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Health

Most healthcare providers are honest policyholders and would have nothing to do with insurance fraud, or would report any instances of fraud that they were made aware of. 

But health insurance fraud may exist in this area and some examples include:

    • Billing for consultations or services not performed 
    • Claiming for more costly procedures than actually performed 
    • Carrying out unnecessary procedures and charging for them, often at inflated rates 
    • Participating in the treatment of 'patients' brought in as a result of staged accidents 
    • Participation in false disability claims 
    • Falsifying motor accident treatments where no real injuries exist 
    • Multiple billing in the expectation that health funds won't detect the overpayments


As with all insurance fraud, the pocket it ultimately hits is yours.

If you have information that you believe in good faith is insurance fraud, report it NOW!

Types of Fraud

Workers Comp

This can include employees falsely receiving benefits such as time off work, by faking injuries, exaggerating legitimate ones, claiming for pre-existing injuries or those sustained that have no relation to the workplace.
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Motor Vehicle

This type of fraud takes many forms, including claiming theft in order to obtain money for an unsaleable car, or to cover up 'drink driving' accidents; staging car accidents; or vehicle arson.
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Property

Goods that are unsaleable due to their poor condition, quality or lack of market demand, may also be fraudulently 'lost' or 'destroyed'. In the case of buildings and plant equipment, arson is often involved.
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Arson

Insurance arson typically involves the intentional burning of insured property in order to destroy it and claim its insured value, especially when this is greater than the item's saleable value.
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Life

A typical example of life insurance fraud might be a person claiming a monthly benefit - while working another job on the quiet. More extreme examples include elaborately faking deaths and disappearances for the fraudster and any accomplices to secure the payout.
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Health

Fraudulent acts include healthcare or medical professionals billing for services not performed, claiming higher than actual costs, participating in the treatment of 'patients' brought in as a result of staged accidents, or carrying out unnecessary procedures.
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Other

People might claim falsely for injuries relating to falls (called 'slip and fall' accidents) or other incidents where the consequences can be exaggerated.
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