Fraud investigations

We investigate allegations of workers compensation fraud on a regular basis.

This is done through our Fraud Investigation Branch.

Anyone can refer a matter to us. This includes:

Some examples of the types of matters we might investigate can include:

  • an injured worker on weekly benefits deliberately fails to notify their insurer or employer when they start 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

The review, assessment and investigation process includes:

  • the gathering of  additional factual and background information after receiving notification of the suspected fraud
  • the examination of the allegations by an assessment committee
  • a full investigation where there is an indication that the offence may have been committed
  • investigation techniques include taking of witness statements, surveillance, issuing of notices to obtain documents and other evidence, and the execution of search warrants
  • where there is sufficient evidence to prosecute, the matter will be submitted to our Legal Services for consideration and advice

In some instances where insufficient evidence is uncovered to criminally prosecute a matter in court, costs might be recovered through civil action.

If you suspect fraud, there are several ways to report it.