How to spot workers compensation fraud

If you’ve recently had a worker make a claim for compensation, or if you manage people as part of your job, you’ll be well aware of the risk of fraudulent claims from your employees. Here are some warning signs to help you spot potential fraud and nip it in the bud before it increases your costs and insurance premiums, and makes you pay for the dishonesty of your employees.

Running a business or being a manager means you deal with people and risk every day. Unfortunately, accidents do happen, and sometimes employees will need to make a claim for compensation because of an injury that happened at work. It is absolutely fair for you to compensate an employee that has been injured or negatively impacted by something that happened while working for you. And that’s exactly why you have insurance!

But unfortunately, not everyone is honest in their claims. You need to know if someone is committing fraud against you, and the earlier you find out, the better! It is not fair for you and/or your business to pay for an employee’s dishonesty, nor fair for you to bear the brunt of increased premiums.

So here are some things to watch for if/when an employee makes a claim for compensation. By being more aware of the warning signs that you are being scammed with a fraudulent claim, you can identify insurance fraud earlier and put a stop to it!

Find out about their past
Generally, if someone has committed insurance fraud before, they’ll do it again. It can be difficult to find out whether someone has been involved in potentially fraudulent insurance claims, but a private detective with years of experience finding this information can make it a quick and easy process. Our Sydney/Melbourne detectives have found countless cases of people making multiple false claims across businesses and raking in the payments. By finding out about the employee’s history, through background checks and investigation, you can look for any indication that they might be scamming you.

If they have a previous claim for compensation, it’s a bad sign. If they have multiple claims for compensation in their history, then the alarm bells should be ringing! They may not have been caught before, but that doesn’t mean you have to fall victim as well. This kind of history can at least give you a reason to dig deeper, ask for more proof, or get your own proof of fraud!

Think about how likely their injury is
OH&S is a win-win situation. Employees have a safer environment and reduced risk of injury, employers reduce the risk of lost productivity and money spent on compensation claims. So with all these OH&S measures, it should actually be quite difficult and unlikely for a person to fall victim to a major injury or illness as a result of their work. If a worker is making a claim for an injury that is made very difficult or almost impossible by OH&S standards, you need to seriously consider investigating their claims. They may simply be exaggerating, and it’s just a matter of adjusting their benefits to better align with their injury, but it may be a case of complete fraudulence, and the employee could be deliberately setting out to take advantage of you.

See what they’re really up to
Insurance fraud and workers compensation fraud can vary from exaggeration and white lies to full blown lies and falsehoods. An employee could be lying about being injured or severely exaggerating the impact of the injury in order to get more money out of you. By initiating some discreet surveillance with one of our private investigators, you can find out what the reality of the situation is. If they’re claiming they can’t move their back at all, but you get surveillance footage of them playing sport on the weekend and doing heavy lifting around the house, you now have the evidence you need to challenge and shut down their claim.


If you have suspicions about an employee’s claim, our detectives can help you get the evidence you need to stop a fraudulent claim. We can help you put a stop to workers compensation scams and save you and your business thousands of dollars lost to fraud. If you have your suspicions, please call us today to speak with one of our discreet detectives. We have the highest degree of experience and skill, and know how to get you the evidence you need. Give us a call on 1300 721 715 or email to see how we can tailor a solution to match your business needs.