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Reporting Fraud

Insurance Commission of Western Australia

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Reporting Fraud

Report Suspected Fraud (or False and Misleading Information)

Required fields are marked with an asterisk (*).

Type of insurance claim *

About the person allegedly engaging in fraudulent behaviour/or providing false and misleading information - Personal Details

First Name *

Last Name(s) *

Date of Birth

Age

Street Address

Suburb *

State

Contact Details

Telephone number

Mobile Number

Email Address

Social Media usernames

Description

Gender

Build

Country of Origin

Identifying characteristics (eg, Hair colour/length, facial hair, tattoos etc)

Sports/Hobbies/Recreational pursuits

Living arrangements

Partner's name

Vehicles (maximum three)

Vehicle 1

Registration number

Make

Model

+ add vehicle

Income/Employment/Business details (if currently working)

Employer/Business name

Employer address

If self-employed/own business

Industry type

Work location (if different)

Hours/week - days worked

Additional information (eg time of the day they start/end work, description of work vehicles driven, names of regular work colleagues etc.)

Details of Claim

Claim number if know

When/Where/How did the injury occur?

Injury details

Additional information

Why do you suspect the claim is fraudulent? (Please describe is as much details as possible) *

Document Upload

Do you have any documents/images/social media posts that you believe will assist the Insurance Commission of Western Australia to investigate this matter?

Document Upload

File size limit - 10mb

Person providing the information (optional)

Name

Telephone number

Email address

Preferred method of contact?

When is the best time to contact you?

Do you wish your contact details to remain confidential?

The Insurance Commission of Western Australia seeks to independently verify all information provided of suspected fraudulent activities.

Our Investigations and Intelligence Section ensures that every report of suspected fraud is treated in the strictest confidence and measures are taken to protect the identity of informants who wish to remain anonymous.

Page Last Updated 28 Aug 2020

Contact Us

Phone
+61 (8) 9264 3333 (local call)
1800 643 338 (toll-free outside the Perth metropolitan area)

8am to 5pm, Monday to Friday

Street Address
Level 13, Forrest Centre
221 St Georges Terrace
PERTH Western Australia 6000
View Map

Postal Address
Insurance Commission of Western Australia
GPO Box L920
PERTH Western Australia 6842

Reporting Fraud

Insurance Commission of Western Australia

Report Suspected Fraud (or False and Misleading Information)

About the person allegedly engaging in fraudulent behaviour/or providing false and misleading information - Personal Details

Contact Details

Description

Vehicles (maximum three)

Vehicle 1

Vehicle 2

Vehicle 3

Income/Employment/Business details (if currently working)

Details of Claim

Document Upload

Person providing the information (optional)

Contact Us