Bogus ACC claims top $570,000 in Bay

By Natalie Bridges
One was caught playing rugby. Another doing martial arts. Some are elderly women. Others millionaires.
It's people like this who have swindled hundreds of thousands of dollars from you and other Bay taxpayers in the past year.
Bay of Plenty Times inquiries have revealed that ACC fraud uncovered in Tauranga and other parts of the Bay of Plenty totalled $570,000 in the past 12 months - and the actual amount could be even more.
ACC risk and assurance fraud manager Ernest Le Roux said of fraudsters: "It all varies so much, there is no profile of a typical fraudster - there is no such thing. We get defrauded by 80-year-old ladies to 25-year-old guys, millionaires to labourers."
And, what's more, fraudsters are going to great lengths.
In one case, a Bay fraudster claimed compensation for an injured back while playing forward for his local rugby team. Similarly, another was caught taking part in martial arts. Fraud investigators say it is impossible to know the problem's full extent.
Tauranga ACC receives between four and five allegations of fraud a week - via letters, anonymous telephone tip-offs, or through the ACC 0800 Fraud Hot Line.
About a quarter of complaints are made to the hot line.
Private investigators are hired to catch them out, said Mr Le Roux.
"We use private investigators for - amongst other things - things like surveillance.
"Surveillance of that person can identify if they are going to the gym for example, or deep sea diving - and is a good indicator of the capacity of that person.
"We will use whatever appropriate and legal means to make sure the public's funds and monies are properly managed."
Fraud takes many forms, he said.
After making a work-related injury claim to ACC, it was discovered one claimant had provided a falsified earnings certificate. Over a five-month period, they gained an overpayment of about $19,000 in weekly compensation.
An ACC case manager began an investigation after suspicions were raised. The courts ordered the repayment of the debt and 400 hours of community service.
Four successful court convictions also recovered $45,480 in reparations in the past year. A further 16 cases of fraud are currently with Bay solicitors, in addition to five arrest warrants.
Fraud investigators say it is impossible to know the problem's full extent.
Tony Lahman, ACC's serious fraud investigations and support manager, said: "Making a statement as to the size of the problem is impossible. I am unable to put a figure on something I simply don't know."
Mr Lahman said the court was now taking a harder line on ACC fraud than it had previously.
"About ... five years ago we were getting 25 per cent of reparations back through the courts. Now, it is more like 45 per cent," he said.
But even with increased success rates in the court, some money swindled by fraudsters is lost from the public pocket forever.
"It's not always full reparation in every case because people simply can't afford to pay the money back - but they are taking it more seriously in court now."
Sometimes it is not cost effective to take the offender to court, especially when fraud is relatively small.
Under ACC laws, the agency can outside of court demand fraudsters pay back up to three times the amount of debt. Nine such cases have come to light in the past year and were forced to repay a total of $14,234.
Under ACC, claimants can receive up to 80 per cent of their previous salary, or financial help ranging from the full cost of emergency care and ambulance assistance; part payment of non-urgent surgery; subsidised GP or specialist and other medical treatment; support services such as home help; or one-off tax free lump sum payments.
Taxpayer-funded Government agencies are hit hardest when it comes to ACC fraud.
"That is because it is not seen as fraud but as fair game."
Mr Lahman agreed the sense of a "victim" is missing from the crime.
"One judge described fraud against ACC as a victimless crime. People think 'I've paid into the Government, that Government has a bottomless pit of money' and they will get as much as they can out of it."
But the real victims are in fact the general public.
Said Mr Le Roux: "All of us pay ACC levies and none of us want money taken out of a scheme that can be used for good purposes."