Fraud during work stoppages has become one of the most sensitive subjects in the French health system. Designed to protect sick employees, work stoppages are now misused by certain individuals or organized networks who make it a real fraud tool. The phenomenon is constantly progressing and its consequences weigh on both Health Insurance and insured persons. What do we call stoppage fraud? How to protect yourself from it? We tell you more in this article.
In 2024, theHealth insurance identified and stopped near 42 million euros in fraud linked to work stoppages.
In a nutshell, the work stoppage is a medical document that certifies that an employee is temporarily unable to perform his duties. Its duration is limited and depends on the nature of the situation.
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Health insurance mainly distinguishes between three types of work stoppagesL: the one linked to a disease or to a Accident outside of workl The one associated with a occupational disease The one that results from a accident at work
The increase in false work stoppages is spectacular. How can it be explained? In large part by the rise of false sick leave offered on social networks. These fraudulent documents, sold in the form of” ready-to-use kits ”, contain false work stoppages and false work certificates. They no longer aim to justify an absence but to Divert daily allowances directly.
The amounts involved are considerable: nearly 30 million euros have been detected on this category of fraud alone in 2024, compared to 8 million the previous year.
These figures reveal both the professionalization of fraudsters and the extent of the attempts.
To find out more, read our article on Health insurance fraud !
Faced with this rise in fraud, several measures have been taken to reinforce the security of prescriptions.
Health Insurance is now strongly encouraging the use of The dematerialized shutdown, transmitted directly from the doctor's professional software to the patient's cash register. This procedure limits the risks of falsification.
In addition, since July 2025, when a paper document remains necessary, practitioners must use secure Cerfa forms, printed on special paper with magnetic ink and holographic label.
Finally, since February 2024, the Prescribed stops in teleconsultation are limited to three days when they do not come from the attending physician or the referring midwife. The objective? Reduce abusive prescriptions and reserve long-term stops for professionals who really know the patient.
Do you want to discover more? Listen to our podcast with Marc Scholler Deputy Director of Health Insurance in charge of Finances, Fraud Control and Audit.
Sick leave fraud is not limited to the simple presentation of a false document. Today it takes several forms. Let's take stock!
1- Documentary falsification
Documentary falsification consists in manipulating an authentic medical document in order to make it more advantageous for the employee.
The most common methods are changing the duration of an initial stop, theadding or reproducing a medical stamp or even theAlteration of a signature.
At first glance, these changes may seem small: turning a five-day break into ten doesn't seem that big of a deal.
However, these alterations have a direct impact, they unduly prolong the employee's absence and lead to additional cost for the business and for the health system.
With the democratization of digital tools, these manipulations have become more and more accessible. A simple image editing software is enough to change a date or insert a fraudulent stamp.
2- The creation of false work stoppages
The fabrication of false work stoppages is one of the most worrying forms of fraud because it is directly linked to the rise of genuine parallel markets.
Now, some fraudsters design medical documents from scratch that perfectly mimic official forms. These fakes are then put on sale on the Internet or disseminated via social networks, often in the form of ready-to-use “kits”.
These kits include not only fake sick leave, but also forged employer certificates. They allow the fraudster employee to justify an absence from his company and to trigger, in some cases, the payment of daily allowances by Health Insurance.
The aim is no longer just to get a few illegitimate days off, but to embezzling public funds.
3- Judgments of convenience
Arrests of convenience are still a very widespread practice.
Unlike forged documents made from scratch, they are in fact issued by a health professional but without real medical justification. In this case, the practitioner issues a sick leave at the request of the patient, often out of indulgence, out of habit, or sometimes even out of personal interest.
These judgments pose a particular problem because they are, in documentary terms, perfectly authentic: they come from a duly registered doctor and follow the official form. However, in essence, they divert the purpose of the work stoppage, which is to protect the health of the employee. They thus allow a person in perfect capacity to work to benefit from an unjustified absence, while possibly receiving daily allowances.
Read on with our article on Internal document fraud in hospitals: understand and act
While sick leave fraud is expensive for Health Insurance, it impacts businesses and their employees just as much.
When a false document is presented, the company may be tricked into maintaining an undue salary, to reorganize its workforce and to face a drop in productivity.
Beyond the financial cost, fraud also generates a Climate of injustice. Employees who respect the rules note that some people abuse the system. They feel penalized, which can affect team cohesion and trust in the organization.
In some cases, a lack of control or too lax management can even expose the company to criticism, or even a reputational risk.
That is why the fight against document fraud should not be perceived as an administrative constraint but rather as a strategic challenge of responsible management.
Despite the advances made by Health Insurance, the risk remains. Falsified documents are still circulating and HR departments, often under pressure, can have difficulty identifying them.
An altered medical stamp, a discreetly changed date or a non-compliant form are all signs that may go unnoticed.
It is precisely to meet this challenge that Finovox proposes a comprehensive document verification software.
Thanks to this approach, companies can quickly verify the validity of the sick leave that is presented to them. Want to know more? Contact a Finovox expert!
