At the beginning of December, Deputy-Ombudsman Pasi Pölönen gave his decision on 20 complaints, which criticised the processing times of sickness allowance matters in the Social Insurance Institution of Finland (Kela).
According to the report received, the processing of sickness allowance cases had become heavily backlogged in spring 2021. As a result, the processing times had increased from the three weeks set as the target in Kela.
The main reason for the backlog was the strong increase in applications for the daily allowance on account of an infectious disease. In 2019, 120 people received the daily allowance for infectious diseases, whilst by the end of September 2021, Kela had received more than 125,000 applications for daily allowance on account of infectious diseases. In addition, the revenue reform of the Health Insurance Act and the introduction of a new processing system that entered into force in 2020 contributed to the application backlog.
Kela reacted to the situation and at the beginning of May, 60 new solution experts started working on applications for sickness allowance and allowance on account of an infectious disease. Kela has also carried out overtime work in order to clear the backlog. In October 2021, Kela reached the average processing time of three weeks in accordance with its objective.
The Deputy-Ombudsman considered that Kela had responded to the increase in the number of daily allowance applications and the resulting backlog in their processing appropriately and without undue delay. The increase in the number of daily allowance applications on account of infectious diseases had been so high that the Deputy-Ombudsman considered it a valid justification for the delay and that Kela had processed applications without undue delay in cases where the target time had been exceeded by two weeks, for example.
In some cases, however, the processing time was up to 9–10 weeks and over 14 weeks in one, without giving other reasons for the delay in addition to the general backlog of the application processing. In these cases, the Deputy-Ombudsman considered that Kela had neglected its duty to handle matters without undue delay. According to the Deputy-Ombudsman, Kela had not succeeded in ensuring the equal treatment of all its customers. He urged Kela to examine these aspects of its activities in order to avoid similar differences in the processing times of future applications.
Deputy-Ombudsman Pölönen also expressed his concern that the average processing time for sickness allowance matters had again increased to 26 days in December. He urged Kela to act so that the processing time would decrease again towards the target time.
For more information, please contact Principal Legal Adviser Juha Niemelä, tel. +358 9 432 3356.