Workers compensation insurance schemes are extremely important to ensure those that are injured or debilitated during the course of their employment are adequately remunerated so that they can continue to support their family, pay the rent or make their mortgage payments and put food on the table.
According to the Australian Workers’ Compensation Statistics Report 2017-18, there were 107,335 serious Australian workers’ compensation claims in the 2017-18 financial year which made up over nine people in every 1000 employers.
Soft tissue injuries made up 36 per cent of all of those claims, including neck and back strains, while falls, trips and slips made up another 23 per cent. Being hit by moving objects was next at 16 per cent. The average time lost in working weeks from serious claims was 5.8 weeks and labourers, community and personal service workers, machinery operators and drivers were the occupations with the highest rates of serious claims.
Whilst employers have a duty of care to their employees in terms of conducting proper risk assessments, safety training and providing adequate PPE, workers can still sustain injuries and workers compensation schemes are in place to protect the livelihood of both workers and employers. For vast majority of claims legitimate claims, early intervention and support is key to a successful outcome. Unfortunately, there is also a small percentage of fraudulent or protracted claims that can undermine an insurance scheme and compromise its integrity and commercial viability.
False workers compensation claims can be extremely harmful to Australian businesses
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The Insurance Fraud Bureau of Australia believes that fraudulent workers compensation claims could cost our economy up to $9 billion each year. But the IFBA also stated that only $280 million in fraudulent claims was detected in 2017, meaning there is a large gap between false claims detected and those that slipped through the cracks.
It puts businesses in a difficult place, as they want to ensure their workers are protected and get the compensation they deserve while also having to do their due diligence to ensure the claims are genuine.
Precise Investigation can conduct thorough Factual Insurance Investigations on behalf of all parties to assist in the delivery of a sound and proper liability determination decision.
It is in the best interests of workers, employers and insurance companies that the right outcomes are reached in all workers compensation claims without the process dragging on unnecessarily.
Our Factual Insurance Investigations will involve detailed interviews with all parties including statements and records with full confidentiality assured to assist insurers in determining liability.
Factual Insurance Investigations are for those cases where there is doubt or unclear information or evidence so that the right outcome can be reached.
It is important that the interview process as part of an investigation is undertaken with procedural fairness in mind. Workers and witnesses need to feel that they can trust the process to ensure that the integrity and quality of evidence is maintained.
The process includes notifying the worker and making them fully aware of what is involved and the reason behind the investigation, as well as giving them the opportunity to choose the time and place for the interview, including the option of having a support person attend with them.
Workers and employers can nominate relevant witnesses to be interviewed as part of the overall evidence gathering and verification process. In addition, there may also be further persons of interest or potential witnesses identified during the investigation.
Precise Investigation has the necessary experience and expertise to conduct a factual investigation that is procedurally fair, thorough and effective in assisting insurers in making informed and speedy decisions on personal injury claims.
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For extra support or assistance with your case, please do not hesitate to contact us at firstname.lastname@example.org or Tel: 03 9564 7303.