21-07-2022-Kingaroy

The worker defrauded the insurer by claiming reimbursement of travel expenses from the insurer for medical appointments that were not related to his claim.

The worker was employed as a security officer when he sustained a right ankle injury. He lodged a claim for compensation with the insurer which was accepted.

The worker underwent several surgeries as a result of his injury and was required to attend numerous consultations with various medical practitioners for care, treatment, and rehabilitation.

As part of the management of his claim, the worker lodged various travel claims with the insurer for reimbursement of the mileage costs he purportedly incurred while travelling to and from appointments related to his injury. The worker lodged these travel claims electronically through the insurer’s Worker Assist App.

The insurer became suspicious of some of the claims the worker had submitted as no invoices were being provided by the medical practices which related to the appointments the worker had claimed he attended.

Enquiries with the worker’s treating medical team identified the worker was not attending many of the appointments he said he had attended when claiming for travel.

Workers must not claim reimbursement for costs that are unrelated to their claim, or for costs they did not incur.