Capgemini works with welfare agencies to implement flexible approaches to tackling fraud using business intelligence solutions. Welfare fraud costs governments billions annually. While anti-fraud efforts exist, current control methods are not optimal for evolving fraud practices. Capgemini offers welfare agencies solutions like data analysis and risk profiling to both prevent and detect fraud through a holistic approach.

1. Global Public Sector the way we see it
Protecting Social Welfare Systems
from Fraud and Error
Capgemini works with welfare agencies to implement flexible approaches to
tackling fraud, supported by cutting-edge business intelligence solutions.
A CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS

2. Global Public Sector the way we see it
A CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS
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3. Global Public Sector the way we see it
A CONTEMPORARY ISSUE ROOT CAUSES OF FRAUD AND ERROR OUR OFFER TO SOCIAL WELFARE AGENCIES CAPGEMINI’S UNIQUE SOLUTIONS
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The Struggle Against Fraud
A social issue in the spotlight
Welfare fraud is common to all developed French Minister for Work, Employment proportion of total welfare recipients,
countries and costs governments and Health Xavier Bertrand reported that and that some who overclaim do so
billions. Preventing welfare fraud has €458m of welfare fraud was detected in through genuine need. Nonetheless,
therefore become essential in order to France in 2010, twice as much as in 20061. welfare fraud represents a cost which
protect tax payers and citizens who really
British Prime Minister David Cameron stated many governments forced to reduce
need benefits.
that ‘Welfare and tax credit fraud and error public spending and deficits
The objective of most governments around
costs the taxpayer £5.2 billion a year’ in cannot afford.
the world is to reduce the welfare gap
2010, though administrative error accounts
by 30% every year. But although
for a large proportion of this at £1.6bn2.
anti-fraud cells exist in most public
Most fraud occurs when claimants withhold
sector organizations, control methods
information, or provide misleading
and detection strategies are not optimally
or inaccurate data about their status
structured to tackle evolving practices of
and income to government agencies.
fraud, and achieve only limited success.
Demonization of benefit fraudsters by the
Accurate figures on the sums lost to welfare
media and politicians can obscure the fact
fraud are naturally difficult to obtain.
that they account only for a very small
1
http://www.budget.gouv.fr/files/bilan-dnlf-2010.pdf Previous | Next
2
http://www.number10.gov.uk/news/pm%e2%80%99s-article-for-manchester-news/, Published 10th August 2010.

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Segmentation of the Social Welfare Domain
How to strengthen the system’s defenses?
Multiple agencies – responsible for social welfare claims under scrutiny.
insurance, family allowances, healthcare Although success in tackling welfare The fraud typology adds further complexity
protection or pensions – have their own fraud and error varies between countries, to the anti-fraud struggle: It can either be
operating models and use different certain barriers are common to many accidental or intentional. The gravity of
processes to allocate the right resources
administrations. A disjointed approach by offences usually depends on the fraudster’s
to the right recipients.
central government to managing welfare profile and network, with professional
Fraudsters often exploit the boundaries and
provision across multiple agencies, and at fraudsters taking most from the system.
lack of information sharing between these
a local level, makes the system easier to Individuals can deliberately omit to report
organizations. Australia’s social security
exploit. The technology solutions, training income but fraud can also be due to errors,
agency Centrelink uncovered and reversed
and resources required to tackle fraud are especially administrative errors within
fraudulent payments totaling $112.5m in
often weak. Cultural factors also impose the social welfare organization itself or
2008-9 through matching data on claimants
constraints, as in many countries staff submission of false information without the
across government agencies to identify
motivated by an ethic of public service declaring individual being aware.
inconsistencies in data about incomes,
may feel reluctant to place the legitimacy of
payments and personal identities.3
3
http://www.aic.gov.au/publications/current%20series/tandi/401-420/tandi418.aspx Previous | Next

6. Global Public Sector the way we see it
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7. Global Public Sector the way we see it
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Our Offer to Social Welfare Agencies
Prevention and Cure
In order to tackle the fraud problem, allows inter-agency cooperation to prevent surveillance and social network analysis.
governments need to adopt a targeted fraudsters caught in one particular region
and holistic approach which combines operating in another. • Detecting inconsistencies. Analysis
cure and prevention. Successful management of fraud depends often reveals claimants who present
On one hand, the cure has a quick impact on effective gathering and analysis of data. different sets of information about their
and removes fraudsters who are already in We have worked with social welfare agencies circumstances or identities to different
the system. On the other, prevention is less to put in place fraud detection systems and parties, possibly in order to commit
costly and ensures a progressive reduction of processes based on four stages of activity: fraud. This demands cross-detection
the welfare gap. Technology combined with among different sources of data. This
continuously improving business processes • Accumulating data on claimants. analysis usually reveals administrative
can provide solutions to detect fraud and This can often be migrated from the errors which can then be rectified.
act on both prevention and cure. It can systems of multiple agencies into
evolve constantly to fight fraudsters who a central repository which enables • Targeting. As the human resources
are increasingly skilful and well-informed. business analysis. Other sources of data available to investigate cases are
A holistic approach at a national level can include bank statements, mobile necessarily limited, agencies must weigh
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up the likely cost of an intervention rules. Social welfare organizations need
against the probable value of the fraud processes which make it easy for citizens to
in order to maximize results. Using understand their obligations and comply
estimates, we develop a business case for with the rules, and difficult for them not to.
intervening in each possible instance of Above all, systems must be flexible enough
fraud. to allow prevention and detection strategies
and business rules to change regularly,
• Intervention, with the aim of so that agencies are not outmaneuvered
investigating the claim, recovering any by the constantly evolving tactics of the
money lost to fraud and prosecuting fraudsters. This kind of flexible approach
those responsible. allows governments to tackle the roots of the
problem and significantly reduce the cost
At the same time, upstream measures should of welfare fraud; it is what we define as a
be built around multiple independent mature anti-fraud protection system.
defences against fraud, including identity
management, risk profiling, watchlists,
and advanced business and transaction
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Capgemini Develops Unique Solutions for Welfare
Agencies at Different Levels of Maturity.
Capgemini has experience in providing Our offer to social welfare agencies typically combined with a small pilot initiative
government agencies with business consists of: to trial the solution and demonstrate its
information, data management analysis value to stakeholders.
and anti-fraud intelligence system • Fraud and Error Assessment – A
integration. three to six-week assessment of existing • Solution Implementation – A larger
We have applied a combination of technology and processes for fraud proof of value with a broader scope,
consulting and technology expertise to detection and prevention to identify the followed by the design and build of a
transformational projects with social key areas for improvement, and what the full-scale fraud management system with
welfare agencies in the US, France, Norway, priorities are. options for fraud management as an IT
Germany, the UK and Netherlands. We managed service or as Business Process
have a proven ability to run projects which • Solution Design – A design phase of Outsourcing.
deliver a rapid return on investment, and approximately three months to produce
operate with an ecosystem of partners well- the blueprint for a holistic fraud
placed to provide the business analytics management approach, underpinned by
software products required as part of a fraud best of breed technology. This is often
management solution.
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Three distinctive elements of our
approach are:
• Collaboration with Social Welfare
Department directors and leaders to
define business priorities for anti-fraud
and error protection. This allows a
program to achieve rapid RoI by tackling
the easiest cases first, and strengthening
compliance to reduce errors.
• A strategic approach to targeting
specific, high-risk segments which
offer the strongest business case for the
Capgemini offers demonstrations and
administration to intervene. discussions tailored to the unique
environment of each organization.
• Implementation of a medium to long-
term fraud and error prevention solution For more information or to request a
which works in tandem with the business meeting please contact:
intelligence analytical system. publicsector.global@capgemini.com
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