Claims administration
Claims processing
3.1 It is important that new claims and changes of circumstances are processed rapidly and accurately in order to eliminate the risk of fraud or error entering the system.
3.2 We limited the scope in this area to one Performance measure (PM 6) and 4 enablers (E3, E9, E10 and E16).
Gathering information
3.3 Broadland District Council did not meet this enabler.
3.4 To ensure claims are dealt with promptly a council should request any additional information from the customer or third party within 7 days of receipt of the claim. In 2006/07 the council had not monitored performance against this measure.
3.5 Our sample of 30 new claims showed that, on average, requests for further information and evidence were made within 8 days of receipt of the claim. In April 2007, the council changed its procedures for dealing with claims by checking the claim immediately on receipt, and requesting any outstanding evidence promptly. See recommendation 10.
3.6 The certificate of earnings form instructed the employer to return the form directly to the council. It also advised that the form should be authenticated by an employer’s stamp and signature.
3.7 Benefits assessors, customer service staff and visiting officers had a good understanding of the procedures for issuing a certificate of earnings form, and what to look for to authenticate the information provided.
Quality and reducing error
3.8 Members and senior managers, who are accountable for the delivery of effective and secure HB and CTB administration, need assurance that the Benefits service and counter-fraud efforts are working as planned. A council should therefore ensure that it has arrangements to make full use of management information and checking data across the full range of their benefit activities.
Performance measures
3.9 Figure 3.1 shows the council’s reported performance for accuracy for 2005/06 and 2006/07.
|
Performance measure |
Description |
2005/06 |
Score |
2006/07 |
Score |
|---|---|---|---|---|---|
|
PM 6 |
% of cases for which the calculation of the amount of benefit due is correct |
97.4 |
Meeting minimum requirements |
99.4 |
Excellent |
Source: Broadland District Council
3.10 We found that Broadland District Council’s Checking Officer undertook quarterly Best Value statistical accuracy checks in accordance with Departmental guidance.
3.11 In 2005/06 Broadland District Council was meeting minimum requirements for accuracy. To improve performance additional training was provided for staff and the appraisal process was reviewed to include individual accuracy performance. We consider these measures contributed to the council’s improvement in this area in 2006/07.
Performance enablers
Quality checks
3.12 Broadland District Council met one (E10) of the 2 enablers.
3.13 The council’s Checking Officer undertook quality checks on 10% of decisions made by individual officers. This check covered all aspects of claims administration. In addition, a pre-notification check was carried out on all cases where the first payment was in excess of £750.
3.14 During the period November 2005 to May 2006, the council increased the level of checking to 100% for each assessor on a rolling basis to provide an assessment of each individual’s error rate. Although no fundamental errors were found the council told us that it would repeat this exercise in the near future to ensure performance levels were being maintained.
3.15 We were concerned that the standard
10% check was normally carried out after the customer had been notified of
the decision. To prevent overpayments or underpayments occurring, it is important
that management checks are conducted before the customer is notified of the
decision.
See recommendation 9.
3.16 A database was used to record the checks and results were analysed. This information was used to monitor team and individual performance and to inform training and development needs. The results of all quality checks were fed back to individuals and their team leaders.
3.17 Where common errors were found the Checking Officer issued minutes to provide guidance to all staff.
Overpayments
3.18 To minimise loss to public funds, councils must process HB and CTB effectively to prevent overpayments. Councils should have clear policies and procedures to manage overpayments and should pursue recovery by the speediest, most cost-effective and efficient methods available, in line with legislation.
2.89 We limited the scope in this area to one enabler (E16), which Broadland District Council did not meet.
2.90 We examined the council’s overpayment policies and records for the collection of administrative penalties. Although recovery was taking place in relevant cases, we found that recovery was not actively monitored.