ACC has a zero tolerance policy towards dishonesty and fraud. It is standard practice to review and investigate claims when a client or treatment provider is suspected of being dishonest or if they are not meeting legal requirements. ACC has a team of specialist investigators based throughout New Zealand. These investigators assist with managing the ACC scheme by helping to ensure that ACC makes payments to (clients and providers) who are legally entitled to receive them and undertaking assessments and investigations where people have received payments, to verify if they were legally entitled to them.
What is a fraudulent act?
ACC considers a fraudulent act to be one that is intentional, dishonest and deliberate for the purpose of receiving payment that they or another person are not entitled to.
What can I do to help?
Where you have information, or access to information, that someone is acting fraudulently against the ACC, please contact the Investigations Unit on 0508 ACC FRAUD (0508 222 37283) or email investigations@acc.co.nz.
You may request that your call be treated in confidence.
Examples of behaviour that we are interested in hearing about
ACC clients
- Working while receiving weekly compensation, without advising ACC.
- Misrepresenting an accident and/or injury.
- Misrepresenting incapacity in order to receive payment or entitlements.
- Making false declarations.
- Altering documents to receive payment or receive entitlements.
ACC treatment providers
- Claiming for ACC funded treatments and services that they have not provided
- Claiming treatment times in excess of the time spent with the client.
- Providing unnecessary services for financial gain.
- False invoicing.
- False statements and declarations.
What happens next?
The information you provide will be sent to ACC’s Investigation Unit.
The Investigation Unit will assess the information received and consider whether further investigation is warranted. If, following an investigation, there are grounds for concern or proof a person has acted dishonestly, then ACC may consider one or more of the following actions:
- meeting with the provider or client to discuss the findings and seek an explanation.
- taking no further action
- informing the client’s ACC client services contact of any findings relevant to a claim
- establishing an overpayment
- recommending a review of a client’s entitlements
- issuing a warning to the provider or client
- applying penalties and raising debts
- recommending a formal complaint to a provider’s professional body
- removing or restricting provider invoicing privileges
- prosecution.
Last updated: 20 June 2008