In its latest report on the accounts of Social Security, the Court of Auditors estimates at between 6 and 8 billion euros per year all social fraud. Here are the main areas of fraud that the government wants to tackle.
► Social security contribution fraud
The first item of fraud would be on the business side with contribution fraud. Real Urssaf scams have developed in particular with short-lived companies which are created to benefit from aid before dissolving by transferring their assets abroad, thus organizing their insolvency to escape from the Urssaf. For Île-de-France alone, the damage would amount to 100 million euros per year.
► The under-declaration of platform workers
By not fully declaring their activity, the 200,000 microentrepreneurs on the platforms (such as Uber or Deliveroo) conceal around 800 million euros in turnover. “A social time bomb, since these workers will have no social rights”, warns the Minister of Public Accounts Gabriel Attal in Le Parisien.
► Health benefits fraud
In terms of health, 70% of cases of fraud are thought to be at the initiative of health professionals, whether by over-invoicing or invoicing for fictitious acts. The panel ranges from care billed by health centers but not performed, to sick leave of convenience sold on social networks.
300 million euros of fraud were detected in 2022 by health insurance, but the Court of Auditors estimates the fraud between 185 and 215 million euros for general practitioners, between 286 and 393 million for nurses, between 166 and 234 million for physiotherapists, between 91 and 105 million for pharmacists and between 145 and 177 million for paramedics.
► Vitale card hijacking
If the health insurance has closed the rights of an insured person, the Vitale card can still be used with a health professional (except in a pharmacy), unless the latter checks the rights of the insured person with health insurance. According to the Court of Auditors, the financial stake would nevertheless be “limited”: 6.6 million health costs paid in 2022 for cards for which rights had been closed (0.01% of health insurance regulations ).
Another case of fraud: that of the Vitale card used for “illegal medical tourism”, foreigners who have never contributed coming to France and using someone else’s Vitale card for treatment. Gabriel Attal estimates the cost for Social Security at “several million euros per year”.
► Residence fraud
The National Family Allowance Fund (Cnaf) assesses fraud in the various allowances it pays at 2.8 billion euros. In the crosshairs of the State, there are in particular allowances conditional on residence but paid to people living most of the time abroad.
Another case of fraud: retirees whose death was not declared to their pension fund (in particular because they lived in a country that does not practice automatic data sharing with France). Recently, two investigators from the National Old Age Allowance Fund went to Algeria – where 300,000 of the 500,000 retirees outside Europe live – and called 1,000 retirees over 98: 30% did not show up. …
► RSA fraud
“In many cases, RSA fraud is the result of mafia networks”, assures Bercy, who gives the example of a recent Lithuanian network which had hacked into the accounts on the pension insurance site of many beneficiaries to replace their bank details. 10 million euros were thus embezzled.
Cnaf’s lack of access to bank data also prevents it from knowing the exact income of RSA beneficiaries, for example if they have a quasi-self-employed activity by regularly selling on websites.
In total, the various frauds of which the Cnaf would be a victim would amount to between 2 and 2.5 billion euros, according to the Court of Auditors.