According to the report of the Forensic Audit of the National Insurance Scheme (NIS), over half of the claims records requested for analysis could not be produced.
The audit, which was tasked with among other things carrying out “a comprehensive financial systems review,” noted that the auditors requested a sample of 383 claims records, totaling in excess of $157 million, for the year 2012 but 213 or 56% could not have been located.
Further, “a sample of 31 claims records totaling an amount of $34,973,062 was requested for the year 2013 of which 16 or 52% could not have been located and a sample of 58 claims records totaling an amount of $49,877,440 was requested for the year 2014 of which 35 or 60% were not presented as they could not have been located,” the report said.
According to the report, these claims were not produced because “some were either at the out-of-town locations or just could not be found due to an overcrowded, ineffective filing system.”
Also missing was information necessary for the auditors to assess the accuracy of the computed amounts paid to several claimants, some of whom were paid in excess of $1 million on old age benefits.
Additionally, 1,886 persons registered with the scheme and who have attained the age of 60 are not receiving pensions because they have not “accumulated the number of contributions” necessary for them to qualify.
“During the period November, 2011, to 31st July, 2015, the Scheme recorded a total of 8,769 persons who would have attained the age of 60 years. However, out of this total only 502 persons achieved the required amount of 750 contributions to qualify for old age pension. 6,381 persons satisfied the requirement of 50 contributions to qualify for the old age grant. The remaining 1,886 persons accumulated less than 50 contributions and were therefore not eligible to claim for the old age grant/ pension,” the report explains.
Additionally, there are 1,336 individuals registered with the scheme who have attained the age of 60 years and also accumulated the required 750 contributions but have not submitted a claim to receive their pension.
As of July 31, 2015, there were 733 pensioners 90 years and older who are in continuous receipt of pension.
However, some pensioners who would not have collected their pensions for a period longer than one year are still categorised as active pensioners. It is only when death certificates are submitted that a pensioner is removed from the active list.
The process to verify a pensioner’s status was described as “not always an easy task;” rather, it relied on NIS staff making efforts to contact pensioners via telephone and the mailing system although responses were not always received.
The report recommended that all documents received for the processing of claims and pensions be filed immediately into their respective folders to avoid the issue of missing documentation and calculations of benefits should be rechecked by supervisors and a sample by the Internal Auditors to ensure that accurate amounts are being paid out to claimants.
