Whistleblower System for Reporting Social Welfare Insurance Violations

China: The Whistleblower System

China has established a whistleblower program to report Social Insurance fraudulent, or embezzled embezzlement. The Ministry of Human Resources and Social Security (MOHRSS) and the Ministry of Finance (MOF) have jointly issued the Management Measures for Supervision and Reporting of Social Insurance Funds (《社会保险基金监督举报工作管理办法》，Renli Ziyuan Shehui Baozhang Bu Ling No. 2023-49), which took effect on May 1st, 2023.

According to the Management Measures, citizens, legal persons, and other social organizations who report and provide relevant leads on violations related to fraud, misappropriation, or embezzlement of Basic Endowment Insurance, Unemployment Insurance, and Work Injury Insurance Funds will be rewarded if their reports are verified by the relevant authorities and conform to the Interim Measures for Reward.

Through the Management Measures, the government aims to force organizations/enterprises/individuals to fully take responsibilities for their actions and punish any fraudulent behavior.

According to this Management Measures, the behaviors defined as violation which can be reported are divided by four main areas.

1.

1)    Falsifying the conditions for Social Insurance participation and illegally making up payments by providing false proof materials or other means;

2)       Falsifying or altering relevant documents, archives, or materials to defraud Social Insurance Funds;

3)       Organizing or assisting others to fraudulently obtain insurance coverage, early retirement qualifications, or illegally apply for social insurance benefits by forging or altering files, materials, or other means;

4)       After an individual loses their eligibility to enjoy Social Insurance benefits, they or the relevant beneficiaries fail to fulfill their obligation to inform or conceal facts in violation of regulations to enjoy Social Insurance benefits;

5)       Other cases of fraud, embezzlement, or misappropriation of Social Insurance Funds.

1)       Work Injury Insurance medical institution, work injury rehabilitation institution, work injury insurance auxiliary equipment configuration institution, work injury prevention project implementation unit, occupational injury protection entrusted undertaking institution and its staff defraud or assist or cooperate with others to defraud Social Insurance Funds by means of forging, altering or providing false certification materials and relevant reimbursement bills, impersonation, etc.;

2)       Training institutions and their staff who enjoy Unemployment Insurance training subsidies defraud or assist or cooperate with others to defraud Social Insurance Funds by means of forging, altering, or providing false training records

3)       Other cases of fraud, embezzlement, or misappropriation of Social Insurance Funds.

1)       Concealing, transferring, occupying, misappropriating, or intercepting Social Insurance Funds;

2)       Violating the review and approval of Social Insurance application materials, handling insurance participation, make-up payment, participation file transfer, treatment verification, treatment qualification certification, and distributing Social Insurance benefits in violation of regulations;

3)       Falsifying or tampering with payment records, records of enjoying Social Insurance benefits, and other Social Insurance data, as well as personal rights and interests’ records;

4)       Other cases of fraud, embezzlement, or misappropriation of Social Insurance Funds.

1)       The administrative bureau of Human Resources and Social Security and its staff violate regulations in issuing administrative law enforcement documents, conducting work-related injury identification, and handling early retirement in violation of regulations, which infringes on social insurance funds;

2)       The labor capacity appraisal committee and its staff violate regulations in conducting labor capacity appraisal, which infringes on Social Insurance Funds;

3)       Labor and personnel dispute arbitration institutions and their staff violate the rules by issuing arbitration documents and infringe on Social Insurance Funds;

4)       Information technology comprehensive management institutions and their staff forge or tamper with Social Insurance data, personal rights and interests’ records, such as payment records, records of enjoying Social Insurance benefits, etc.;

5)       Other cases of fraud, embezzlement, or misappropriation of Social Insurance Funds.