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WorkCover Internet > Law and policy > Fraud > Fraud investigations

Fraud investigations 

While the majority of people comply with their legal obligations, unfortunately some don’t.  WorkCover has a dedicated Fraud Investigation Branch whose role is to examine allegations of workers compensation fraud. 

 

All referrals received by the Fraud Investigation Branch are reviewed and if deemed appropriate allocated for further investigation.  The review, assessment and investigation process is:
  • referral is received or suspected fraud identified through  WorkCover Authority.
  • further factual and background information is gathered
  • the referral and further information examined by an assessment committee
  • if there is an indication that an offence may have been committed the matter is allocated for investigation
  • investigations are completed by WorkCover Investigators and may also be outsourced to private investigation companies
  • investigation techniques include the taking of witness statements, surveillance, issuing of notices to obtain documents and other evidence and the execution of search warrants
  • in some instances where insufficient evidence is uncovered to criminally prosecute a matter in court, costs maybe able to be recovered through civil action
  • where there is sufficient evidence to prosecute, the matter will be submitted to WorkCover’s Legal Group. 

A 'referral' means a complaint or ‘tip off’.  Any person can refer a matter to WorkCover including an employer, injured worker, or member of the public.

Examples of the types of matters investigated by WorkCover’s Fraud Investigation Branch:

  • An injured worker on weekly benefits fails to notify the Agent or employer of commencement of other employment.
  • A sub-contractor supplies a company with a falsified certificate of currency.
  • An employer fails to pass on workers compensation benefits to an injured worker.
  • A medical practitioner invoices for a consultation that did not take place.
  • An injured worker submits an altered medical certificate.

NB: in some instances whilst the activities of a person may be highly suspicious and it may appear that they are defrauding the system, there may be insufficient admissible evidence to prosecute.

 

To report suspected fraud:

Note: fraud referrals can be made anonymously.

Call 13 10 50 for more information about fraud investigations.


Did you know...

If an employee is convicted of committing fraud against the Workers Compensation System an employer may be entitled to a retrospective amendment of their workers compensation premiums.