Medicaid fraud

Every year, benefit fraud costs Northern Ireland taxpayers millions of pounds. If you suspect someone of benefit fraud, you can report them and prevent them from taking money from those who need it the most.

Because the law requires a good reason to investigate someone for benefit fraud, you will need to provide as much of the following information as possible:

  • the name and address of the person being reported, as well as their partner, if they have one
  • a description of the individual
  • the type of benefit fraud you believe they are committing, as well as the reasons you suspect them
  • If you believe they are employed, please provide information about their employer.
  • if they have a vehicle, information about it
  • any other information you believe will help the investigation

How to Report Welfare Fraud

You can do this online, over the phone, or in writing. You can provide information anonymously if you prefer.

Fill out an online form

  • Online reporting of benefit fraud

Make a call to the Benefits Fraud Hotline.

Send information via postal mail

  • Benefit Security DivisionContact the Benefit Security Division.

What occurs when you report fraud?

The information you provide will be scrutinized by benefit fraud investigators. If you have provided sufficient information, they will investigate the individual's benefit claim.

An investigation can take time, and benefit fraud investigators are not permitted to reveal the outcome.

An investigation may result in no action being taken. In many cases, the person suspected of benefit fraud has already declared that they are or have been working while claiming benefits, so their benefit is unaffected.

The outcome of benefit fraud investigations can result in a criminal record and the recovery of any benefits, as well as the confiscation of assets up to the value of the benefits lost through fraud.

The Effects of Benefit Fraud

If you are suspected of benefit fraud, you may be called in for an interview to discuss your claim. While the matter is being investigated, your benefit may be suspended. If this occurs, you should receive a letter informing you of the situation.

Following the investigation

Officers will decide whether to take further action after gathering facts about your case. If there is evidence that you have committed or are committing benefit fraud:

  • You could face prosecution and a fine or prison sentence.
  • As an alternative to prosecution, you may be asked to pay a fine.
  • You may be issued a formal warning.
  • Your benefit may be reduced or terminated.
  • Your assets may be seized.

You will be asked to repay the overpaid benefit in all cases.

Administrative penalties for benefit overpayment

An overpayment occurs when you receive too much benefit. It is considered benefit fraud if you have:

  • withheld information from your benefits office on purpose
  • given false information that may result in you receiving benefits to which you are not entitled

An administrative penalty of 50% of the overpayment may be imposed. For example, if you overpaid by £900, you would have to pay a £450 penalty. However, there is a minimum penalty of £350 and a maximum penalty of £2,000 that can be imposed.

If it is suspected that someone attempted to commit benefit fraud, a fixed penalty of £350 may be imposed instead of prosecution.

If your circumstances change, you must notify a benefits office so that you receive the correct amount of money. This will help to avoid any overpayments.

  • Report a change in your circumstances to receive benefits.

Benefits reduction

Depending on the severity of the benefit fraud committed and previous benefit fraud convictions, your benefits could be suspended for 13 weeks, 26 weeks, or up to three years.

For the most serious cases of organized or identity fraud, there will be an immediate three-year loss of benefit.

Benefits that are sanctioned

Benefits that can be withdrawn or reduced are referred to as sanctionable benefits. Among these are, but are not limited to:

  • Allowance for Employment and Support
  • Housing Assistance
  • Disability Benefit
  • Income Assistance
  • Allowance for Unemployed People
  • Pension Benefit
  • The Universal Credit system

Disqualifying advantages

Only sanctioned benefits can be reduced or discontinued. Some benefits are not sanctioned and are instead referred to as disqualifying benefits.

Among these are, but are not limited to:

  • Pension at Retirement
  • Allowance for Disability Living
  • Allowance for Attendance
  • Payment for Individual Independence

If fraud is committed against one of these benefits, a penalty against that benefit may be imposed.


If you commit benefit fraud while receiving any of the following benefits, your benefits will not be stopped or reduced:

  • Scheme for Diffuse Mesothelioma (2008)
  • Grant for Pregnancy Health
  • Maternity Benefit
  • 1979 Pneumoconiosis (Workers' Compensation)
  • Statutory Adoption Allowance
  • Statutory Maternity Allowance
  • Statutory Paternity Allowance
  • Statutory Sick Time

How your benefit claim is investigated for fraud

The information you provide to support your claim is double-checked to ensure its accuracy. This is used to determine how much benefit you may be eligible for.

Checks on your claim can be made at any time, not just when you file it. A spot check is sometimes performed on everyone receiving a specific benefit or on a specific group of people who claim.

To avoid being accused of benefit fraud, make sure the information you provide is up to date and accurate. You must maintain contact with your benefits officer to ensure that the information they have on file for you is correct.

Checks on your benefit claim on a regular basis

When you file a claim, benefits officers will investigate to ensure that the information you provided is correct.

What you say or write on the claim form may be compared to information held about you by another government agency. HM Revenue and Customs (HMRC) may, for example, ask if you are working and paying tax, or to confirm the earnings you have stated.

Information about you may also be shared with the Housing Executive and Land & Property Services, which must verify claims before approving Housing Benefit.

Providing proof to back up your claim

You may be asked to provide proof of your income or information about any property you own, such as your home or other real estate.

You will also be required to provide your National Insurance number or apply for one if you do not already have one. If you cannot recall your National Insurance number, you will be asked for information (such as your date of birth and address) in order for your National Insurance number to be located.

If an error is discovered in your claim,

If inquiries about you do not match the information in your claim, authorized officers may request that you attend an interview to discuss the matter.

Your claim will not be paid until these checks are completed, so it is critical that you attend the interview and respond quickly to any letters regarding the investigation.

Comprehensive examination of your benefit claim

If benefit officers suspect serious fraud, authorized officers will conduct a more thorough investigation into your claim. They may collect information about you and your family members and compare it to information previously provided on claim forms or during interviews.

Officers may contact private and public organizations that hold information about you, such as:

  • banks
  • establishing societies
  • providers of credit
  • credit card firms
  • Companies that transport money
  • companies that provide insurance
  • credit reference organizations
  • educational service providers
  • suppliers of gas and electricity
  • Telecommunications firms, including mobile phone companies
  • Student Loans Corporation
  • HMRC is one example of a government agency.
  • international authorities

Officers can only conduct investigations if they have reasonable grounds to suspect you are committing benefit fraud or assisting someone else in doing so.

Personal data and your rights

The Department for Communities gathers and stores information about you and any benefits you claim. It is legal to cross-check this data and share it with certain other organizations.

By law, you have the right to know what personal information organizations have on file for you. The Information Commissioner is in charge of enforcing it.

  • The Office of the Information Commissioner

Where can I get advice?

If you are concerned about being accused of benefit fraud, you should seek independent counsel.

If you are facing prosecution for benefit fraud, a penalty as an alternative to prosecution, or a formal caution, you should seek legal advice from a solicitor or speak with an experienced adviser.

Northern Ireland solicitors and the services they offer are listed by the Law Society of Northern Ireland.

  • Find a solicitor on the Law Society NI websiteOn the Law Society NI website, you can look for a solicitor.
  • Using the 08 and 03 numbers
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