(Source: Internet)

Different ways of abusing social insurance, health insurance funds

According to the Viet Nam Social Security (VSS), in 2017, the sector paid 207.31 trillion VND in social insurance, health insurance and unemployment insurance benefits, of which 45.17 trillion VND was from the State budget, 132.47 trillion VND from the social insurance fund, 7.42 trillion from the unemployment fund, and 85.25 trillion VND from the health insurance fund.

Many provinces and cities reported high social insurance payments such as Bac Ninh, Thai Nguyen and Dong Nai. Through inspections, the social insurance sector uncovered many cases of seeking profit from the social and health insurance funds.

Particularly, in Ho Chi Minh City, a number of individuals joined hands with collectives to appropriate maternal allowance and social insurance worth 1.3 billion VND. In Hai Duong, a personnel official made 36 fake dossiers and 44 sets of maternal insurance payment requests to pocket 867 million VND. Meanwhile, the VSS discovered more than 200 fake hospital discharge documents and leave allowance in Bac Giang with total payment of over 250 million VND.

Similar cases were also occurred in many other localities. In Ben Tre province, by faking dossiers of 13 workers, an official of a company declared the salary for counting maternal insurance of each worker at 18 million VND each month, while their salary in tax payment declaration was only 2.5 million VND per month.

In Can Tho, a company recruited a lot of pregnant women in document and registered their social insurance to receive insurance payments, but not employed them in reality.

Meanwhile, authorities in Dong Nai province discovered many people who made false receipts and documents and submitted them to social insurance agencies to receive payments. As many as 116 fake dossiers worth 394 million VND were handed over to the police for investigation.

Strict punishments needed to tackle violations

According to Dieu Ba Duoc, Director of the VSS’s Department for Social Insurance Policy Implementation, policy loophole is the major reason of abusing the social and health insurance funds.

Specifically, under Article 157 of the Labour Code, during labourers’ paid maternal leave of six months, two months higher than previously, but the payment amount and duration have yet to be adjusted (leading to a difference of 68 percent between  insurance paying and receiving amounts). This is the major reason behind the easy abuse of fund for sickness and maternal insurance. At the same time, there has been no mechanism to inspect and control employment status of labourers. In some cases, the labourer already found new job but still enjoyed unemployment insurance payment. However, punishments on such violations have not been strict enough.

Furthermore, administrative reform with the reduction of many administrative procedures has created favourable conditions for labourers and employers, but caused difficulties to the social insurance sector in controlling and preventing violations, leading to fund losses.

Duoc held that in order to minimise the abuse of the social and unemployment insurance funds, it is necessary to continue completing legal system in the field, including the adjustment of Circular 14/TT-BYT issued by the Health Ministry to add clearer list of health establishments eligible to grant paid sickness leave allowance. It is also crucial to clarify responsibilities of the facilities and individuals involving in issuing and submitting the documents in line with regulations on online transactions and receipts, thus posting documents related to social insurance to national data system and online portal of the VSS, while bearing full legal responsibility in the legacy and accuracy of the documents.

Punishments on dishonest declaration on employment status should be stricter, he added.

Alongside, the VSS should strengthen inspection and coordination in inter-sectoral investigations at social insurance agencies of provinces and recruiters, in a regular or sudden basis. The sector should also work with other ministries and sectors to detect and prevent all signs of abusing sickness, maternal and unemployment insurance funds, while supervising the implementation of social insurance policies in localities to give timely instructions.

Duoc also suggested that the sector should improve communications on social and unemployment insurance policies to raise labourers and employers’ awareness of the policies.

He added that authorized agencies should strictly handle violations of regulations in social and unemployment insurance such as hindering and causing difficulties for organisations and individuals in making transactions with social insurance agencies, seeking profit from the social and unemployment insurance funds, or hiding violations of enterprises, labourers, people, and shaking hands with organisations and individuals to abuse the funds.

International Cooperation Department