How we protect you against fraud

Fraud against the fund impacts all our members – here’s how we prevent it. 

  • Fraud results in higher premiums and reduced benefits
  • Our investigations team identifies and prosecutes offenders
  • You can help us in the fight against fraud

As a not-for-profit fund, everything we do is to benefit our members. When someone commits fraud against the fund we all pay the price – through higher premiums and reduced benefits.

What is health insurance fraud?

Claiming for treatment or services that haven’t been provided, providing false information and falsifying documents are all examples of health insurance fraud.

What we do about it

Our investigations team detect fraud in a number of ways, from using sophisticated technology to identify unlikely treatment patterns to staff fraud-awareness training.  

What you can do

There are four main ways you can help:

  • Never leave your membership card with anyone, even a provider
  • Always check the details on your receipt – especially with electronic claiming
  • Regularly check your claims history in member services
  • Tell us about suspicious behaviour or irregularities

How to report fraud

We appreciate your help in combating fraud. Our team protects the identity of anyone who provides information. If you choose to remain anonymous, we’ll respect that too.

Online: report fraud

Phone: 1800 727 721


Reporting fraud

162.8KB PDF

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