Sep 16, 2013

Is Worker Compensation Fraud on the Increase?

The Australian Plaintiff Lawyers Association has expressed the opinion that attention focuses too much on employee misdemeanours, and too little on fraud committed by service providers and employers. While that may be the case, Injury Net has commented that, if insurance fraud were to be a corporation it would rank in the Top 25 of Fortune 500 companies.

Although their article focuses on the United States we have no doubt that things are similar in Australia, for crime knows no boundaries and replicates everywhere. The organization describes the main issues involving worker compensation claims as:

  • Claimant Fraud, including malingering and false claims;
  • Provider Fraud, such as false medical claims by consultants;
  • Employer Fraud, involving under-reporting incidents to lower premiums;
  • Insurer Fraud, which is underwriting without authority and denying benefits

Injury Net recommends that a worker compensation claims database be widely circulated, as part of a campaign to counter the scourge more effectively. This is unlikely to be successful in Australia because of our emphasis on individual rights. This begs the question, “what then should Australian employers and insurers do to protect their interests better?”

QLD Covert Investigations’ Approach

We believe that employers should follow a two-pronged strategy, given that provider fraud appears to go largely unnoticed, and our own impression that the low economy is driving employee fraud up. This involves:

  • Monitoring trends in company financial reports, and comparing these with industry averages
  • Rigorously investigating deviations from these norms, and tracking down their causes

Many accountants stop short after they have balanced a client’s books and look no further. If you have not received an audit query about your worker compensation claims costs yet, then you could be doing well, or might equally be losing a significant amount of money.

How QLD Covert Investigations Helps

We employ a dedicated team of corporate workplace fraud investigators, who have trained to analyse and understand financial statements, and to detect the trends we mentioned earlier. After that, they track down the root causes with great skill and specialist surveillance methods. Few employees make false worker compensations claims after one of their workmates has gone to jail. We have also been highly successful in tracing fraudulent medical providers, and seeing them dealt with under professional rules.

How to Contact Our Worker Compensation Claims Team

Our switchboards are open throughout the day and night, to receive your call and arrange a meeting. If you are unable to call 1300 553 788 for whatever reason, please click on the “contact us” tab, and complete a web enquiry that takes no time at all. We will contact you as per your request.

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