Fraud control

Comcare is fully committed to complying with the Commonwealth Fraud Control Framework 2014 (Fraud Control Framework) (in particular section 10 of the Public Governance, Performance and Accountability Rule 2014) to minimise the incidence of fraud.

Comcare’s CEO has certified that we:

  • prepare fraud risk assessments and fraud control plans
  • have in place appropriate fraud prevention, detection, investigation, reporting and data collection procedures and processes that meet our specific needs
  • take all reasonable measures to minimise the incidence of fraud and investigate and recover the proceeds of fraud against Comcare.

Fraud prevention

Comcare’s Compliance Investigation Unit investigators are authorised by the CEO, to undertake investigations of criminal fraud and non-compliance regarding the claims and liability management functions of Comcare. All criminal fraud investigations are conducted in compliance with the Commonwealth Fraud Control Framework and the Australian Government Investigations Standards 2011.

During 2015–16, the Compliance Investigation Unit received 147 referrals for investigation. This is compared with 163 notifications in 2014–15 and a historical average of 110 notifications. The matters that were finalised in the 2015–16 year resulted in a reduction of $3.3 million in ongoing claim liabilities.

There were two matters before the Commonwealth Director of Public Prosecution for prosecution and sentencing during the reporting period. One matter was finalised, with the offender receiving a sentence of imprisonment (two years). The second matter is still before the courts.

Comcare continues to actively participate in the annual Commonwealth Fraud Liaison Forum. The forum is jointly managed by the Attorney-General’s Department and the Australian Federal Police.

Covert surveillance

Comcare acts in a lawful manner that is consistent with relevant legislation and guidelines. A cost/benefit analysis is used to determine whether covert surveillance should be used, taking into account the subject’s right to privacy.

During 2015–16, covert surveillance was undertaken on four APS employees. Of the matters that were finalised during the year, surveillance resulted in two of these employees having the liability on their workers’ compensation claims ceased.