Fraud
At ReturnToWorkSA we take fraud seriously. We investigate allegations of fraud to protect the integrity of the Return to Work scheme, and pursue prosecution where we find evidence of offending.
Fraud increases the costs of running the Scheme and takes money away from providing services to people who have been injured at work. Fraud also impacts employers in the Scheme by negatively impacting insurance premium rates.
The information you provide us with can help us in our investigations.
Employers, workers and service providers found guilty of offending can be liable for criminal penalties, fines, recovery costs and even imprisonment.
What is fraud?
Fraud is obtaining financial gain or other benefits through deception and dishonest means.
Examples of work injury insurance fraud include:
Employer fraud
- failing to register with ReturnToWorkSA when they are required to do so
- supplying false information to obtain or renew insurance
- falsifying documents such as a certificate of registration
- underestimating workers' remuneration or misclassifying workers to avoid paying the correct amount of premium (including “sham contracting”)
- discouraging employees from pursuing a claim.
Worker fraud
- claiming for an injury that didn't occur as a result of their work
- working while claiming to be totally incapacitated and receiving income support
- providing false information related to a claim or exaggerating an injury
- altering a medical certificate or other documents related to a claim.
Service provider fraud
- billing for consultations or services that didn't occur
- providing false or misleading information on a medical certificate or other documents.