish  Health  Service  Executive  does 
not have to meet additional costs insofar Ireland is not competent. 

3.3.2.  Awareness-raising directed at providers  

In  addition  to  the  foregoing  initiatives  directed  at  the  citizens,  a  number  of  Member 
States (HR, CZ, FI, DE, IE, LV, LT, MT, NO, RO) have (also) implemented measures to 
ensure  greater  compliance  from  the  perspective  of  the  providers  of  social  security 
benefits.  As  aforementioned,  Croatia  and  Finland  provide  information  directed  at 
healthcare providers and the private sector via their respective websites. The foregoing is 
also done by the biggest health insurance company in the  Czech Republic. Identically, 
in  Germany  compliance  is  promoted  via  the  means  of  online  information  targeted 
specifically at service providers for the purpose, amongst others, of preventing fraud and 
error. In addition, case handlers at the statutory accident insurance institutions regularly 
attend professional training seminars where they receive expert advice on the prevention 
of fraud and error.  

The  Irish  Health  Service  Executive,  which  is  the  competent  institution  for  benefits  in 
kind,  has greater  interaction  with  institutions  in  other  Member  States.  This  cooperation 
greatly  assists  in  resolving  issues  in  determining  matters  such  as,  amongst  others, 
eligibility  and  residency.  The  Health  Service  Executive  has  a  central  contact  for 
institutions  in  other  Member  States  to  facilitate  the  issuing  of  temporary  replacement 
certificates.  This  is  where  a  person requires  an  entitlement  document  urgently.  This 
ensures the person has not to meet the cost, but is provided with care under regulations. 
This  email  contact  also  gives  the  opportunity  for  institutions  in  other  Member  States  to 
correspond electronically with local health offices in Ireland. Not only does this provide a 
central contact point for citizens; it also leads to uniformity in the application process and 
in responding to other Member States on outcomes. The Health Service Executive, in its 
obligation to confirm and record information on entitlement documents, has updated all 
healthcare  providers  on  what  is  required  to  facilitate  the  reimbursement  from  other 

44 

 
Member States. This ensures that all relevant information is available to claim from the 
institution in the competent State. 

In  order  to  strengthen  proper  application  of  the  EU  social  security  cooperation  rules,  in 
Latvia  the  competent  institution  –  responsible  for  the  provision  of  state-funded  health 
care  services  –  provides  daily  support  to  healthcare  providers  by  means  of,  amongst 
others,  consulting  health  care  providers  on  specific  issues  and  distributing  informative 
leaflets.  

In  Lithuania,  the  contract  between  a  healthcare  provider  and  the  THIF  simply  obliges 
the  healthcare  provider  to  comply  with  the  provisions  of  the  coordination  Regulations 
when  providing  healthcare  services.  As  is  done  to  provide  pertinent  information  to 
citizens,  the  Norwegian  Health  Economics  Administration  provides  information,  in 
addition to arranged meetings and guidelines, to institutions and healthcare providers via 
different channels such the internet, social media and the national contact point, in order 
to promote compliance with the coordination rules.  

Maltese  practice  provides  for  regular  in-house  training  and  online  and/or  telephone 
support concerning the interpretation and application of the coordination provisions.  

Initiatives  in  the  Netherlands  aimed  at  the  service  providers  include,  amongst  others, 
dissemination  of  relevant  information  directed  at  the  providers  concerned  via  the 
internet.  Similarly  to  the  practice  in  the  Netherlands,  the  dissemination  of  updated 
information  in  Portugal  is  achieved  via  the  internet  in  conjunction  with  circulars 
disseminated by the Ministry of Health. 

Regarding  the  benefits  in  kind,  the  National  Health  Insurance  Office  in  Romania,  as  a 
liaison  body,  has  submitted  through  its  competent  bodies,  namely  the  health  insurance 
offices, information necessary for the implementation of EU regulations, directed at both 
the insured persons as well the healthcare providers. Similarly to the practice in Norway, 
the dissemination of relevant information is achieved by means of, amongst others, the 
Internet, meetings at the level of competent institutions and mass media. 

3.4.  Remaining issues 

In a large number of Member States (AT, BE, BG, FI, DE, IE, LV, NO, PL, ES) certain 
matters that have not been discussed  do remain unresolved, despite the laudable steps 
taken to prevent issues as such. 

Austrian Social Security finds the incidence of and potential for circumvention under the 
applicable legislation particularly problematic. The problems in this area have been raised 
in  numerous  notes  and  expert  reports  within  the  Administrative  Commission  over  the 
past few years, and are currently being discussed in more detail in the 'Posting' Working 
Group.  

As  regards  applicable  legislation  in  Belgium,  the  competent  institutions  note  that  the 
conditional  withdrawal  of  PDs  A1  by  the  competent  foreign  institutions  remains 
problematic  as  well  as  the  final  payment  of  social  security  contributions  in  the  correct 
social  security  scheme  and  cross-border  recovery.  Additionally,  the  implementation  of 
direct  recovery  between  the  competent  social  security  bodies  of  undue  social  security 
contributions  (in  the  posting  Member  State)  also  remains  problematic.  Lastly, 
discrepancies between what constitutes fraud and error in the Member States concerned 
render cooperation more difficult. 

In  Bulgaria  a  practical  problem  has  been  observed.  It  appears  that  there  is  a  lacking 
willingness  to  treat  patients  that  are  insured  outside  of  Bulgaria.  This  is  further 
aggravated by the fact that there is no efficient means to verify this observed reluctance 
to treat patients as such.  

45 

 
 
The Finnish Centre for Pensions finds the payment of contributions to different Member 
States particularly difficult. Some employees have lost their jobs or are simply not hired 
due to the fact that the employers do not want to bother with foreign payments. This is 
considered  as  an  impediment  to  the  free  movement  of  workers.  Furthermore,  the 
retroactive  cases  that  need  correction  consistently  cause  problems  and  despite  the 
initiatives  taken  to  curb  long  handling  times  per  case,  this  nevertheless  persists  as  a 
distinct issue.  

Accident  insurance  institutions  in  Germany  have  limited  competence  in  performing 
controls and checks in companies with the aim of preventing abuse of the system in the 
form of illegal employment, improper application of the provisions on which legislation is 
applicable, and undeclared work.  

Notwithstanding that it has been mentioned repeatedly, in Ireland, note is made of the 
fact  that  more  immediate  and  electronic  transfers  of  case-by-case  information  requests 
from and to all organisations is necessary. The existing systems are constrained by time 
delays  and  an  inefficient  use  of  resources.  Moreover,  clarification  from  social  security 
organisations  on  what  investigations  and  enquiries  can  legitimately  be  undertaken  by 
them  for  social  security  organisations  having  regard  to  their  national  and  EU  legislation 
would  help.  Lastly,  there  is  a  need  to  ensure  that  all  cross-jurisdictional  outcomes  are 
collated and recorded to measure the effectiveness of ongoing co-operation.  

With an increasing move towards electronic service delivery, e-fraud is an emergent risk 
variable that will require consideration by all organisations. 

In  Latvia  three  distinct  remaining  issues  can  be  identified.  Firstly,  the  Office  of 
Citizenship and Migration Affairs does not maintain data on persons’ departure outside of 
Latvia,  and  therefore  the  competent  institution  of  Latvia  (the  State  Social  Insurance 
Agency)  does  not  have  this  information.  As  a  result,  it  is  not  possible  to  apply  the 
bilateral agreement between pension institutions of Latvia and Lithuania on the exchange 
of information on the death of pension receivers or their departure to another country as 
effectively  as  it  should.  Secondly,  an  agreement  between  pension  institutions  of  Latvia 
and  Estonia on  the  exchange of  information  on  pension  receivers  in  electronic  form  has 
still not been concluded. Lastly, the pension receivers living abroad are not satisfied with 
the  situation  that  they  annually  have  to  submit  life  certificates  for  further  pension 
payment.  

Norway  has  experienced  problematic  cases  in  the  field  of  benefits  in  kind  whereby  an 
individual  sent  a  Norwegian  healthcare  provider  a  copy  of  the  EHIC  after  the  treatment 
has  taken  place,  whereas  the  EHIC  (and  the  insurance  period  of  the  person) 
subsequently  turned  out  to  have  started  after  the  treatment  took  place.  In  such  cases 
the  individual  concerned  should  have  paid  for  the  benefits  in  kind  and  not  been  given 
rights following the rules in the EU social security coordination.  

In  Poland  issues  persist  in  the  field  of  pensions.  Specific  sources  of  concern  are 
inconsistent  rules  concerning  the  recovery  of  pensions  from  a  bank  account  following  a 
beneficiary’s  death,  and  problems  with  the  retrieval  of  benefits  from  some  EU/EFTA 
Member States. In addition, the lack of access to pertinent registers renders it impossible 
to  get  assistance  from  certain  Member  States  with  respect  to  the  deaths  of  unshared 
customers. As a result, use need still be made of hard-copy life certificates.  

In Spain, the difficulties persist of determining the habitual residence of pensioners in a 
State  other  than  the  competent  State.  Within  this  context  and  in  view  of  the  many 
tourists and residents, pensioners and/or their relatives frequently stay in Spain for long 
periods  of  time,  claiming  that  they  are  staying  only  temporarily  and  with  no  interest  in 
formally  becoming  habitual  residents.  Furthermore,  Article 11  of  Regulation  (EC) 
No 987/2009 stipulates that once an overall assessment has been made of an individual's 
circumstances,  if  there  is  disagreement  between  the  institutions,  it  is  the  individual’s 
intention that always prevails for the purpose of determining the habitual residence in a 

46 

 
State other than the competent State. In casu, this can thus lead to or increase the risk 
of  defrauding  the  presumed  competent  State  and  also  has  serious  implications  for  the 
country  where  these  individuals  are  staying,  theoretically,  on  a  temporary  basis.  The 
country the individual is 'visiting' is subject to an excessive demand for benefits in kind, 
often  related  to  chronic  and  pre-existing  illnesses,  which  it  is  obliged  under  the  current 
provisions of Decision S3 to provide, but which would in practice be more in keeping with 
habitual residence, given the regularity with which insured individuals require them. This 
all has significant repercussions for the planning of health services, as these individuals – 
oftentimes pensioners – cannot be included as actual residents, even though in practice 
the frequency and type of health care they require is more in keeping with a supposition 
of habitual residence. 

Conversely  to  the  foregoing,  in  Croatia,  the  Czech  Republic,  Denmark,  Estonia, 
Greece,  Hungary,  Iceland,  Italy,  Lithuania,  Malta,  the  Netherlands,  Portugal, 
Romania and Slovakia no (significant) new issues have been identified. 

3.5.  Recommendations 

For  the  purpose  of  resolving  issues  concerning  the  applicable  legislation,  Belgium 
proposes  to  make  increased  use  of  Decision  A1.  Concerning  family  benefits,  the 
competent institution notes that meetings between counterpart European institutions are 
required to draw up agreements on combatting social security fraud and errors. The aim 
of  these  agreements  should  be  to  define  a  legal  framework  for  transparent  cooperation 
and effective information processing. 

Estonia  notes that  increased  use  of  electronic  data  exchange  would  facilitate enhanced 
and more effective cooperation, thereby minimising the potential for fraud and error.  

From  the  Finnish  perspective,  it  is  noted  that  a  key  proactive  resolution  could  be  to 
reach  employers  and  employees  and  give  them  adequate  information  as  early  as 
possible, allowing for their respective social security matters to be dealt with in advance. 
As  a  suggestion  to  resolve  this  issue,  easy  access  to  information  on  how  to  pay 
contributions  should  be  provided.  For  example,  a  joint  website  could  be  created  which 
has information on all the Member States and their contribution collection practices or EU 
webpages on practical guidelines. Concerning the cases that need correction afterwards, 
the  Regulations  could  for  example  provide  means  to  reimburse  social  security 
contributions  between  the  Member  States’  competent  institutions,  as  the  coordination 
rules  require  Member  States  to  determine  the  applicable  legislation  as  well.  Lastly, 
regarding the avoidance of long handling times, it is noted that a workable solution could 
be to consider time limits for providing answers to requests for information.  

In  addition  to  the  foregoing,  Greece  notes  the  possibility  of  converting  the  personal 
identification number (PIN) provided for in Article 52(3) of Regulation (EC) No 987/2009 
into a pan-European number, with integrated use and recognition by all EU social security 
bodies and, of course, registration in a single computerised database. 

4.  DATA EXCHANGE IN THE FIELD OF FRAUD AND ERROR 

4.1.  Actions  taken  and  measures  implemented  to  enhance  cross-

border cooperation and information exchange  

In  what  follows  a schematic  overview  is  provided,  elaborating,  per Member State,  upon 
measures  taken  to  enhance  cross-border  cooperation  which  have  not  already  been 
elaborated upon in addition to the bilateral agreements that have been concluded in the 
context of data exchange.  

Member States 

Initiatives 

47 

 
 
Austria  

Belgium 

Actions 
 

Establishment of a national 'fraud and error' contact point: the Austrian 
contact  point  was  set  up  in  consultation  with  the  Federal  Ministry  for 
Labour,  Social  Affairs  and  Consumer  Protection  at  the  Central 
Association of Austrian Social Insurance Institutions (Hauptverband der 
österreichischen  Sozialversicherungsträger).  The  insurance  institutions 
and  other  public  authority  stakeholders  were  given  comprehensive 
information about the tasks and possibilities of the H5NCP network and 
encouraged to make active use of it. 
Active participation by Austrian Social Security in the following working 
groups and projects: 

o 

o 

o 

The  Administrative  Commission  Ad-Hoc  Group  on  'Combating 
Fraud  and  Error  through  the  Exchange  of  Personal  Data', 
Brussels; 
The Conference on 'International exchange of data on deaths', 
Cologne; 
'Red  Flags! 
in  Ghent  University's  project 
Participation 
Prevention,  Detection  and  Cooperation  in  the  Fight  Against 
Cross-Border Social Fraud'; 

Participation in the 'European Working Group on Benefit Fraud', Dublin. 

Agreement  with  Germany  on  combating  undeclared  work:  In  2012,  at 
the  initiative  of  the  Finance  Administration,  Austria  and  Germany 
entered  into  an  agreement  on  cooperation  in  combating  cross-border 
undeclared  work  and  illegal  cross-border  hiring  of  labour.  The 
agreement provides for better bilateral cooperation. 
Electronic  exchange  of  data  on  deaths  via  Deutsche  Post's  pensions 
service:  on  the  basis  of  an  agreement  with  Deutsche  Post's 
Rentenservice,  data  on  deaths  is  exchanged  between  the  Austrian 
pensions insurance institute and the German DRV Bund (pension fund).  
Electronic  exchange  of  data  on  pension  amounts  with  the  German 
statutory pension insurance scheme (Deutsche Rentenversicherung) via 
the Worldwide Exchange of Social Security Information (WESSI) system 
developed  by  the  Austrian  social  security  institutions.  The  basis  is  an 
agreement  between  the  Austrian  pension  insurance  institution  and  the 
German DRV Bund. 

 
Bilateral agreements 
 

Actions 
 

the  social 

As  regards  applicable  legislation,  the  competent  institutions  list  the 
following  activities  and  measures:  annual  informal  trilateral  meetings 
with  representatives  of 
the 
Netherlands,  Belgium  and  Germany  and  informal  meetings,  at  their 
request,  with  the  German  financial  police  (Finanzpolizei),  who  are 
competent for undeclared work, with the aim of exchanging information 
and possibly concluding an agreement on cooperation.  
In  general,  Belgium  promotes  optimum  use  of  the  network  of  national 
contact points under Decision H5 and particularly the e-platform, which 
was set up at the request of the Administrative Commission. 

inspection  services  of 

 

 

 

 

the 

family  benefits  system.  The 

Bilateral agreements 
  With  respect  to  family  benefits,  the  competent  institution  (FAMIFED) 
notes  that,  in  cases  of  fraud,  the  Brussels  agreement  on  cross-border 
cooperation  between 
local  authorities  and  public  bodies  of 
16 September 2002 specifies the legal framework for such cooperation 
between  France  and  Belgium  for  the  purposes  of  cross-border 
cooperation  on 
institutional 
organisation of the Kingdom of Belgium delegates its responsibilities to 
federated  bodies,  municipalities  and  regions,  whilst  in  France  they  are 
shared  between  the  State  and  the  various  levels  of  local  authorities. 
However, it should be noted that, as far as the family benefit system is 
concerned,  the  exchange  of  information  under  the  agreements  for 
cross-border  cooperation  is  virtually  non-existent.  The  exchange  of 
information with European public institutions does not function because 
of  the  communication  difficulties  encountered  by  our  services  when 
fraud  is  identified  in  files  for  social  beneficiaries  residing  in  Europe 
outside  the  Belgian  territory  or  receiving  various  social  allowances  in 
Europe outside the Belgian territory.  

Bulgaria 

Actions: N/A 
Bilateral agreements:  
 
 
 

Agreement concerning data exchange with Germany 
Agreement concerning data exchange with the United Kingdom 
Agreement concerning data exchange with the Netherlands 

Croatia 

Actions: N/A 

48 

 
Czech Republic 

Denmark 

Estonia  

Finland 

Bilateral agreements: 
 

Bilateral agreement with Slovenia  concerning electronic data exchange 
with  respect  to  mortality  information,  rendering  the  use  of  life 
certificates redundant.  

Actions: N/A 
Bilateral agreements: 
 

Agreements  with  Germany,  France  and  the  Netherlands  concerning 
illegal  work  and  the  combating  of  misuse  of  social  security  benefits. 
These are rarely applied, however.  

Actions 
  Denmark is actively represented on the H5NCP Platform. 
  Denmark is represented in several working groups, such as the Nordic 
working  group  on  Benefit  Fraud  and  the  Working  Group  on  European 
Benefit Fraud.  

  Denmark  has,  as  mentioned  above,  established  a  central  unit  for 
international  administrative  cooperation  as  well  as  a  section  on  data 
and  data  matching  under  the  auspices  of  Udbetaling  Danmark. 
Moreover,  Denmark  is  in  the  process  of  further  strengthening  the 
former  initiative  by  establishing  an  international  control  unit  focusing 
specifically on cooperation and control within the EU/EEA area.  

Bilateral agreements  
 

Udbetaling  Danmark  has  concluded  a  Memorandum  of  Understanding 
between  Udbetaling  Danmark  and  the  Department  for  Work  and 
Pensions  and  the  Department  for  Social  Development  of  Great  Britain 
and  Northern  Ireland  concerning  cooperation  and  mutual  assistance  in 
the administration of  social security and social assistance programmes 
in  October  2014.  The  declaration  awaits  implementation  while  the 
technical  platform  for  exchange  of  data  is  decided.  The  agreement  is 
intended to enhance cooperation on information exchange and is hence 
not  intended  solely  to  fight  fraud  and  error.  The  agreement  is  in  its 
current form limited to cooperation on administration of pension, but it 
is the mutual intention to extend the agreement to other areas. 

  Denmark is in the process of drawing up an agreement between Nordic 
institutions  in  Finland,  Iceland,  Norway,  Sweden  and  Denmark  on 
cooperation  and  exchange  of  information  via  secure  e-mail  on  social 
security  and  payment  of  benefits.  The  agreement  is  expected  to  be 
concluded in 2015. 
A new Nordic Convention on social security entered into force on 1 May 
2014.  The  agreement  contains  among  other  things  commitment  to 
enhanced cooperation on electronic information exchange. 

 

No de iure bilateral agreements have been established. 

Actions: N/A 
Bilateral agreements 
 
  De  facto  cooperation  meetings  are  held  with  the  Finnish  competent 
institutions  every autumn where issues concerning fraud and error are 
discussed. 

Actions: N/A 
Bilateral agreements 
 

 

 

Cooperation  with  Estonia;  meetings  and  negotiations  in  different 
branches of social security. 
Secure  e-mail  connections  with  Estonia  and  Sweden.  Negotiations  for 
establishing  secure  e-mail  connections  with  other  Nordic  pension 
institutions are ongoing.  
Electronic exchange of insurance number data (E501) between Finland 
(the  Finnish  Centre  for  Pensions,  ETK)  and  Sweden,  Norway  and 
Germany.  The  ETK  submits  the  insurance  numbers  also  to  Kela,  the 
social insurance institution of Finland. 

  Online access to German insurance history data (E505) and information 
on  pension  amounts  from  the  ETK,  employment  pension  institutions 
and Kela. 
Unilateral  exchange  of  insurance  history  (E505)  from  Norway  and 
Sweden to Kela. 
Based on bilateral agreements, Finland electronically exchanges: 

 

 

o 

life  certificates  between  Finland  (both  ETK  and  Kela)  and 
Sweden and Norway. 

 

life  certificates  between  Kela  and  Germany  (Deutsche  Post).  The 
exchange of information on deaths with Germany and Spain are under 
negotiations. 

Germany  

Actions: N/A 
Bilateral agreements  

49 

 
 
Greece  

Hungary 

Iceland 

Ireland 

Italy 

Latvia 

 

Further  progress  in  the  testing  of  and  preparation  for  the  introduction 
of  procedures  for  automated  cross-checking  of  data  on  deaths  with 
Belgium,  Bulgaria,  France,  Greece,  Croatia,  Poland  and  the  United 
Kingdom.  

Actions: N/A 
Bilateral agreements 
 

The  electronic  exchange  of  data  on  deceased  pensioners  has  been  put 
into effect between social security bodies in Germany and Greece (IKA-
ETAM and OGA). 

The  German  pension  institution  and  the  Greek  social  security  bodies  (IKA-
ETAM,  OGA  and  OAEE)  share  the  possibility  of  automated  access  to  the 
German E505 certificate concerning the insurance history of a worker and to 
information on pension amounts. 

Actions 
  Data exchanges with competent authorities.  
 
 
Bilateral agreements: 
 

Legal assistance and awareness raising amongst stakeholders. 
Contacts with Member State representatives. 

Bilateral agreement with Austria and Slovakia (although these have not 
proven to be sustainable).  

Actions: 
 

Establishment  of  the  National  Contact  Point  Platform  based  upon 
decision H5NCP. 

Bilateral/multilateral agreements 
 

Nordic working group on benefit fraud, which holds yearly meetings.  

Actions: N/A 
Bilateral agreements 
 

A  Memorandum  of  Understanding  (MOU)  between  the  Government  of 
Ireland  and  the  Government  of  the  United  Kingdom  and  Northern 
in  the 
Ireland  concerning  co-operation  and  mutual  assistance 
administration  of  social  security  schemes  was  signed  on  9  October 
2000. 
Under the MOU, procedures have been implemented to ensure that all 
information  requests  and  data  exchanges  are  made  through  a  single 
point of contact in each jurisdiction.   
A Cross Border Operational Forum operates under the MOU. The Cross-
Border Operational Forum comprises of senior fraud managers from the 
Department of Social Protection, the Department for Work and Pensions 
(UK)  and  the  Northern  Ireland  Social  Security  Agency  of  the 
Department  for  Social  Development.  The  Forum’s  remit  is  to  liaise  at 
operational  level  and  ensure  that  measures  are  in  place  to  ensure 
effective cooperation, prevention and detection of fraud. 

The forum continues to look at areas and opportunities for data exchanges. 

Actions: N/A 
Bilateral agreements: 
 

Agreement  with  Austria,  Germany  and  Switzerland  concerning  data 
exchange 

Actions: N/A 
Bilateral agreements  
 

Agreement  between  the  State  Social  Insurance  Fund  Board  of  the 
Republic  of  Lithuania  and  the  State  Social  Insurance  Agency  of  the 
Republic  of  Latvia  on  electronic  exchange  of  information  on  pension 
receivers  (05.08.2011).  Parties  electronically  exchange  information  on 
change of residence or the death of mutual pension receivers.  
Arrangements  have  been  made  for  the  conclusion  of  an  agreement 
between the National Social Insurance Board of the Republic of Estonia 
and the State Social Insurance Agency of the Republic of Latvia on the 
electronic  exchange  of  information  on  pension  receivers.  It  is  planned 
that  parties  will  electronically  exchange  information  on  change  of 
residence or the death of mutual pension receivers. 

 

 

 

Lithuania 

Malta 

The Netherlands 

 

No new measures were taken in 2014. 

Actions: N/A 
Bilateral agreements: 
  Data exchange agreement with the United Kingdom concluded in 2011.  

Actions:  
.  
 
Health  care:  participation  in  the  International  Association  of  Mutual 
 
Benefits  and  the  European  Healthcare  Fraud  and  Corruption  Network. 

50 

 
Norway 

Poland 

Portugal 

Romania 

Slovakia 

Spain 

EHFCN’s  activities  aim  to  support  members  and  associate  entities  in 
their  work  of  prevention,  detection,  investigation,  prosecution  and 
redress of healthcare fraud, corruption and waste. 
A national contact point for social security has been established.  

 
Bilateral agreements 
 

Concerning  posting,  agreements  have  been  concluded  with  Romania, 
Bulgaria and Poland.  
Concerning  the  exchange  of  information  with  respect  to  deaths, 
agreements have been concluded with Belgium, Germany and France. 

 

Actions 
 
Bilateral agreements 
 

Establishment of a national contact point, operative since 2014. 

Yearly  meetings  are  held  between  the  Nordic  countries  assessing  the 
mutual adherence  to the Nordic and European treaties in the field and 
addressing mutual challenges in combating fraud and error.  

Actions (by the NCP network): 
  Obtaining  information  on  entities  entitled  to  verify  a  signature  and  life 

certificate in a given Member State. 

  Obtaining information on bilateral agreements entered into by EU/EFTA 
Member States, which provide for the aggregation of insurance periods 
completed in third countries. 

  Obtaining  information  included  in  agreements  on  the  electronic 

exchange of information on beneficiaries’ deaths. 

  Obtaining 

and 

the 

exchange 

of 

information 

on 

contact 

persons/institutions competent to handle a particular case. 

  Obtaining information on national legislation concerning the retrieval of 
benefits from foreign bank accounts following the beneficiary’s death. 

Bilateral agreements  
 

As  regards  ZUS:  In  order  to  avoid  overpayment  of  benefits  following 
the  beneficiary’s  death,  actions  have  been  taken  in  order  to  effect  the 
electronic  exchange  of  information  on  deaths.  Currently,  agreements 
have  been  signed  with  Germany,  Australia  (a  project  has  been 
implemented)  and  Sweden.  Currently,  work  is  under  way  to  facilitate 
electronic exchange of information with the Netherlands, the UK, Spain, 
Italy and Croatia.  
As  regards  KRUS:  In  order  to  avoid  overpayment  of  benefits  following 
the  beneficiary’s  death,  steps  have  been  taken  to  implement  the 
electronic exchange of information on the death of pensioners between 
KRUS and the German institution. 

Actions: N/A 
Bilateral agreements: 
 

Bilateral  agreement  with  Switzerland  concerning  disability  and  pension 
insurance. 
Bilateral agreement with Ireland concerning marriages of convenience. 
Bilateral  agreement  with  the  Netherlands  concerning  information-
sharing with respect to fraud and error.  

Actions 
 

According to the duties under the application of Decision H5, the CNPP, 
as a national contact point in combating fraud and error in  the field of 
social  security,  via  the  Directorate  for  International  Relations,  has 
assigned two employees for solving the related requests. 

  Bilateral agreements: N/A 

Actions: N/A 
Bilateral agreements 
 

Information  is  exchanged  with  the  Czech  Republic  concerning  the 
administration of pensions. 
A  bilingual  form  has  been  developed  in  cooperation  with  the  HMRC  in 
the United Kingdom to facilitate information exchange. To prevent and 
detect fraud, bilateral working meetings are held with the institutions in 
neighbouring  States  (the  Czech  Republic,  Hungary  and  Austria)  to 
improve  cooperation  and  information  exchange  in  order  to  prevent 
fraud and error and to deal with cases of fraud and error. 

 

 
 

 

Actions: N/A 
Bilateral agreements: 
 

collaboration 
Bilateral  negotiations  are  underway 
agreements  with  liaison  bodies  of  other  Member  States,  in  order  to 
obtain information relating to pensioners of one State who reside in the 
other,  with  the  objective  of  monitoring  the  proper  implementation  of 
the priority rules for benefits in kind set out in Article 25 of Regulation 

concerning 

51 

 
 
Sweden 

United Kingdom 

 

 

(EC) No 883/04. 
Spain and the United Kingdom have continued to make progress in the 
exchange of information relating to British citizens who are recognised 
as  UK  pensioners,  but  who  are  eligible  for  health  care  under  Spanish 
legislation only because they are resident in Spain. 
A collaboration agreement also exists between Spain and Germany for 
the  electronic  exchange  of  information  on  pensioners  of  both  states. 
With  the  information  provided  by  Germany,  a  process  of  cleaning  this 
data has been initiated, with the aim of verifying cases of people whose 
health  care  should,  under  the  priority  rules,  be  funded  by  the  country 
paying their pension, as they are currently eligible for health care under 
Spanish law only because they are resident in Spain. 

Actions 
 

The Social Insurance Agency actively participates in seminars and other 
activities organised by the European Commission in this area. 

Bilateral agreements  
 

An  exchange  of  information  between  countries  in  the  form  of  requests 
between  them  is  therefore  necessary  to  minimise  the  risk  that  the 
payment is made from two countries simultaneously. Cooperation with 
the  relevant  authorities  in  other  Member  States  takes  place  primarily 
through the exchange of information on individual cases. For example, 
if a child lives abroad, the Social Insurance Agency sends a request to 
another  Member  State  once  a  year  to  ensure  that  the  right  to  the 
family benefit still exists.  

Actions: N/A 
Bilateral agreements  
 

 

Ireland  –  Continued  participation  in  the  Cross  Border  Operational 
Forum  with  Ireland  and  Northern  Ireland.  Data  matching  continues  on 
unreported deaths in the state pension caseload. 
Spain  –  Data  matching  continues  on  unreported  deaths  in  the  state 
pension  caseload.  Officials  from  the  UK  visited  Spain  and  held 
productive  talks  with  Spanish  officials  on  how  to  tackle  cross-border 
fraud.  A  Memorandum  of  Understanding  is  currently  being  worked  on 
which will allow greater data sharing on working age cases. 

 

  Germany  –  Talks  have  been  held  on  progressing  data  matching  on 
unreported  deaths  in  the  state  pension  caseload.  Initial  testing  took 
place in spring 2015 with a view to full live running in autumn 2015. 
Poland – Hosted a visit in London for Polish officials on progressing data 
matching  on  unreported  deaths  in  the  state  pension  caseload.  Testing 
is  to  take  place  during  2015  with  a  view  to  full  live  running  in  early 
2016. 
The  Netherlands  –  Work  continues  to  get  data  matching  on  state 
pension caseload live.  

 

  Malta  –  Data  matching  for  unreported  deaths  was  tested  and  became 

live in December 2014. 

  Denmark  –  Memorandum  of  Understanding  signed  in  2014.  Work  on-

 

going to get data matching live, target date autumn 2015. 
Negotiations  with  France,  Italy  and  Switzerland  have  been  on-going 
during 2014 to agree and sign Memorandums of Understanding.  

4.2.  Cross-border social security cooperation and privacy concerns  

4.2.1.  General Findings  

In the large majority of Member States (AT, BE, BG, HR,  CZ, DK,  EE, FI, DE, IS,  IT, 
LV,  MT,  NL,  NO,  PL,  PT,  RO,  SK,  SE)  privacy  and  the  protection  and  security  of 
personal data is guaranteed by both international as well as national legal provisions. In 
particular the foregoing refers to the applicable EU provisions pertaining to the protection 
of data, but equally so national safeguards that have been implemented in this respect.  

In  addition  and  noteworthy,  Belgium,  Finland  and  Latvia  have  concluded  bilateral 
and/or multilateral agreements with other States concerning the protection of such data 
and privacy. Furthermore, a measure worth mentioning is the encryption of data as done 
by the Czech Republic, Germany, Ireland and Latvia as a means to safeguard privacy 
and data whilst nevertheless complying with the coordination provisions.  

52 

 
 
4.2.2.  Overview of Member State-specific action  

In what follows a short overview is provided of the noteworthy individual Member State 
initiatives  as  concerns  the  protection  of  data  and  privacy  in  the  field  of  social  security 
coordination.  

In Belgium, as regards family benefits, the competent institution (FAMIFED) notes that 
information  is  exchanged  in  compliance  with  Article  76  (4)  of  Regulation  (EC)  No 
883/2004.  This  Article  stipulates  that  the  institutions  and  persons  covered  by  the 
Regulation  have  a  duty  of  mutual  information  and  cooperation  to  ensure  the  correct 
implementation  thereof.  Article  77  refers  to  compliance  with  the  legislation  on  data 
protection  in  the  Member  State,  which  provided  the  data  and  in  the  Member  State 
receiving the data in compliance with EU rules on the protection of natural persons with 
regard to the processing and free movement of personal data. Concerning unemployment 
insurance, the competent institution indicates that the Belgian legislation covering ONEM 
applies  to  the  members  of  its  staff.  The  Belgian  legislation  concerned  is:  the  Royal 
Decree of 2 October 1937 on the status of officials of the state amended by Royal Decree 
of  26  September  1994  reforming  various  regulatory  provisions  applicable  to  state 
officials; the Act of 15 January 1990 on the institution and organisation of the Crossroads 
Bank for Social Security (CBSS),10 hereinafter the CBSS Act; the Act of 8 December 1992 
on the protection of privacy with regard to processing personal data,11 hereinafter the Act 
on  privacy;  and  the  Act  of  11  April  1994  on  government  information.12  In  addition, 
Belgium has concluded a treaty with the Netherlands on the development of cooperation 
and  administrative  assistance  on  social  security  (28  February  2013)  as  well  as  an 
agreement  with  the  French  Republic  for  the  development  of  cooperation  and 
administrative  assistance  on  social  security  (17  November  2008).  Finally,  there  have 
been  authorisations  by  the  Sectoral  Committee  on  Social  Security  and  Health  with 
respect to the exchange of personal data. In particular, this concerns the authorisation of 
the  Sectoral  Committee  on  Social  Security  and  Health,  ‘social  security’  section,  on  the 
exchange  of  personal  data  between  the  NEO  and  the  UWV  (Uitvoeringsinstituut 
Werknemersverzekeringen – Netherlands) obtained on 7 May 2013, and the authorisation 
of the Sectoral Committee on Social Security and Health, ‘social security’ section, on the 
exchange of personal data between the NEO and Pôle Emploi (France), obtained on 7 July 
2013.13 

In Denmark, in cases of cross-border cooperation and information exchange, the privacy 
and protection of personal data is guaranteed by adhering to relevant national legislative 
provisions in both countries as well as relevant EU provisions, e.g. Directive 95/46/EC on 
the  protection  of  individuals  with  regard  to  the  processing  of  personal  data  and  on  the 
free  movement  of  such  data.  Additionally,  personal  data  protection  is  guaranteed  by 
securing  the  technical  platform  for  information  exchange,  which  the  data  protection 
provisions prescribe. 

Similarly,  whilst  implementing  Regulation  (EC)  No  883/2004,  the  insured  person’s 
personal  data  is  processed  in  accordance  with  the  Estonian  Data  Protection  Act.  There 
are certain restrictions concerning access to and the processing of personal data in EHIF. 

10 Belgian Official Journal of 22 February 1990. 

11 Belgian Official Journal of 18 March 1993. 

12 Belgian Official Journal of 30 July 1994. 

13  In  the  light  of  the  recent  BARA  judgment,  the  legal  status  of  such  bilateral  cooperation  agreements,  which 
even before said judgement according to some was unclear, has now become even more uncertain. The same 
goes  for  many  other  types  of  cooperation  involving  the  exchange  of  personal  information  discussed  in  the 
national reports, all of which were drafted before the Court of Justice's judgement in the BARA case. The impact 
of  said  judgement  should  be  subject  to  research  and  must  be  considered  as  a  new  item  for  next  year's 
questionnaire. 

53 

 
 
                                                 
Access to the information concerned is limited to specialists who are engaged in dealing 
with  e-forms  and  the  implementation  of  Regulation  (EC)  No  883/2004  and  only  insofar 
the data is effectively required in order to complete their tasks. 

To safeguard the protection of personal data, Finland – as has been done in Belgium – 
has  concluded  a  bilateral  agreement  with  Norway  and  Sweden  on  data  exchange 
management  according  to  Decision  117/82.  Insofar  the  exchange  of  information  is 
possible according to both countries’ legislation on data protection, an agreement can be 
made  on  it  between  two  or  more  countries.  The  provisions  in  Regulation  (EC)  No 
883/2004 (especially Article 76) also support the exchange of this information on a case-
by-case  basis  if  the  information  is  needed  when  implementing  the  Regulations  in 
practise. Furthermore, data matching in the pensions sector concerning the exchange of 
PINs  and  insurance  periods  is  directly  derived  from  Regulation  (EC)  No  987/2009. 
Additional provisions concerning the exchange have been agreed upon in the agreements 
with Sweden, Norway and Germany.  

In  Germany,  for  social  security  purposes,  §77  SGB  X  in  conjunction  with  Regulations 
(EC) No 883/2004 and No 987/2009 (or their respective predecessors) forms the general 
legal  basis  for  the  transmission  of  social  security  data  to  foreign  bodies.  Data  may  be 
transmitted only to the extent necessary to enable German social security institutions or 
foreign authorities to perform their statutory tasks, and provided that doing so does not 
contravene  the  principles  in  Article 6  TEU.  The  IT  security  objectives  of  the  German 
Social Security Code are very closely aligned with the security objectives of the EU Data 
Protection  Directive  (Article 17  of  Data  Protection  Directive  95/46/EC).  In  particular, 
electronic  data  transfer  occurs  using  SSL  encryption  and  –  provided  the  foreign 
institution has the technological capabilities – via the sTesta network. Wherever possible, 
data  to  be  exchanged  is,  additionally,  pgp  or  pkcs#7-encrypted.  It  need  be  noted, 
however, that the data protection rules under national law vary widely from one Member 
State to another. Lastly, for the purposes of the German child benefit under the Income 
Tax Act, §30 of the Fiscal Code (Tax secrecy) in conjunction with the Regulations forms 
the legal basis for the transmission of child benefit data to foreign institutions responsible 
for family benefits. Under this provision, child benefit data may only be disclosed if this 
serves  the  implementation  of  child  benefit  tax  procedures/proceedings,  if  it  is  expressly 
permitted by law, in cases of compelling public interest, or if the person concerned gives 
his or her consent. 

In Iceland data processing is protected by Act No 77/2000 on the Protection of Privacy.  

As  is  the  case  in  Germany,  in  Ireland  robust  procedures  and  practices  are  in  place  for 
the secure transmission of sensitive data to other bodies. One of the methods employed 
to safeguard the protection of personal data is via the encryption thereof.  

Italy  also  guarantees  privacy  rights  and  protects  data  by  reference  to  national  and 
international  legislation.  Claimants  are  informed  on  how  their  respective  data  will  be 
handled.  Furthermore,  data  exchange  is  solely  permitted  insofar  the  parties  have  given 
consent  for  such  exchange.  Lastly,  timely  notifications  are  obliged  in  case  of 
malfunctions, defects, or other irregularities pertaining to the confidentiality of data.  

In Latvia, privacy and the protection and security of personal data on a national level is 
guaranteed  according  to  the  Personal  Data  Protection  Law.  Furthermore,  there  are 
various  provisions  as  such  in  all  international  agreements  on  social  security  between 
Latvia  and  third  countries  (Australia,  Belarus,  Canada,  the  Russian  Federation  and 
Ukraine). Lastly, in the exchange of data between Latvia and Lithuania, it need be noted 
that the data is also encrypted – as is the case in Germany and Ireland.  

In  Lithuania,  the  protection  and  security  of  personal  data  within  the  context  of  social 
security  coordination  is  ensured  by  the  Law  on  Legal  Protection  of  Personal  Data.  In 
addition,  data  exchanges  are  subject  to  the  privacy  provisions  in  the  relevant  European 
instruments. Again, these same forms of protection are accorded in Norway, by the Act 

54 

 
of  14  April  2000  No  31  relating  to  the  processing  of  personal  data  (Personal  Data  Act), 
which implemented Directive 95/46/EC on the protection of individuals with regard to the 
processing  of  personal  data  and  on  the  free  movement  of  such  data.14  In  addition, 
section  7  of  the  Act  of  the  Norwegian  Labour  and  Welfare  Administration  regulates  the 
duty  of  confidentiality.  In  Poland,  data  processing  is  also  protected  by  detailed 
provisions, including the Personal Data Protection Act of 29 August 1997 (Journal of Laws 
of  2014,  item  1182  as  amended)  and  the  Classified  Information  Protection  Act  of  5 
August 2010 (Journal of Laws of 2010, No 182, item 1228 as amended), as well as the 
European relevant provisions.  

In  Malta  reference  is  made  to  the  bilateral  agreement  between  Malta  and  the  United 
Kingdom,  which  was  drafted  in  conformity  with  EU  Directive  95/46/EC  and  the  Data 
Protection Act.  

Data  processing  and  privacy  concerns  in  Portugal  are  dealt  with  by  the  National 
Personal  Data  Protection  Act  (Act  No  67/98),  which  lays  down  the  basic  and  general 
regulations in this respect.  

In  Croatia,  Romania  and  Slovakia  reference  is  made  to  the  national  acts  and 
instruments that govern the protection of data processing. Similarly, as concerns Spain 
two national acts are worth mentioning which govern the protection of data pursuant to 
data processing. Firstly, Article 66(1) of the General Law on Social Security provides that 
data obtained in connection with social security administration  must be confidential and 
must  not  be  given  or  communicated  to  third  parties,  except  as  permitted  by  the  Law. 
Secondly, Organic Law 15/1999 of 13 December 1999 on the Protection of Personal Data 
is  designed  to  guarantee  and  protect  –  in  the  area  of  the  handling  of  personal  data  – 
public  freedoms  and  the  fundamental  rights  of  natural  persons,  and  especially  their 
honour and personal and family privacy. 

4.3.  Assessing potential conflicts vis-à-vis privacy legislation15 

Mindful of the foregoing, a number of Member States (AT, BG, HR, CZ, EE, DE, HU, IS, 
IT, LV,  LT,  MT, NL,  NO, PT, RO,  SK, SE) have noted that no conflict  is considered to 
exist  in  view  of  the  coordination  rules  vis-à-vis  the  EU  privacy  and  data  protection 
legislation.  As  noted  by  Italy,  however,  the  necessary  cooperation  required  to  combat 
fraud  and  error  in  the  realm  of  social  security  coordination  does  flirt  with  potential 
privacy concerns. Consequently, it is not inconceivable that several other Member States 
(BE, DK, FI, EL, IE, PL, ES) make note of the fact that issues as such may in fact arise 
due to the discrepancies between the two fields of legislation. Iceland notes that privacy 
legislation  hinders  the  cooperation  between  competent  authorities,  thus  taking  into 
consideration  the  opposing  perspective  not  focused  on  the  privacy  concerns  of  the 
claimant.  

apply 

protection 

In  Belgium  for  example,  the  competent  institutions  in  the  field  of  unemployment 
insurance  consider  it  to  be  a  concern.  If,  depending  on  the  administrative  and 
judicial/criminal nature of the investigation,  various European provisions on privacy and 
competent 
data 
institutions/authorities,  the  investigators  in  the  field  find  themselves  in  a  difficult 
position.  Whilst  the  investigation  may  be  criminal  in  nature  (but  only  in  the  requesting 
Member  State),  a  request  for  cooperation  is  frequently  confined  to  an  administrative 
request  to  the  competent  administration  in  the  Member  State  to  which  the  request  is 
directed.  The  competent  foreign  administrations  may  also  be  forced  to  comply  with 
stricter  national  regulations  on  privacy  because  they  do  not  have  investigatory  powers 

inspection 

services 

and 

the 

the 

to 

14 OJ L 281, 23.11.1995, p. 31–50. 

15 As mentioned before, the national reports were received before the BARA judgement and said judgement has 
not been taken into account during the writing of this report. 

55 

 
 
                                                 
and,  most  of  the  time,  depend  on  sincere  cooperation  on  the  part  of  the  public  and 
employers. Concerning family benefits, the competent institution (FAMIFED) emphasises 
that when domestic Belgian legislation on privacy is so strict as to make it necessary to 
obtain an explicit authorisation for the communication of personal data to a third party, 
there is in fact a conflict.  

Denmark considers the need for a system of safe communication between the Member 
States to be the most substantial challenge in relation to EU privacy and data protection 
provisions and cross-border cooperation and information exchange. It is hoped that this 
problem will be solved with the implementation of the EESSI system. Within this context, 
Finland  and  Greece  note  that  one  of  the  problems  with  cross-border  cooperation  and 
information exchange is that the Regulations on the coordination of social security do not 
contain provisions on data matching. Ireland, Poland and Spain echo these concerns.  

Within  this  context,  the  majority  of  Member  States  (DK,  EE,  DE,  EL,  LV,  LT,  NO,  PL, 
RO, SK, ES) have yet to put forward suggestions to resolve said issues. Belgium on the 
other hand notes that concerning unemployment insurance, the social inspection services 
indicate  that  a  system  enabling  cross-border  information  exchange  between  inspection 
services could be set up to cover all cross-border exchange of information relating to the 
rules on coordination and in particular those on determining the applicable legislation. As 
regards  family  benefits,  the  competent  institution  (FAMIFED)  notes  that  it  might  be  a 
solution  to  clarify  the  authorisation  system.  Finland  furthermore  specifies  that  specific 
provisions taking account of the importance of cross-border cooperation and information 
exchange could provide a sound legal basis for the institutions in questions to rely on. In 
addition, attempts should be made to draft provisions on a European level to govern data 
matching.  Lastly,  Ireland  notes  that  financial  service  providers  and  public  sector 
investigative  agencies  who  are  currently  working  to  prevent  fraud  and  reduce  fraud 
losses could jointly share specific data from a financial and crime prevention perspective, 
which is currently restricted under the existing data protection legislation. 

Belgium  notes  that  regarding  the  applicable  legislation  the  social  inspection  services 
indicate  that  a  system  enabling  cross-border  information  exchange  between  inspection 
services could be set up to cover all cross-border exchanges of information relating to the 
rules on coordination and in particular those on determining the applicable legislation. As 
regards  family  benefits,  the  competent  institution  (FAMIFED)  notes  that  it  might  be  a 
solution  to  clarify  the  authorisation  system.  Finland  notes  that  specific  provisions  that 
would  take  into  account  the  importance  of  cross-border  cooperation  and  information 
exchange  would  provide  a  sound  legal  basis  for  the  institutions  in  questions  to  rely  on. 
Moreover, Finland notes that the provisions on a European level for data matching would 
prove  beneficial  in  combating  fraud  and  error.  Ireland  notes  that  financial  service 
providers  and  public  sector  investigative  agencies  who  are  currently  working  to  prevent 
fraud and reduce fraud losses should jointly share specific data from a financial and crime 
prevention  perspective,  which  is  currently  restricted  under  the  existing  data  protection 
legislation, in an attempt to enhance the fight against fraud and error in the field of social 
security coordination. Finally, the Netherlands notes that any issues that may arise with 
respect to data protection whilst implementing the coordination rules may be prevented 
or resolved by (increased) use of bilateral agreements.16  

Data exchange and Data Protection 

Member States 

Not perceived as conflicting 

AT, BG, HR, CZ, EE, DE, HU, IS, IT, LV, LT, MT, NL, 
NO, PT, RO, SK, SE 

16 Whether or not this is correct remains subject of debate for various reasons. It is clear from this report that 
the  number  and  variety  of  bilateral  agreements  regarding  the  exchange  of  personal  data  in  the  field  of  social 
security pose problems in the light of ground principles of the applicable rules and regulations regarding privacy 
and data protection (e.g. the principle of foreseeability and more specifically the criterion of purpose limitation). 

56 

 
                                                 
Perceived as conflicting 

BE, DK, FI, EL, IS, IE, PL, ES 

57 

 
 
 
 
5.  CONCLUSION  

Similarly  to  last  years’  findings,  the  Member States  have reported  a diverse  plethora of 
measures undertaken – with varying intensity - in order to combat fraud and error within 
the  respective  territories.  Notwithstanding  these  discrepancies  and  differences  amongst 
Member  States  as  concerns  fraud  and  error  however,  these  measures  are  nevertheless 
demonstrative  of  the  continued  willingness  of  the  respective  States  to  combat  these 
practices, as was the case in 2014.17 Mindful of the foregoing, the following conclusions 
can be drawn.  

The  different  approaches  undertaken  by  various  Member States  in  combating  fraud  and 
error  may  –  in  part  –  be  attributed  to  the  fact  that  the  sources  delineating  what 
constitutes  fraud  and  error  in  social  security  coordination  vary  significantly  across 
Member  States.  Whilst  in  some  Member  States  such  definitions  are  tailored  to  specific 
social  security  branches,  other  Member  States  make  use  of  generally  applicable 
administrative  and  criminal  law  for  the  determination  thereof.  Not  inconceivably,  this 
entails that certain Member States are more focused and aware of the specificity of fraud 
and  error  in  social  security  coordination,  whilst  others  are  possibly  less  confronted  with 
such issues, as a result of which less focus is given thereto. Consequently, this could also 
affect the intensity with which fraud and error are dealt with.  

As concerns the prevalence of fraud and error as two conceptually distinct phenomena a 
number  of  observations  are  in  order.  The  entirety  of  the  Member  State  reports  were 
telling  in  this  respect  –  the  data  concerning  the  prevalence  of  fraud  and  error  is 
extremely  fragmented  and  inconclusive.  Due  to  the  unsystematic  approach  to  data 
collection  amongst  Member  States,  no  pertinent  and  conclusive  comparisons  can  be 
made.  It  suffices  to  note  in  this  respect,  that  certain  Member  States  have  collected 
substantial  data  in  the  field  of  family  benefits,  whilst  others  have  collected  data  with 
respect to unemployment benefits. As previously indicated, the unsystematic approach to 
data  collection  in  this  field  may  be  attributed  to  a  number  of  factors.  This  includes, 
amongst  others,  the  fact  that  various  authorities  are  competent  for  varying  social 
security  branches  –  whilst  some  of  such  authorities  may  find  it  useful  to  collect  such 
data,  others  simply  do  not.  Moreover,  as  indicated  on  a  number  of  occasions,  certain 
Member  States  simply  do  not  make  the  distinction  between  fraud  and  error  as  two 
distinct  concepts,  whilst  others  do  not  collect  data  with  respect  to  social  security  fraud 
and  error  exclusively  in  relation  to  coordination  matters.  Due  to  these  obstacles  in  the 
field  of  data  collection,  it  is  extremely  difficult  to  make  telling  comparisons  concerning 
the  prevalence  fraud  and  error  in  this  particular  field  across  Member  States,  which 
furthermore renders it difficult to assess the magnitude of the phenomena.  

Notwithstanding the ambiguity as to the prevalence of fraud and error in social security 
coordination,  Member  States  have  nevertheless  become  increasingly  aware  of  the 
potential thereof and thus have taken to initiatives – similarly to last year - aimed at both 
preventing and curbing fraud and error in social security.  It need be noted however, that 
these  initiatives  are  not  limited  to  a  national  context  only,  and  thus  are  also  aimed  at 
fraud  and  error  in  a  cross-border  context.  Within  this  context,  three  large  trends  are 
ascertainable  in  conjunction  with  Member  State-specific  initiatives.  Firstly,  an  increased 
use of data exchange, data matching and data mining is noticeable. In addition thereto, 
much focus has been shifted to the combatting of fraud and particularly error in the field 
of  pensions  and  the  exchange  of  mortality  information.  Finally,  increased  use  is  being 
made of bilateral agreements – indicated as a recommendation in last years’ findings.  

17 Dismayingly, it need be noted that these findings can however, only be compared to foregoing studies in a 
highly limited manner, as the focal points of foregoing studies do not necessarily correspond with the focal point 
of the current report.  

58 

 
 
 
 
 
                                                 
Notwithstanding  the  undertaken  national  initiatives  however,  the  application  of  the 
coordination  provisions  remains  somewhat  problematic.  In  particular,  a  number  of 
overarching  and  persistent  issues  have  been  identified  by  the  national  Member  State 
reports.  These  issues  include,  amongst  others,  and  not  in  the  least,  the  lack  of 
information  exchange  between  authorities  on  a  national  and  on  an  international  scale. 
This is further aggravated by the lacking awareness of rights and obligations in a cross-
border  context  from  the  perspective  of  employers  as  well  as  benefit  claimants.  Lastly, 
note  has  been  made  of  the  increasing  difficulty  concerning  the  determination  of 
residence, which has been facilitated by increasingly mobile citizens. In countering these 
particular  issues,  three  types  of  initiatives  have  been  identified,  in  addition  to  other 
Member  State  specific  arrangement:  awareness  raising  of  the  claimant,  awareness 
raising of the providers and bilateral agreements.  

Finally,  as  concerns  the  recourse  to  increased  data  exchange  as  a  requisite  means  to 
combat fraud and error, mention need be made of the data protection concerns that may 
arise  as  a  result  thereof.  The  majority  of  Member  States  concerned  are  of  the  opinion 
that  the  current  frameworks  governing  the  exchange  of  information  as  a  means  to 
combat  fraud  and  error  in  the  field  of  social  security  coordination,  are  sufficiently 
protective and in conformity with applicable data protection legislation. However, if this is 
correct  remains  subject  of  debate  and  further  research  on  this  topic  is  highly 
recommended since more and more personal information is exchanged between different 
actors in different Member States and more and more cases depend on said cross-border 
and often interdisciplinary exchange of information.18 

In view of the foregoing, it appears that one of the most fundamental steps that needs to 
be taken, concerns the facilitating of inter and intra-state information exchange with due 
regard for data protection concerns. As indicated at the beginning of the report, the lack 
of  cooperation  in  this  respect  singlehandedly  functions  as  a  gateway  to  a  number  of 
issues  amongst  Member  States  in  the  field  of  social  security  coordination,  including 
amongst others, double insurance, erroneous payments of pensions and lacking certainty 
as  concerns  residency.    Consequently,  this  appears  to  be  a  requisite  first  step  in  any 
further action concerning fraud and error in the context of social security coordination. In 
this  respect,  the  United  Kingdom  is  of  the  opinion  that  "EESSI  has  the  potential  to 
significantly  improve  the  flow  of  data  exchanges,  to  the  great  advantage  of  the  fight 
against fraud and error".  

18 The foregoing is even more pertinent after the recent judgement of the Court of Justice on a case of national 
multidisciplinary exchange of information (cfr. C-201/14, Bara and Others, 1 October 2015, not yet published). 

59 

 
 
 
 
 
 
  
 
                                                 
ANNEX 

Czech Republic  

Fraud 

Error 

Define main types 
of fraud 

No of 
cases 

Amount 
involved 
(in €) 

Result 

Amount 
recovered 
(in €) 

Define main 
types of error 

No of 
cases* 

Amount 
involved** (in 
€***) 

Result 

Amount 
recovered 
(in €)**** 

Determination of 
the applicable 
legislation (e.g. 
posting of 
workers) 

Determination of 
the country of 
residence 

Sickness benefits 
in kind 

the 

basis 

Providing  of  health 
care  by  the  foreign 
health  care  provider 
of 
on 
officially  valid  EHIC 
although  the  person 
is no longer insured in 
the  MS  which  issued 
(non-
EHIC 
such 
returning 
of  EHIC 
after  termination  of 
health insurance) 

956 

1,060,620 

Invalidity benefits 

falsification of medical 
results 
examination 
by    invalidity  benefits 
claimants 
or 
beneficiaries 

60 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Old-age benefits 

cases 
undue 
of 
pension  payments  as 
a  result  of  death  of 
the  pensioner,  not 
necessarily  fraudulent 
act 

Survivors' benefits 

Benefits in respect 
of accidents at 
work and 
occupational 
diseases 

Death grants 

Unemployment 
benefits 

report 

Occasional  cases  of 
on 
overpayments 
widow´s 
or 
widower´s  pensions 
as  a  result  of  failure 
to 
new 
marriage.  Results  in 
reimbursement, 
recovery 
the 
overpayment,  more 
grave  cases  may  lead 
to 
criminal 
prosecution. 
Overpayments 
survivors´pensions 
may  be  connected  to 
a failure to report end 
of studies. 

on 

of 

1 

3,432.24 

pending 

1  case,  where  a 
widow´s  pension 
was  granted  on 
grounds 
of 
erroneous 
in  
information 
for  a 
E203  UK 
from 
period 
25.7.2010 
until 
24.7.2011  instead 
of from 25.7.2011 
until 24.7.2012 

1 

The overpayment 
may  be  set  off 
against 
due 
pension 
payments 

a client did not inform 
on  the  beginning  of 
employment 

foreign 

a 
institution 
confirmed  by  mistake 
continuing 
of 
registration of a client 
with 
exported 
benefits from CZ 

overpayment 

16 

8,641 

overpayment 

1 

51 

61 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pre-retirement 
benefits 

Family benefits 

34 

104 

Non-declaration of 
the change in MS of 
residence 

Non  declaration  of 
gainful 
in 
another MS 

activity 

Another fraud without 
statistical  data:  non-
declaration 
of 
termination  of  gainful 
activity  in  the  Czech 
gainful 
Republic; 
activity 
family 
of 
members  in  another 
MS (non-declaration) 

146,907.14 

62,756.83 

62 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fraud 

Error 

Define main 
types of fraud 

No of 
cases 

Amount 
involved 
(in €) 

Result 

Amount 
recovered 
(in €) 

Define main 
types of error 

No of 
cases* 

Amount 
involved** (in 
€***) 

Result 

Amount 
recovered 
(in €)**** 

Denmark19 

Determination of 
the applicable 
legislation (e.g. 
posting of workers) 

Determination of 
the country of 
residence 

Sickness benefits in 
cash 

Omission to give 
information about 
work / holiday 

Maternity benefits 

Invalidity benefits: 

Income / 
residence/ marital 
status 

42 

Misconduct on the 
part  of  the  citizen 
or the authority to 
information 
give 
/ 
about  work 
holiday 

184,122 

- Anticipatory pension   

481 

3507148 

19  Please  note  that  the  data  does  not  specifically  and  exclusively  illustrate  cases  of  fraud  and  error  in  relation  to  coordination  of  social  security  under  Regulat ion  (EC)  No 
883/2004, as these cases are not registered separately. Note, moreover, that cases of fraud and cases of error are gene rally not registered separately. The requested data is 
registered in the appendix under “fraud”, but may constitute cases of error as well. It is, lastly, not possible to provide d ata on each type of error specifically. 

63 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                 
2-5 cases 
each year 
(*note 
that these 
numbers 
also 
includes 
cases of 
survivors' 
benefits 
and death 
grants, 
but that 
distinction 
is not 
possible) 

- Pension for civil 
servants 

Late notification 
of deceased 
claimants 

Old-age benefits: 

- Old-age pension 

Income / 
residence/ marital 
status 

- Pension for 
claimants residing 
outside of Denmark 

Income / 
residence/ marital 
status 

607 

56 

- Danish Labour 
Market 
supplementary 
pension (ATP) 

- Pension for civil 
servants 

Survivors' benefits: 

- Danish Labour 
Market 
supplementary 
pension (ATP) 

- Pension for civil 
servants 

6,078,144 

369,850 

Late  notification 
of 
deceased 
claimants  

64 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Applicable law 

3 

Benefits in respect 
of accidents at 
work and 
occupational 
diseases: 

- Workers’ 
Compensation 

Death grants: 

- Danish Labour 
Market 
supplementary 
pension (ATP) 

- Pension for civil 
servants 

Unemployment 
benefits: 

- Unemployment 
insurance benefits 

Omission to give 
information about 
work / holiday / 
availability 

Pre-retirement 
benefits 

- Voluntary early 
retirement pay 
scheme 

Family benefits: 

Omission to give 
information about 
work / holiday / 
availability 

Total 
amount 
Unimploym
ent 
benefits: 
2.361,1 mill 

Total 
amount 
Pre-
retirement 
benefit: 
2.160,0 mill 

3,7 mill 

Misconduct on the 
part  of  the  citizen 
or the authority to 
information 
give 
/ 
about  work 
/ 
holiday 
availability +  

Total amount 
Unimployment 
benefits: 
2.361,1 mill 

9,5 mill 

0,4 mill 

Misconduct on the 
part  of  the  citizen 
or the authority to 
information 
give 
/ 
about  work 
holiday 
/ 
availability 

NA 

Total amount 
Pre-retirement 
benefit: 
2.160,0 mill 

3,9 mill 

65 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
 
 
  
 
 
 
 
 
- Family benefits 

- Children benefits for 
single parents 

Residence/ marital 
status 

Income / 
residence/ marital 
status 

856 

241 

877,447 

543,697 

66 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fraud 

Define main 
types of fraud 

No of 
cases 

Amount 
involved 
(in €) 

Result 

Amount 
recovered 
(in €) 

Define main 
types of error 

No of 
cases* 

Error 

Amount 
involved** (in 
€***) 

Result 

Amount 
recovered 

inappropriate use 
of a valid EHIC 

42 

€ 
16,663.61 

5 cases 
are 
brought 
to court 

In some 
cases EHIF 
has entered 
into 
extrajudicial  
voluntary 
agreements 
for payment 
by 
instalments 

Estonia 

Determination of 
the applicable 
legislation (e.g. 
posting of 
workers) 

Determination of 
the country of 
residence 

Sickness benefits 

Maternity and 
equivalent 
paternity benefits 

Invalidity 
benefits 

Old-age benefits 

Survivors' 
benefits 

Benefits in 
respect of 
accidents at work 

67 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
and occupational 
diseases 

Death grants 

Unemployment 
benefits 

Pre-retirement 
benefits 

Family benefits 

68 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Germany 

Define main 
types of fraud 

No of 
cases 

Fraud 

Amount 
involved 
(in €) 

Determination of 
the applicable 
legislation (e.g. 
posting of 
workers) 

contract of 
employment 
concluded under 
the wrong 
legislation 
(Maltese-Cyprian) 

1 

n/a 

Amount 
recovered 
(in €) 

n/a 

Result 

invalid 
contract with 
regard to 
Social Security 
provisions 

Define main 
types of error 

No of 
cases* 

Error 

Amount 
involved** 
(in €***) 

Result 

Amount 
recovered 

Determination of 
the country of 
residence 

Sickness benefits 

Maternity and 
equivalent 
paternity 
benefits 

Invalidity 
benefits 

Old-age benefits 

Survivors' 
benefits 

Benefits in 
respect of 
accidents at 
work and 
occupational 
diseases 

Decline of request 
on reimbursement 
of medical 
treatment costs 
paid by the 
German Social 
Accident Insurance 
Scheme in the 
event of A1 form 
issued 
retroactively by 

1 

35.998,23 
EUR 

0 EUR 

No 
reimbursement 
whatsoever by 
the Polish 
scheme 

n/a 
(several) 

more tens of 
thousands of 
EUR 

not enough 
and/or proper 
awareness on 
the side of the 
competent 
Cyprian social 
security 
authorities 
concerned 

69 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
the Polish 
competent 
authority 

Death grants 

Unemployment 
benefits 

Pre-retirement 
benefits 

Family benefits 

70 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hungary 

Define main types 
of fraud 

No of cases 

Fraud 

Amount 
involved 
(in €) 

Result 

approximatel
y 100 

No data. 

withdrawal 
of A1 
certificates 

false  declaration  on 
activity; 
substantial 
no substantial activity 
during 
posting; 
difference  in  working 
hours  of  the  posted 
person in the State of 
activity 
in 
Hungary;  

and 

Determination 
of the 
applicable 
legislation 
(e.g. posting 
of workers) 

Determination 
of the country 
of residence 

Define main 
types of error 

No of 
cases* 

Error 

Amount 
involved
** (in 
€***) 

Result 

Amount 
recover
ed 

Amount 
recovered 
(in €) 

No data. 

Use of invalid EHIC 

Sickness 
benefits 

Maternity and 
equivalent 
paternity 
benefits 

Invalidity 
benefits 

Old-age 
benefits 

The 
criminal 

concept 

fraud 

of 
is 

In  2014,  the 
National 

The 
total 
amount  of 

Unfortunatel
y  we  have 

Unfortunatel
y  we  have 

In  the  case  of 
one 
error, 

No data. 

lack of application 
of Article 11 of 
Regulation 
987/2009 - 
residence is 
determined 
according to 
national law in 
proceedings 
initiated for issuing 
S1 document 

certificates 
incapacity 
work 
accepted 

are 

of 
for 
not 

No data. 

No data.  Decision 

is 
annulled  and 
is 
residence 
determined 
according 
coordination 
regulations 

to 

Certificate  will 
be 
accepted 
and  the  cash 
benefit  will  be 
disbursed 

71 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
of 

Pensions 
Directorate 
reported  353 
cases 
concerning 
the  benefits 
its 
under 
jurisdiction. 
157  of  these 
involved 
forgery 
official 
documents, 
while 
majority 
the 
remaining 
196 
comprised 
misuse 
payment 
fraud 
cards, 
or  failure  to 
comply  with 
notification 
obligations.  

the 
of 

of 

in 

to 

as 

Below 

defined 
the 
Criminal  Code  in  the 
following  terms:  'Any 
person  who,  for  the 
purpose  of  unlawful 
deliberately 
gain, 
another 
induces 
person 
to  hold  or 
continue  to  hold  a 
and 
false 
belief 
thereby 
causes 
damage,  is  guilty  of 
a 
fraud.' 
legally 
certain 
stipulated 
threshold, 
this  is  not  classed  as 
a  criminal  offence, 
but 
a 
misdemeanour.  The 
provisions  governing 
delay 
default 
or 
the 
attributable 
claimant 
laid 
down  in  the  Taxation 
Act.  In  this  case  the 
institution  presumes 
and 
negligence, 
objective  grounds  for 
exemption 
and 
deadlines  have  been 
included  in  the  social 
legislation. 
security 
Fines,  compensation 
for 
and 
damages 
imprisonment  are  all 
possible 
consequences 
of 
criminal  fraud.  In  the 
case  of  error,  one 
possibility  is  to  make 
good  omissions,  but 
fines  may  also  be 
for 
imposed 
or 
negligence, 
costs 
procedural 

are 

no  means  of 
breaking 
down 
figure. 

this 

no  means  of 
breaking 
down 
figure. 

this 

the 

damage 
arising 
from 
old-age 
benefit 
cases 
reported 
was 
HUF 242 6
76 243.  

is 

to 
possibility 
good 
make 
omissions, 
but 
fines  may  also  be 
for 
imposed 
negligence, 
or 
procedural  costs 
recovered. 
Another 
legal 
consequence  may 
be  an  order  to 
the 
reinstate 
situation 
lawful 
existing 
before 
the 
error  was 
committed. 

72 

 
recovered. 
Another 
consequence 
legal 
may  be  an  order  to 
lawful 
reinstate  the 
situation 
existing 
before  the  error  was 
committed. 

The 
national 
definition  of  fraud  is 
laid  down  in  Act  C  of 
2012  on  the  Criminal 
Code.  In  2014,  no 
criminal charges were 
brought  under 
that 
the 
in 
definition 
counties  in  respect  of 
unemployment 
benefit 
without entitlement.  

received 

In  2014,  no 
criminal 
charges 
were 
brought 
in 
the  counties 
in  respect  of 
unemployme
nt 
benefit 
received 
without 
entitlement.  

Survivors' 
benefits 

Benefits in 
respect of 
accidents at 
work and 
occupational 
diseases 

Death grants 

Unemploymen
t benefits 

Pre-
retirement 
benefits 

"failure to notify a 
gainful activity 

the 

In  2014, 
no 
criminal 
charges 
were 
brought 
in 
counties 
in 
respect 
of 
unemplo
yment 
benefit 
received 
without 
entitleme
nt.  

The  national 
definition  of 
fraud  is  laid 
down  in  Act 
C of 2012 on 
the  Criminal 
In 
Code. 
no 
2014, 
criminal 
charges 
were 
brought 
that 
under 
definition 
in 
the  counties 
in  respect  of 
unemployme
benefit 
nt 
received 
without 
entitlement.  

73 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Family 
benefits 

Acquiring 
family 
unlawfully 
benefit 
through  deliberately 
misleading, 
or 
keeping  under  a  false 
apprehension, 
the 
body  evaluating  the 
claim.  

of 

"There  have 
no 
been 
actual 
or 
suspected 
cases 
criminal 
as 
fraud 
defined 
in 
the  Criminal 
Code,  so  no 
prosecutions 
been 
have 
brought.  The 
number 
of 
undue 
payments 
made  due  to 
failure 
to 
comply  with 
notification 
obligations 
not 
did 
exceed  1% 
of  all  cases.  
A  number  of 
administrativ
e  procedures 
for 
repayment 
have 
been 
initiated  due 
to  failure  to 
meet 
notification 
obligations. 
The  most 
frequent 
reasons 
these are:  

for 

Acquiring 
family 
benefit  unlawfully 
through 
deliberately 
misleading, 
or 
keeping  under  a 
false 
apprehension,  the 
body 
evaluating 
the claim.  

74 

 
 
 
 
 
 
 
 
 
 
Fraud 

Define main 
types of fraud 

No of 
cases 

Amount 
involved 
(in €) 

Result 

Amount 
recovered 
(in €) 

Define main 
types of error 

No of 
cases* 

Error 

Amount 
involved** (in 
€***) 

Result 

Amount 
recovered 

195 

72885 

No information 

The part of 
the amount 
has been 
recovered 

Inappropriate use 
of a valid EHIC by 
a person who was 
no longer insured 
as well as cases 
when care was 
provided on the 
basis of the EHIC 
before the 
holder`s 
entitlement to the 
health insurance. 

Lithuania 

Determination of 
the applicable 
legislation (e.g. 
posting of 
workers) 

Determination of 
the country of 
residence 

Sickness benefits 

Maternity and 
equivalent 
paternity 
benefits 

Invalidity 
benefits 

Old-age benefits 

False IDC 

Concealed info 
about pension 

1 

1 

76.37 

75 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
False certificate 

1 

Survivors' 
benefits 

Benefits in 
respect of 
accidents at work 
and occupational 
diseases 

Death grants 

Unemployment 
benefits 

Pre-retirement 
benefits 

Family benefits 

76 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The Netherlands 

Fraud 

Error 

Define main types 
of fraud 

No of 
cases 

Amount 
involved 
(in €) 

Result 

Amount 
recovered 
(in €) 

Define main 
types of error 

No of 
cases* 

Amount 
involved** (in 
€***) 

Result 

Amount 
recovered 
(in €)**** 

Determination of 
the applicable 
legislation (e.g. 
posting of 
workers) 

Determination of 
the country of 
residence 

Sickness benefits 
in cash 

Lack of substantial 
activities of posting 
company 

Lack of previous 
insurance of posted 
worker 

Exceeding maximum 
posting period 

Posting certificate 
not authentic 

698 

warnings or no 
financial loss 
('error') 

administrative fines 

1,113 

1,008,000 
(= fines) 

3,504,000 
(= total loss) 

criminal prosecution 

57 

Maternity and 
equivalent 
paternity benefits 

Invalidity benefits 

warnings or no 
financial loss 
('error') 

172 

3,654 

77 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
administrative fines 
(incl. TW 
(allowance)) 

5,734 

9,664,000 
(= fines) 

21,608,000 
(= total loss) 

criminal prosecution 

111 

Withholding 
information on 
income 

Withholding 
information on living 
together 

Beneficiary deceased 

Other 

Total 

Withholding 
information on 
income 

Withholding 
information on living 
together 

212 

892,547 

591 

1,447,813 

42 

54 

25,753 

254,667 

899 

2,620,780 

38 

107,553 

69 

824,251 

 Being alive 

 Other 

Total 

2 

18 

24 

74,467 

127 

1,006,296 

Old-age benefits 

Survivors' benefits 

Benefits in respect 
of accidents at 
work and 
occupational 
diseases 

Death grants 

Unemployment 
benefits 

78 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
warnings or no 
financial loss 
('error') 

Pre-retirement 
benefits 

administrative fines 

43,385 

44,612,000 
(= fines) 

63,088,000 
(= total loss) 

5,339 

Family benefits 

criminal prosecution 

108 

Withholding 
information on 
income child 

Insufficient financial 
support of child 

Lack of qualifying 
education condition 
of child 

529 

215,696 

92 

74,732 

284 

87,323 

Beneficiary deceased 

2 

1,424 

Withholding 
information on living 
situation 

Withholding 
information on 
change of address 

210 

166,922 

177 

142,839 

Not insured 

534 

417,608 

Lack of guardianship 
of child 

 Self disadvantage 

1 

3 

233 

2,213 

 Other 

Total 

26 

22,312 

1,858 

1,131,303 

79 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Norway 

Determination of 
the applicable 
legislation (e.g. 
posting of 
workers) 

Determination of 
the country of 
residence 

Sickness benefits 

Maternity and 
equivalent 
paternity benefits 

Fraud 

Error 

Define main types 
of fraud 

No of 
cases 

Amount 
involved 
(in €) 

Result 

Amount 
recovered 
(in €) 

Define main 
types of error 

No of 
cases* 

Amount 
involved** (in 
€***) 

Result 

Amount 
recovered 
(in €)**** 

recipients 
to 
Due 
abroad 
residing 
contradicting 
the 
terms  for  receiving 
benefits 

Claiming  benefit  and 
earning  an  income 
incompatible 
with 
terms, 
the 
illegitimate 
residence 
abroad, 
the  basis  of  benefit 
incompatible 
with 
previous income 

Claiming  benefit  and 
earning  an  income 
incompatible 
with 
the terms,  the basis 
benefit 
of 
incompatible 
with 
previous income 

No data 

No data 

No data 

No data 

No data 

No data 

109 

2,778.481 

3,912 

12,705.386 

11,596.835 

11 

240,492 

1,839 

5,597.825 

4,102.880 

80 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Invalidity benefits 

Old-age benefits 

Survivors' benefits 

Benefits in respect 
of accidents at 
work and 
occupational 
diseases 

Death grants 

Unemployment 
benefits 

Pre-retirement 
benefits 

Family benefits 

Claiming  benefit  and 
earning  an  income 
incompatible 
with 
the 
terms, 
illegitimate 
residence 
abroad, 
the  basis  of  benefit 
incompatible 
with 
previous income 

Claiming  benefit  and 
earning  an  income 
incompatible 
with 
the 
terms, 
illegitimate 
abroad, 
residence 
the  basis  of  benefit 
incompatible 
with 
previous income 

Illegitimate 
residence 
abroad, 
living  with  the  other 
parent,  not  meeting 
legal  conditions  for 
activity 

36 

2,673.234 

13,410 

56,727.730 

28,347.260 

81,165 

17,119 

991 

24,023.877 

10,190 

67,098.786 

58,058.395 

114 

2,473.544 

14,157 

30,976.379 

23,905.476 

81 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fraud 

Error 

Define main 
types of fraud 

No of 
cases 

Amount 
involved 
(in €) 

Result 

Amount 
recovered 
(in €) 

Define main 
types of error 

No of 
cases* 

Amount 
involved(in €) 

Result 

Amount 
recovered 

748044,96 

26310,37 

Poland 

Determination of 
the applicable 
legislation (e.g. 
posting of 
workers) 

Determination of 
the country of 
residence 

Sickness benefits 

Maternity and 
equivalent 
paternity 
benefits 

Invalidity 
benefits 

Old-age benefits 

Survivors' 
benefits 

Benefits in 
respect of 
accidents at work 
and occupational 
diseases 

Death grants 

82 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Unemployment 
benefits 

Lack of/wrong 
information about 
employment in 
another Member 
State ; SED's on 
Export 

28 

3475 

1185 

16 

1100 

715 

The person 
informed the 
competent 
institution about 
wrong dates of 
employment in 
another MS ; the 
assisting 
institution 
informed the 
competent 
institution too late 
(via SED U010) 
about taking up 
employment in 
another MS 

Pre-retirement 
benefits 

Family benefits 

Lack of/wrong 
information about 
family situation 

8947 

2.703.071 

83 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fraud 

Error 

Define main 
types of fraud 

No of 
cases 

Amount 
involved 
(in €) 

Result 

Amount 
recovered 
(in €) 

Define main 
types of error 

No of 
cases* 

Amount 
involved(in €) 

Result 

Amount 
recovered 

Art. 58 Reg. 
883/2004 

More 
than 
2000 

More 
than 
5000 

Spain 

Determination of 
the applicable 
legislation (e.g. 
posting of 
workers) 

Determination of 
the country of 
residence 

Sickness benefits 

Maternity and 
equivalent 
paternity 
benefits 

Invalidity 
benefits 

Old-age benefits 

Survivors' 
benefits 

Benefits in 
respect of 
accidents at work 
and occupational 
diseases 

84 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Death grants 

Unemployment 
benefits 

Pre-retirement 
benefits 

Family benefits 

85 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ANNEX 2 

Overview Sanctioning Fraud: Austria 

Legal provision 

Title 

Penalty 

§ 153c StGB20 

§ 153c StGB 

Non-payment of 
employees' social security 
contributions 

Imprisonment of up to 2 
years 

Basic penalty of up to 3 
years; qualified penalty 
of 6 months to 5 years 

Fraudulent non-payment 
of social security 
contributions and 
supplements pursuant to 
the Act on leave and 
severance pay for 
construction workers 

§ 153e StGB 

Organised undeclared 
work 

Imprisonment of up to 
two years 

§ 146 StGB 

Fraud 

Imprisonment of up to 6 
months or a fine of up to 
360 daily amounts 

§ 147 StGB 

Serious fraud 

Imprisonment of up to 3 
years; qualified penalty: 
imprisonment of 1 to 10 
years 

Scope of practical 
application 

Evasion of employees' 
social security 
contributions by an 
employer 

Evasion of social security 
contributions, if the 
employees are registered 
with social security and 
the intention at the date 
of registration was to 
underpay the 
contributions; in practice 
usually applies to the 
registration of employees 
of a front company 

Placing, providing, 
recruiting or employing 
illegal workers (i.e. 
employed workers not 
registered with social 
security or self-employed 
workers without the 
necessary business 
licence); active 
involvement in the 
operation of a large group 
of illegal workers 

Causing financial loss 
through deception; 
applicable to contribution 
evasion through 
deception and to 
intentionally fraudulent 
claiming of social security 
benefits 

As above under § 146 
StGB; mainly applicable 
to cases of falsification or 
if the damage exceeds 
€3,000; application of the 
maximum penalty if the 
damage exceeds 
€50,000. 

20 Austrian Criminal Code (Strafgesetzbuch). 

86 

 
 
 
 
 
                                                 
Overview Sanctioning Fraud: Belgium21  

Imprisonment 

Criminal fine* 

Administrative fine* 

Level 1 penalty 

Level 2 penalty 

Level 3 penalty 

Level 4 penalty 

€55 to €550 

either  a  criminal 
between 
€2,750 

€275 

fine 
and 

or  an  administrative  fine 
between  €137.50  and 
€1,375 

either  a  criminal 
between 
€5,550 

€550 

fine 
and 

or  an  administrative  fine 
between €275 and €2,750 

either 
imprisonment 
between  six  months  and 
three years 

and/or  a  criminal 
fine 
between  €3,300  and  € 
33,000 

or  an  administrative  fine 
and 
between 
€16,500 

€1,650 

21 The introduction of the Social Criminal Code in Belgian legislation can be called a best practice. Before its 
introduction,  sanctions  were  scattered  throughout  the  various  acts  and  regulations  that  constitute  Belgian 
social law. Moreover, as a the result of various legislative intiatives throughout the years and the lack of any 
coordination  whatsoever,  the  levels  of  sanctions  varied without any  meaningful  logic. The  Belgian  Social 
Criminal  Code  coordinates  all  infringements,  harmonizes  the  levels  of  sanctions  and  decriminalises  the 
infringements  punished  by  a  level  1  sanction,  which  is  since  then  purely  administrative.  Furthermore,  the 
Belgian Social Criminal Code clarifies the relation between the criminal and administrative enforcement of 
infringements  as  well  as  the  relations  between  and  the  competences  of  the  different  actors  involved.  The 
original text of article 101 on the sanction levels read:  

"Art. 101 The sanction levels 
The infringements as provided for in Book 2 shall be punished with a level 1, a level 2, a level 3 or a level 4 

sanction.  

The level 1 sanction shall be an administrative fine between 10 and 100euros. 
The level 2 sanction shall either be a criminal fine between 50 and 500euros, or an administrative fine between 

25 and 250 euros. 

The level 3 sanction shall either be a criminal fine between 100 and 1000euros, or an administrative fine between 

50 and 500 euros. 

The  level  4  sanction  shall either be  a  prison  sentence  between  six  months  and  three  years  and  a  criminal fine 
between  600  and  6000euros,  or  only  one  of  these  sanctions,  or  an  administrative  fine  between  300  and 
3000euros". 

(cfr.  De  Coninck  M.,  Gillis  D.  &  Jorens  Y.,  The  Belgian  Social  Criminal  Code.  An  English  Translation  by 

IRIS|international research institute on social fraud, Die Keure, Brugge, 2013) 

87 

 
 
 
 
 
 
 
 
 
                                                 
Unjustified affiliation 
with a foreign social 
security system (with, 
as the case may be, a 
fictitious registered 
office abroad) 

Fictitious affiliation in 
Belgium (affiliation in 
order to obtain benefits 
without services actually 
being provided) 

Fraud, forgery and 
deception (false 
declarations, use of false 
identity cards or false A1 
documents, etc.) 

Criminal penalties (Social Criminal Code) 

Article 
§ 1. Level 2 penalties are imposed on: 

Forwarding 

223. 

of 

documents 

to 

institutions 

by 

employers 

1. employers, their deputies or their authorised representatives who do not forward to 
the  National  Social  Security  Office  a  declaration  providing  evidence  of  the  amount  of 
social security contributions due under the Law of 27 June 1969 revising the Decree-
Law of 28 December 1944 concerning social security for workers; 

[…] 

When acts are committed knowingly and deliberately a level 3 penalty is imposed. 

For infringements under paragraph 1, the fine is multiplied by the number of workers 
concerned. 

Article 221. Fraudulent affiliation 

A 
level  4  penalty 
representatives who: 

is 

imposed  on  employers,  their  deputies  or  authorised 

1. fraudulently subject one or more persons to application of the Law of 27 June 1969 
revising the Decree-Law of 28 December 1944 concerning social security for workers; 

2.  fraudulently  subject  one  or  more  persons  to  application  of  the  Decree-Law  of 
7 February 1945 concerning the social security of sailors in the merchant navy. 

For  the  infringements  under  paragraph  1,  the  fine  is  multiplied  by  the  number  of 
workers concerned. 

The judge may also impose the penalties provided for by Articles 106 and 107. 

Article 232. Fraud and the use of forgery under social criminal law 

A level 4 penalty is imposed on anybody who, in order to obtain or have obtained, or 
to keep or have kept an undue social advantage, or not to pay contributions or not to 
have them paid, or to pay less or to have less paid than is required by that person or 
the other party: 

1.  a)  has  committed  a  forgery,  either  by  false  signatures  or  by  counterfeiting  or 
alteration of the written word or signatures or by fabricating agreements, provisions, 
obligations  or  discharges  or  by  inserting  them  in  a  document  either  by  adding  or 
altering  clauses,  declarations  or  facts  which  that  document  was  intended  to 
incorporate or record; 

b) has committed forgery or falsified a document; 

[…] 

Article 233. Inaccurate or incomplete declarations concerning social advantages 

§ 1. A level 4 penalty is imposed on anybody who knowingly and deliberately: 

1. makes an inaccurate or incomplete declaration to obtain or have obtained, keep or 
have kept an undue social advantage; 

2. has omitted or refused to make a declaration which they are obliged to make or to 
provide  information  they  are  obliged  to  supply,  to  obtain  or  have  obtained,  keep  or 
have kept an undue social advantage; 

3.  received  a  social  advantage  to  which  they  were  not  entitled  or  were  only  partially 
entitled following a declaration referred to in paragraph 1.1, an omission or a refusal 
to  make  a  declaration  or  to  provide  information  referred  to  in  paragraph  1.2  or  an 
action referred to in Articles 232 and 235. 

When the infringements referred to in paragraph 1 are committed by employers, their 

88 

 
 
 
 
deputies  or  their  authorised  representatives  to  obtain  or  have  obtained  a  social 
advantage to which the worker is not entitled, the fine is multiplied by the number of 
workers concerned. 

§ 2. A level 3 penalty is imposed on anybody who knowingly and deliberately  fails to 
declare that they are no longer entitled to a social advantage, if only in part, in order 
to keep an undue social advantage. 

Article 234. Inaccurate or incomplete declarations concerning contributions 

§ 1. A level 4 penalty is imposed on anyone who knowingly and deliberately: 

1.  makes  an  inaccurate  or  incomplete  declaration  in  order  not  to  pay  or  have  paid 
contributions,  to  pay  less  or  have  paid  less  than  those  they  or  other  parties  are 
required to pay; 

2. fails or refuses to make a declaration which they are obliged to make or to provide 
information they are obliged to give in order not to pay or have paid contributions, or 
to pay less or have less paid than those which they or the other party are required to 
pay; 

3. pays fewer contributions than those they are required to pay or does not pay them 
following a declaration referred to in 1, failure or refusal  to make a declaration or to 
provide information referred to under 2 or an act covered by Articles 232 and 235. 

Where  the  infringements  referred  to  in  paragraph  1  are  committed  by  employers, 
their deputies or their authorised representatives the fine is multiplied by the number 
of workers concerned. 

§ 2. A level 3 penalty is imposed on anybody who knowingly and deliberately fails to 
declare  that  they  are  no  longer  entitled  to  a  dispensation  from  or  reduction  of 
contributions, even if only in part, in order not to pay contributions or to pay less than 
they are required to pay. 

Article 235. Deception under social criminal law 

A level 4 penalty is imposed on anyone who, in order to obtain or have obtained, keep 
or have kept an undue social advantage or not to pay contributions or not have them 
paid, to pay less or have less paid than those which they or the third party is required 
to pay, has made use of false names, false titles or false  addresses or has used any 
other fraudulent act to mislead people into believing in the existence of a false person, 
a false enterprise, a fictitious accident or any other fictitious event or to abuse trust in 
any other manner. 

Where  the  infringement  referred  to  in  paragraph  1  is  committed  by  employers,  their 
deputies  or  authorised  representatives  to  have  obtained  or  have  kept  a  social 
advantage to which the workers are not entitled, the fine is multiplied by the number 
of workers concerned. 

89 

 
 
 
 
Unjustified affiliation with 
a foreign social security 
system (with, as the case 
may be, a fictitious 
registered office abroad) 

Fictitious affiliation in 
Belgium (affiliation in 
order to obtain benefits 
without services actually 
being provided) 

Civil penalties (Royal Decree of 28/11/1969) 

Article 54ter. 

§ 1.  Without  prejudice  to  the  civil  penalties  provided  for  under  Articles  54  and 
54bis, in the absence of a declaration or in the case of an incomplete or inaccurate 
declaration, employers or trustees are debited a flat rate of 50 euros and a rate of 
4  euros  per  line  or  missing  occupation  for  which  the  remuneration  to  be 
considered is amended, if the civil servants referred to in Article 31 of the Law or 
the  internal  departments  of  the  Office  have  to  draw  up  or  rectify  the  three-
monthly declaration. […] 

§ 2.  Failure  to  submit  to  the  National  Social  Security  Office,  by  the  deadline  laid 
down in Article 33 or Article 35bis, the three monthly declaration and the annexes 
required will result in employers or the trustees being debited a flat rate of 495.79 
euros and 247.89 euros for each tranche of 24 789.35 euros of contributions over 
and above 49 578.70 euros. 

Deregistration  without  any  civil  penalties  involving  the  NSSO  (but  intervention  of 
other  IPSS  (Institutions  publiques  de  sécurité  sociale  –  Public  social  security 
institutions) for the unduly paid allowances) 

Unjustified affiliation in 
Belgium 

Deregistration  without  any  civil  penalties  involving  the  NSSO  (but  intervention  of 
other IPSS for the unduly paid allowances) 

Overview Sanctioning Fraud: Portugal 

Administrative Offences 

Minor  

Serious  

Very Serious 

False declarations  

Failure  to  declare  the  termination  or  suspension  of 
and changes to the nature of the work contract  

Failure to report or delay in reporting recruitment of 
workers  

Omission  of  mandatory  communications  concerning 
the  employer  –  changes  to  identifying  details, 
including  those  relative  to  the  establishment,  start, 
suspension or termination of activity  

X 

X 

X 

Failure to deliver or delay in delivering declaration of 
remuneration  

X 

Failure  to  include  the  worker  in  the  declaration  of 
remuneration  

Omission  of  any  other  element  that  should  be 
included in the declaration of remuneration pursuant 
to the regulation  

Failure  to  provide  evidence  of  elements  requested 
from self-employed workers  

Failure to declare total value of sales  made and  the 
value  of  the  services  provided  within  the  prescribed 
time  

Failure  to  pay  or  delay  in  paying  contributions  by 
employers,  self-employed  persons  or  contracting 
bodies  

Drawing  benefits  while  engaging  in  paid  activity  in 
breach of the specific legal provisions 

X 

X 

X 

X 

Failure  to  submit  declaration  or  other 
legally 
required documents where no specific punishment is 
provided for  

X 

X 

X 

X 

X 

X 

X 

X 

 X 

 X 

X 

90 

 
 
 
 
 
 
  
  
  
  
  
 
 
 
 
 
  
  
  
  
  
  
  
 
Classification of the 
administrative 
offence 

Type of 
infringement 

Amount of the fines 

Natural person 

Legal person with: 

Fewer than 50 
employees 

50 employees or 
more 

Minor 

Negligence 

€ 50 to 250 

€ 75 to 375 

€ 100 to 500 

Fraud 

€ 100 to 500 

€ 150 to 750 

€ 200 to 1 000 

Serious 

Negligence 

€ 300 to 1 200 

€ 450 to 1 800 

€ 600 to 2 400 

Fraud 

€ 600 to 2 400 

€ 900 to 3 600 

€ 1 200 to 4 800 

Very serious 

Negligence 

€ 1 250 to 6 250 

€ 1 875 to 9 375 

€ 2 500 to 12 500 

Fraud 

€ 2 500 to 12 500 

€ 3 750 to 18 750 

€ 5 000 to 25 000 

91 

 
 
 
 
 
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