Ineffective processing of changed circumstances in the social insurance system

Individuals who receive social insurance benefits must report changed circumstances that may affect their right to compensation. This may involve changes in income, housing costs or capacity to work. The obligation does not apply if the agencies already possess such information.

A large proportion of incorrect social insurance payments occur because people do not report changed circumstances, or because agencies do not process the information in a timely manner.

The Swedish National Audit Office has therefore examined whether the Swedish Social Insurance Agency and the Swedish Pensions Agency process changed circumstances effectively. The overall conclusion is that there are several shortcomings.

“These agencies are not successful in prompting the individuals concerned to report changed circumstances to a sufficient extent, partly due to inadequate communication. This leads to incorrect payments, with a potential requirement for people who have been paid too much to pay back hefty sums,” says Deputy Auditor General Claudia Gardberg Morner.

The audit also shows that people who lack access to e-services – or who have special needs due to old age, disability or poor language skills – find it more difficult to report changes. Reduced availability on the phone has a particularly negative impact on these groups.

The Swedish National Audit Office also notes that the agencies do not fully harness current opportunities for effective information sharing on changed circumstances.

“Although it is possible to obtain relevant information from both internal and external sources, the agencies’ processing is largely based on people reporting changes themselves. Because of this, major risks of incorrect payments persist,” says Nina Granqvist, Project Leader for the audit.

The fact that the agencies lack effective procedures for sharing information internally also poses a risk of important information failing to reach the relevant case officer, or of it taking a long time. This situation is aggravated by the fact that both the Swedish Social Insurance Agency and the Swedish Pensions Agency have long had extensive case backlogs for processing changed circumstances.

In addition, the Swedish Social Insurance Agency and the Swedish Pensions Agency lack the type of access to registers that would enable them to effectively obtain data about changes to income. This is relevant information for many of the benefits administered by the agencies.