Select Committee on Social Security Second Report



15. CLASSIFICATION OF CATEGORIES

Definitions of the 7 classifications used

15.1  The interview findings, together with the results of any adjudication action taken by FAMC Unit, were returned to the central helpdesk to be categorised for input to the database and subsequent analysis. The categorisation function was centralised to ensure consistency, both in interpretation of the interview information and application of the categorisation criteria.

15.2  Each case was categorised in one of five broad headings and any instance where this decision was difficult or borderline were discussed and agreed by the helpdesk team, sometimes after further discussion with the interviewer.

No Change

15.2.1  All cases where the information and circumstances used as the basis for the latest award of FAMC were found to be correct, there had been no relevant changes in circumstances and no official error was found.

Departmental Error

15.2.2  Errors in adjudication. This included errors in law, mistaken facts and clerical errors. In some cases the error was too small to affect benefit.

Customer Error

15.2.3  Cases where the customer had provided incorrect information at the start of the claim or failed to report a reportable change, but where there was no suspicion of fraudulent intent. This included a number of cases where employers had provided inaccurate wages details. Benefit was either increased or reduced or in some cases was unaffected; ie change was too small to affect benefit or there was an unreported change of address (which is a reportable change but does not affect benefit).

Suspicion of Fraud

15.2.4  Cases where fraud was suspected by the interviewer but could not be proven. To refine this category further the degree of suspicion held by the interviewer was broken down into one of 2 levels by the central team:

    Low suspicion that fraud exists but no proof

    High suspicion that fraud exists but no proof

The evidence gathered in this category would not be sufficient to allow a prosecution should the Department decide to pursue the case further.

Fraud

15.2.5  Through admission or third party evidence such as employers' records. All cases where fraud was confirmed to exist would be included here irrespective of whether any subsequent action led to prosecution. The evidence gathered in this category would be sufficient to support a prosecution should the Department decide to pursue the case further.

15.3  A further category "Correct" was used during the analysis. This comprised cases where the current rate of benefit was correct and included No Change cases, Customer Error and Departmental Error cases where benefit was unaffected and where there was no other outcome.


 
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Prepared 4 February 1999