INSS automation denies 65% of requests – 11/14/2023 – Rômulo Saraiva

INSS automation denies 65% of requests – 11/14/2023 – Rômulo Saraiva

Anyone who thought that the automation adopted by the INSS would make life easier for retirees was wrong. So far, the institute has not been able to take full advantage of the technological tool. The audit carried out by the Comptroller General of the Union analyzed the process of automating the analysis of benefit applications implemented in 2022 by the INSS and noticed that the number of denials has been growing.

Considering automatic decisions, the percentage of rejections was 41% in 2021, while in the following year it increased to 65% when monitoring the results resulting from automation processes — robots. It is the highest percentage of rejections recorded since 2006.

According to an audit by the CGU, this significant increase in automatic rejections also favors undue or unfair denials. And it generates a vicious cycle, as automation —desirable precisely to speed up the accumulation of social security demands— ends up disrupting what is no longer going well. The consequence of this excessive unfair denial leads to rework, the return of citizens to the INSS queue to try again, the filing of an appeal with the CRPS (Social Security Appeals Council) or legal action to grant the administratively denied benefit.

It is of no interest to society if the INSS quickly denies benefits, especially when the denial is shown to be statistically unfair and is done in a precarious manner.

The main problem found by the CGU was the lack of risk analysis and planning by the INSS, which has been seeking to improve itself by evaluating the errors and successes perceived since 2017, when automation in benefits analysis began. The automated service systems are configured so that the application analysis steps are carried out according to each scenario generated from the requirements for different types of benefits.

As the stages progress, the automated administrative process may encounter different situations, such as referral to benefit systems for decision-making, creation of an automatic requirement or summary rejection (due to lack of grounds for the claim) . The analysis of a social security benefit is very complex, considering the number of standards that are produced over time and must be applied, the documents to be analyzed, the inconsistencies and absence of data from the National Register of Social Information (Cnis) itself. These are some of the factors that make the process dependent in many cases on human analysis.

The INSS needs to improve its methodology to increasingly define parameters that help reduce this exaggerated number of denials. There is no point in the organization taking advantage of this modernity if it has been causing so much distortion. Adjustments in the management, operationalization and transparency of automatic analyzes can be made, but the main solution involves the need to hire new servers, who are currently decisive in carrying out other activities in the agencies, as well as assisting in this automation process. Often, the robot, which uses Cnis to feed on information, generates an undue denial due to the fact that the database has not been manually updated in its links by the public server.

Across the country, the INSS has 19,510 active employees, compared to more than double in 2013. The CGU report draws attention to the fact that there is still a tendency towards the gradual replacement of human work by machines in relation to analytical activities. But in the social security area “there are processes and stages in which the server’s action is essential, such as in the evaluation and proposition of business rules, in implementing system adjustments, in changes to process flows, in monitoring and evaluating processing and its products, in addition to the execution of control actions”.

From what has been observed in INSS automation statistics, the administrative decision to prioritize robots over humans has worsened the situation of the insured, who needs a sensible analysis of their request for social security benefits.

Under current standards, policyholders have a 65% chance of having their claim rejected. This number needs to be addressed so that the public pension service is fairer in the country.

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