What to Report
Fraud relating to workers’ compensation can take many forms. Here are some examples of fraudulent activity that concerns the Commission:
- employers understating or falsifying assessable payrolls;
- workers submitting false claims or working when they shouldn’t be and while in receipt of benefits; and
- third-party suppliers or health care providers billing for goods not supplied or services not performed.
Who to Call?
Call the Commission’s toll-free referral line at: 1-866-455-6565, providing as much information as you can.
What is Fraud?
Fraud is a criminal act characterized by intentional deception. It is committed when a person knowingly and willfully makes a false representation to the Commission by action or omission that results in payments or services that should not have been made.
The Impact of Fraud
Fraudulent activity impacts the organization’s integrity and accountability to its stakeholders and it adds to the difficulty in maintaining equity within the workers’ compensation system. Fraud affects not only the Commission, but all employers and workers whose rights the Commission must protect and whose responsibilities the Commission ensures are upheld.
Commission’s Corporate Fraud Statement
The Commission will not tolerate fraud or abuse from any party including employers, workers, suppliers, or service providers. The Commission will identify areas of exposure and take corrective measures necessary to protect the system. The Commission will aggressively seek to protect and recover any assets where fraud is suspected or confirmed.
The Commission’s Investigations Department is responsible for carrying our investigations in this area and to protect the Commission’s assets by limiting exposure to fraud and to recover assets that have or are in the process of being compromised.
To fulfill its objectives, this department will:
- identify and investigate instances of suspected fraud;
- promote enhanced fraud awareness through Commission publications;
- advise and assist other Commission departments with implementation of fraud prevention procedures; and
- lead loss recovery initiatives through referral to appropriate law enforcement agencies.
The toll-free referral line for the reporting of suspected fraud relating to workers’ compensation is: 1-866-455-6565. The line will accept calls using a voice mailbox 24 hours a day, seven days a week, and will be answered from 9am - 4pm, Monday to Friday.