Why is compliance important?
A viable and financially sound Workers Compensation Scheme is in everyone’s interest.
WorkCover’s compliance policy is designed to take a balanced and fair approach by actively pursuing insurance fraud or non-compliance wherever it may be found in the Scheme. Such actions cost the Scheme – and ultimately employers – thousands of dollars. These actions also undermine community perceptions of injured workers and employers.
What we do about fraud and non-compliance?
WorkCover’s Insurance and Occupational Health and Safety (OHS) Divisions work closely together to monitor compliance. OHS inspectors also assist in the detection and investigation of non-compliant activities.
Changes made to protect the integrity of the Scheme include:
- introducing tougher deterrents and harsher penalties, including fines of up to $55,000
- making it simpler to calculate the amount of an employer’s premium by ensuring that all remuneration to a worker will be counted as wages when calculating workers compensation insurance premiums from 30 June 2003
- ensuring businesses compete equally by requiring, from 30 June 2003, principal contractors to check that their subcontractors’ have the appropriate workers compensation insurance
- establishing an Insurance Compliance Improvement Branch with specialist knowledge and experience in the detection of fraud and other non-compliant activities
- establishing a dedicated fraud prosecution unit within WorkCover’s Legal Group to ensure the successful prosecution of people who commit fraud against the Scheme
- introducing sophisticated technology to detect non-compliant activities
- developing a fraud training program to assist insurers to better detect and eliminate fraud-related matters.
What we are working on now
Further measures soon to be implemented by WorkCover include:
- increasing our involvement with government agencies, such as the Health Insurance Commission, Office of State Revenue, Centrelink, Australian Taxation Office, and the Department of Immigration and Ethnic Affairs to improve compliance
- working with insurers to develop more sophisticated fraud detection teams within their organisations
- the retrospective adjustment of an employer's premium should fraudulent activity be proved within a claim.