Fraud and compliance
The TAC is committed to protecting the funds and other assets placed under its control and protection for the benefit of the people of Victoria. Fraud represents potential risks to these funds and assets.
The TAC will not tolerate fraudulent or corrupt activities against its interests and will vigorously pursue parties engaged in such practices or attempting to do so.
Read the TAC Compliance and Enforcement Policy
How to make a report
Should you wish to make a report of fraudulent behaviour or other breaches of the TAC legislation, please contact the TAC's Fraud and Compliance Group by completing the online form, emailing Fraud_Compliance@tac.vic.gov.au or by calling 1300 654 329.
Fraud and the TAC
Fraud is dishonest activity or potential financial loss to the TAC including theft of moneys or other property by employees or persons external to the TAC. This includes:
- the deliberate falsification, concealment or destruction of documentation
- falsified documentation used or intended for use for a normal business purpose
- the improper use of information or position.
The following are examples of fraudulent behaviour:
- knowingly submitting a false claim
- providing false information
- working whilst on compensation benefits
- altering a medical certificate
- submitting false travel expense claims
- claiming for services which were not given (service providers) and
- providing false invoices, medical certificates.
Actions that may be taken by the TAC
Following an investigation, the TAC may:
- Commence criminal proceedings under relevant provisions of the TA Act or relevant criminal legislation
- Issue a letter of caution to the person
- Determine whether civil action should be taken to recover compensation amounts overpaid
- Refer the matter to the Victoria Police, the Coroner, the Office of Public Prosecutions (OPP) or another body (including professional or trade regulatory bodies such as the Australian Health Practitioner Regulation Agency (AHPRA) and the Legal Services Board) or
- Take no further action.
Any employee found to have engaged in, or concealed any such behaviour, may be disciplined, and their employment may be terminated.
TAC billing review program
The TAC has a Billing Review Program to ensure that payments for services provided to TAC clients are reasonable and appropriate. For more information please refer to:
- Billing Review Program - Information for Medical Practitioners PDF, 0.17MB
- Billing Review Program - Information for Medical Practitioners DOC, 0.75MB
- Billing Review Program - Information for Allied Health Providers PDF, 0.18MB
- Billing Review Program - Information for Allied Health Providers DOC, 0.75MB
- Billing Review Program - Information for Dental Providers PDF, 0.16MB
- Billing Review Program - Information for Dental Providers DOC, 0.82MB
2021/22 - Disrupting Fraud
By constantly evaluating emerging risks and using contemporary analytical methods, models, intelligence gathering and reporting techniques, the TAC is better equipped to identify potential fraud and claim anomalies at its origin.
The early identification of vulnerabilities, due to changes in service and benefit provision created by the global pandemic, has allowed the Forensics Group to expand our fraud risk assessments, improve our proactive fraud detection capability and create diverse opportunities to enhance our monitoring activities.
Telehealth, clients and providers supplying false information to the TAC, provider billing anomalies and clients potentially returning to work without notifying the TAC have all contributed to an elevated fraud risk profile during the second year of the pandemic.
Through our continuous monitoring, detection and response enhancements, significant growth has occurred in the number of reviews, investigations and prosecutions being initiated, effectively disrupting fraudulent behaviour and providing both a general and specific deterrence to fraud being committed against the TAC.
Throughout 2021-2022, the following enforcement action was taken:
- Twenty (20) prosecutions were finalised through the Magistrates Court. All cases resulting in a finding of guilt having a total amount in restitution being awarded to the TAC of $683,209.
- Thirty-Two (32) matters are currently before the courts where TAC is alleging fraud against the scheme totalling $1,521,763.
- There are a further Four (4) matters where prosecution has been endorsed with two matters referred to Victoria Police due to the fraud amount and statute of limitation issues and two matters awaiting service of charges totalling $450,089.
- A further Nine (9) matters relate to TAC clients wanted on Warrant with charges yet to be served, with a total fraud amount outstanding of $373,510.
The total alleged fraud against TAC before courts or awaiting service of charges is $2,345,362.
There are a further Eight (8) matters currently being reviewed for legal advice with a view to prosecution or other enforcement action, with a potential fraud amount of $234,426.
Cases that have not met the prosecution threshold are dealt with through the TAC’s principal means of achieving prompt voluntary compliance. Seventeen (17) warning letters were sent for breaches of the Transport Accident Act 1986 relating to fraud and providing false information to the TAC by clients, incorporating demands for reimbursement where appropriate.
Billing Review Program
During the 2021–2022 financial year, the TAC enhanced their proactive monitoring of service provider billing behaviour and adjusted their control landscape, which was supplemented by internal business referrals and information received from the public.
This program focuses on ensuring the invoicing supplied by service providers and the subsequent payments made are an accurate reflection of the services provided to TAC clients. For this reporting period, continuous monitoring activities and reviews were undertaken on more than 200 providers across a broad range of disciplines including Surgery, Physiotherapy, Pharmacy, Occupational Therapy and General Practitioners.
Prosecutions
Date | Defendant | Court | Result |
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12 Dec 2024 | Client AT | Magistrate's Court |
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07 Oct 2024 | Client AS | Magistrate's Court |
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31 Jul 2024 | Client AR | Magistrate's Court |
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24 Jul 2024 | Client AQ | Magistrate's Court |
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08 May 2024 | Client AN | Melbourne County Court |
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24 Apr 2024 | Client AP | Magistrate's Court |
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18 Apr 2024 | Client AO | Magistrates Court |
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28 Mar 2024 | Client AM | Sunshine Magistrates' Court |
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13 Feb 2024 | Client AL | Bendigo Magistrates' Court |
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07 Dec 2023 | Client AK | Ringwood Magistrates' Court |
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20 Nov 2023 | Client AJ | Frankston Magistrates' Court |
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16 Nov 2023 | Client AI | Frankston Magistrates' Court |
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04 Oct 2023 | Client AH | Heidelberg Magistrates' Court |
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21 Aug 2023 | Client AG | Ringwood Magistrates' Court |
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17 Aug 2023 | Client AF | Frankston Magistrates' Court |
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02 Aug 2023 | Client AE | Geelong Magistrates' Court |
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10 Jul 2023 | Client AD | Geelong Magistrates' Court |
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07 Jul 2023 | Client AC | Bacchus Marsh Magistrates' Court |
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03 May 2023 | Client AB | Dandenong Magistrates' Court |
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24 Apr 2023 | Client AA | Melbourne Magistrates' Court |
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14 Apr 2023 | Client N (Appeal) | Melbourne County Court - Appeal against conviction |
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05 Apr 2023 | Client Z | Ringwood Magistrates' Court |
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05 Apr 2023 | Client Y | Moorabbin Justice Centre |
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31 Mar 2023 | Client X | Bacchus Marsh Magistrates’ Court |
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28 Feb 2023 | Client W | Broadmeadows Magistrates’ Court |
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03 Feb 2023 | Client V | Frankston Magistrates’ Court |
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10 Jan 2023 | Client U | Kyneton Magistrates’ Court |
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13 Dec 2022 | Client T | Online Magistrates’ Court |
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12 Dec 2022 | Client S | Dandenong Magistrates’ Court |
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29 Nov 2022 | Client R | Heidelberg Magistrates’ Court |
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24 Nov 2022 | Client Q | Ringwood Magistrates’ Court |
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14 Nov 2022 | Client P | Sunshine Magistrates’ Court |
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09 Nov 2022 | Client O | Ringwood Magistrates’ Court |
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28 Oct 2022 | Client N | Sunshine Magistrates’ Court |
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19 Oct 2022 | Client M | Broadmeadows Magistrates’ Court |
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07 Oct 2022 | Client L | Online Magistrates’ Court |
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09 Aug 2022 | Client K | Ringwood Magistrates’ Court |
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02 Aug 2022 | Client I | Geelong Magistrates’ Court |
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01 Aug 2022 | Client J | Werribee Magistrates’ Court |
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18 Jul 2022 | Client H | Online Magistrates’ Court |
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08 Jul 2022 | Client F | Sunshine Magistrates’ Court |
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16 Jun 2022 | Client E | Dandenong Magistrates’ Court |
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10 Jun 2022 | Client D | Geelong Magistrates’ Court |
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30 May 2022 | Client C | La Trobe Valley Magistrates’ Court |
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16 May 2022 | Client B | Sunshine Magistrates’ Court |
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19 Apr 2022 | Abdul B | Broadmeadows Magistrates’ Court |
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04 Apr 2022 | Olivia A | Geelong Magistrates’ Court |
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09 Feb 2022 | Mahmood S | Heidelberg Magistrates’ Court |
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01 Feb 2022 | Client A | Sunshine Magistrates’ Court |
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11 Jan 2022 | Vicki L | Broadmeadows Magistrates’ Court |
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19 Dec 2021 | Tanveer K | Sunshine Magistrates’ Court |
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22 Nov 2021 | Pati T | Broadmeadows Magistrates’ Court (via Webex) |
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07 Oct 2021 | Ali N | Werribee Online Magistrates' Court |
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01 Oct 2021 | Jesse H | Ringwood Online Magistrates' Court |
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15 Sep 2021 | Blaze M | Heidelberg Online Magistrates' Court |
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10 Sep 2021 | Harrison L | Melbourne Magistrates' Court |
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20 Aug 2021 | Colin M | Sunshine Magistrates' Court (online) |
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07 Jul 2021 | Matthew W | Geelong Magistrates' Court |
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01 Jul 2021 | Robert E | Werribee Magistrates' Court sitting at Sunshine |
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28 Jun 2021 | Iman B | Heidelberg Magistrates' Court Online |
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28 Jun 2021 | Melody S | Wangaratta Magistrates' Court Online |
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22 Jun 2021 | Trash H | Mildura Magistrates' Court |
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22 Apr 2021 | Jonathan H | Dandenong Online Magistrates' Court |
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12 Apr 2021 | Semon L | Broadmeadows Online Magistrates' Court |
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22 Mar 2021 | Lacey B | Wangaratta Online Magistrates' Court |
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23 Feb 2021 | Jasit A | Sunshine Magistrates' Court |
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16 Feb 2021 | Navpreet S | Sunshine Online Magistrates' Court |
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01 Feb 2021 | Reece H | Hume Online Magistrates' Court |
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18 Dec 2020 | Ali A | OMC Broadmeadows Magistrates' Court |
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14 Dec 2020 | Cameron K | OMC Werribee Magistrates' Court |
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04 Dec 2020 | Khushminder P | OMC Heidelberg Magistrates' Court |
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22 Oct 2020 | Craig S | Heidelberg Magistrates' Court |
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08 Oct 2020 | Elizabeth E | Frankston Magistrates' Court |
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17 Sep 2020 | Abdul M | Frankston Magistrates' Court |
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12 May 2020 | Magdalena M | Dandenong Magistrates' Court |
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05 May 2020 | Mitchell L | Bendigo Magistrates' Court |
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16 Mar 2020 | Brooke L | Wodonga Magistrates' Court |
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19 Dec 2019 | Mustafa Y | Frankston Magistrates' Court |
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19 Dec 2019 | George M | Frankston Magistrates' Court |
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19 Dec 2019 | Fouzia M | Frankston Magistrates' Court |
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04 Dec 2019 | Vikwesh S | Heidelberg Magistrates' Court |
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04 Dec 2019 | Seyed G | Heidelberg Magistrates' Court |
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29 Nov 2019 | Paul D | Ringwood Magistrates' Court |
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21 Nov 2019 | Nicholas I | Ringwood Magistrates' Court |
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14 Nov 2019 | Amy P | Seymour Magistrates' Court |
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