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ACC frauds hit $10m over past four years

#1 User is offline   hukildaspida 

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Posted 17 January 2013 - 10:07 PM

Note all the different variations and methodologies how figures are gathered and given in this article.


http://www.nzherald....jectid=10859641

ACC frauds hit $10m over past four years

By Jared Savage jaredsavageNZH
5:30 AM Thursday Jan 17, 2013


Scams would have cost $131 million more if fraudsters hadn't been caught, corporation says.

ACC fraudsters have ripped off taxpayers by more than $10 million in the past four years.

Figures released to the Herald reveal 64 people have been convicted for ACC fraud in that period, including "injured" clients who keep working and medical practitioners who bill for too much treatment.

The total amount ranges from $1.8 million to $3.5 million each year, although ACC says the scams would have cost taxpayers much more if the fraudsters had not been caught.

Stopping the frauds saved a further $131 million, according to figures released under the Official Information Act.

In the most recent financial year, ACC uncovered $3.5 million of false claims. Using actuarial methodology, ACC calculated the true cost would have been $35.9 million if the fraud was undetected and ran its expected course.

Many fraudsters are clients who keep working while receiving weekly compensation for lost earnings, lie about an accident, injury or their incapacity, or make false declarations or alter documents.

Among those convicted were widows who stole more than $763,000 by claiming ACC payments for their dead partners despite starting new relationships.

In some cases, the illegal payments went on for nearly 30 years and one woman was paid nearly $150,000.

The long-running rorts were discovered when the ACC started a nationwide review dating back to the 1980s.

In a separate case, a married couple were convicted in October for each making false claims.

Carl Adam Rutherford and Haley Ann Rutherford were each sentenced to 100 hours of community work and ordered to pay reparation of $8188 and $7683 respectively.

The Southland dairy farmers began receiving weekly compensation from ACC after separate accidents in 2002.

Both went on to work in different jobs while receiving weekly compensation, despite signing declarations stating that they were not in work or receiving income that could affect their entitlement to the compensation they were receiving.

ACC's general manager of claims management, Denise Cosgrove, says this was a disappointing example of deliberate offending, as the couple worked for various different employers while continuing to claim ACC's help.

"Most New Zealanders feel a sense of repugnance at this type of offending," Denise Cosgrove said.

"ACC exists to help people with genuine injury-related needs, and it's disappointing to see some people use it deceitfully for their own financial gain."

ACC also investigates medical practitioners who claim for treatment or services not provided, or claim extra time with clients, provide treatment when not needed or forge documents.

Levy payers who misrepresent their levy class to minimise levy rates, or understate or do not declare earnings to minimise levy rates are also investigated.
By Jared Savage jaredsavageNZH Email Jared
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#2 User is offline   doppelganger 

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Posted 18 January 2013 - 01:25 PM

well must be an old information gathered as the ACC advisor is no longer employed.

Denise Crosgrove has left and coule not make the statement.

I agree that ACC make a large number of claims that are false.

The one statement of claimants working and receiving compensaton due to loss of earnings is not an offence.

Making up documents that is false is an offence.

May be ACC is worried whats comming up.
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#3 User is offline   Alan Thomas 

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Posted 18 January 2013 - 01:47 PM

View Postdoppelganger, on 18 January 2013 - 01:25 PM, said:

well must be an old information gathered as the ACC advisor is no longer employed.

Denise Crosgrove has left and coule not make the statement.

I agree that ACC make a large number of claims that are false.

The one statement of claimants working and receiving compensaton due to loss of earnings is not an offence.

Making up documents that is false is an offence.

May be ACC is worried whats comming up.


You state that claimants working while receiving compensation due to loss of earnings is not an offence. I have been convicted of ACC fraud on the basis of this. Please explain.
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#4 User is offline   doppelganger 

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Posted 18 January 2013 - 02:04 PM

Allan read the legislation

Clause 49 of schedule 1.

Abatement
49 Earnings definitions for purposes of clause 51
(1) [Repealed]

(2) [Repealed]

(3) In clause 51(2), earnings includes any payment made on the termination of employment in respect of leave entitlements. The Corporation must treat such a payment as having been derived after the termination of employment for a period that is equal to the total period that the claimant could have taken as leave if the claimant had not received the payment.

(4) In clause 51(2)—

(a) earnings includes payments—

(i) whether made in New Zealand or overseas:

(ii) whether made in New Zealand currency or an overseas currency:

(B)/> employment includes employment whether in New Zealand or overseas.

(5) Payments made in an overseas currency must be treated as having been converted into New Zealand currency at the average rate of foreign exchange offered, at the date of payment, by registered banks in New Zealand.

Compare: 1998 No 114 Schedule 1 cl 23

Schedule 1 clause 49(1): repealed, on 1 August 2008, by section 33(1) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act 2008 (2008 No 46).

Schedule 1 clause 49(2): repealed, on 1 August 2008, by section 33(1) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act 2008 (2008 No 46).

Schedule 1 clause 49(3): substituted, on 1 July 2010, by section 47(1) of the Accident Compensation Amendment Act 2010 (2010 No 1).

Schedule 1 clause 49(4): amended, on 1 August 2008, by section 33(1) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act 2008 (2008 No 46).

50 Estimation for abatement purposes of earnings that cannot be ascertained
(1) This clause applies to a claimant who has—

(a) earnings as a self-employed person; or

(B)/> earnings as a shareholder-employee.

(2) This clause applies when the Corporation cannot readily ascertain, for abatement purposes, the claimant's actual earnings during a particular period, during incapacity.

(3) In order to calculate the claimant's earnings under this Part, the Corporation may estimate an amount that represents reasonable remuneration for the claimant during the period.

(4) The Corporation must have regard to—

(a) the evidence available of the claimant's earnings; and

(B)/> the nature of the claimant's employment immediately before his or her incapacity commenced; and

© the nature of the claimant's employment that the claimant has during the period of incapacity.

51 Abatement of compensation
(1) [Repealed]

(2) In calculating weekly compensation under this Part, the Corporation must reduce the amount of weekly compensation paid to a claimant so as to ensure that the total of the claimant's weekly compensation and earnings after his or her incapacity commences does not exceed the claimant's weekly earnings as calculated under clauses 33 to 45 or 47.

(3) [Repealed]

(4) The amount of a claimant's weekly earnings under subclause (2) must be adjusted in the manner provided in section 115.

Compare: 1998 No 114 Schedule 1 cl 24

Schedule 1 clause 51(1): repealed, on 1 August 2008, by section 33(1) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act 2008 (2008 No 46).

Schedule 1 clause 51(2): amended, on 1 August 2008, by section 33(1) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act 2008 (2008 No 46).

Schedule 1 clause 51(3): repealed, on 1 August 2008, by section 33(1) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act 2008 (2008 No 46).
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#5 User is offline   Alan Thomas 

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Posted 18 January 2013 - 02:31 PM

Yes doppelgänger I am very familiar with these portions of legislation.

Unfortunately you have not answered my question.

The ACC fraud unit seeks out injured claimants who they think are working. Typically what happens is they are threatened to cancel their own claim or suffer a criminal prosecution for ACC fraud. People like me who state that the ACC are wrong generally get prosecuted for fraud. Given that what you have stated above is correct, Can you explain why this is happening? Are we all dumb and missing something?
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#6 User is offline   Compassion 

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Posted 18 January 2013 - 09:44 PM

View PostAlan Thomas, on 18 January 2013 - 02:31 PM, said:

Yes doppelgänger I am very familiar with these portions of legislation.

Unfortunately you have not answered my question.

The ACC fraud unit seeks out injured claimants who they think are working. Typically what happens is they are threatened to cancel their own claim or suffer a criminal prosecution for ACC fraud. People like me who state that the ACC are wrong generally get prosecuted for fraud. Given that what you have stated above is correct, Can you explain why this is happening? Are we all dumb and missing something?


I'm sure major assumptions are made yes, but in your case Alan, why didn't you mention to acc your overseeing of business's?

If you had been open with the acc, declared your hours, any earnings, costs, any letter you wrote or phone call taken regarding the business's, then being upfront would have stopped acc making the negative assumption that you now say is wrong. If you'd filled in their hours sheets, the acc would of been happy and possibly provided you with OT"s or help in this rehab job you had created.
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#7 User is offline   netcoachnz 

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Posted 26 January 2013 - 08:47 PM

View Postdoppelganger, on 18 January 2013 - 01:25 PM, said:

well must be an old information gathered as the ACC advisor is no longer employed.

Denise Cosgrove has left and could not make the statement.


The reporter probably gained the information from ACC's own website. Denise Cosgrove on 18th October 2012 was presumably still employed by ACC.

doppelganger said:

<snip>
The one statement of claimants working and receiving compensation due to loss of earnings is not an offense.
<snip>


I presume you mean that the ACC claimant has officially told ACC that they are working and any adjustments to their workers compensation can be worked out.

How much can you earn before ACC starts to adjust workers compensation?
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#8 User is offline   MINI 

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Posted 26 January 2013 - 11:10 PM

View Postnetcoachnz, on 26 January 2013 - 08:47 PM, said:

The reporter probably gained the information from ACC's own website. Denise Cosgrove on 18th October 2012 was presumably still employed by ACC.



I presume you mean that the ACC claimant has officially told ACC that they are working and any adjustments to their workers compensation can be worked out.

How much can you earn before ACC starts to adjust workers compensation?


It is my understanding that you can earn up to 100% of your wage before abatement flicks in. That would equate to 20% of you gross earnings of 52 weeks before incapacity!!!

Thats off the top of my head.

If you need it clearer for an arguement in court you'd best look it up in the act.

I would still be inclined to tell them if you only make that much even if it doesnt need abating. Just so you dont get called fraudulent.

Good Luck
Mini
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#9 User is offline   Alan Thomas 

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Posted 26 January 2013 - 11:28 PM

View PostMINI, on 26 January 2013 - 11:10 PM, said:

It is my understanding that you can earn up to 100% of your wage before abatement flicks in. That would equate to 20% of you gross earnings of 52 weeks before incapacity!!! Thats off the top of my head. If you need it clearer for an arguement in court you'd best look it up in the act. I would still be inclined to tell them if you only make that much even if it doesnt need abating. Just so you dont get called fraudulent. Good Luck Mini


Globle warming copyright math
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#10 User is offline   David Butler 

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Posted 27 January 2013 - 06:44 AM

Netcoach

to work out the exact amount you can earn before abatement

get the gross amount weekly amount you receive ''FROM ACC'' payslip data

divide by 8 then multiply by 2

easy was as well same result GROSS dived by 4.


That will give you the amount of your own 20% that can be earnt before the abatement sets in.

forumla arrives at a> [inclusive as 20% gross earnings amount -not a 20% net amount]
as per the acc case managements formula.

applies to being an employee and self employment
A few things like acc levies /personal /company tax returns payments etc come into effect if you do self employment.
check with the case management and get it right re the info from employer to acc every week or the self employment 206 form sheets in to acc/which will then round up at the end of the financial years self employment figures from your tax return re acc levies etc for self employment.
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#11 User is offline   Huggy 

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Posted 27 January 2013 - 07:01 AM

Mini you are quite correct in that as courtesy you should tell ACC if you earn income, and even more importantly, you must tell them if you do any work whether its paid, unpaid, or voluntary, even if it is below the abatement level, which is what I have always told them when I work and how much I have received, however the act is quite clear, and I believe could be challenged if need be,

310 Offence not to provide earnings information to Corporation

(1)This section applies to a person who is receiving—
(a)first week compensation; or
(b)weekly compensation.

(2)A person to whom this section applies commits an offence if he or she fails to advise the Corporation as soon as practicable if his or her earnings have increased after he or she began receiving compensation in such a way as to reduce the compensation payable to him or her.

(3)A person who commits an offence against this section is liable on conviction to a fine not exceeding $5,000.
Compare: 1998 No 114 s 377

So my reading is, if you earn money, and it falls below the abatement level, and does not affect your weekly compensation, then I believe it cannot be classed as an offence if you do not tell them how much you have earned.
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#12 User is offline   David Butler 

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Posted 27 January 2013 - 08:30 AM

yes Huggy

as long as the earnings are declared in any employment and the acc levies / paye is paid or the personal declaration of income tax returns are put in and then its acc who receive that income data from the ird and then send out the self employment levy bill then all the paperwork is done
but it is an obligation to tell acc if you are working paid or unpaid.
the acc assistance to self employment is limited to acc having the paperwork only re abatement data, and they dont seem to care what you do exactly re self employment-Cant have any rehab proper being seen to be done-everyone will want that then and to costly for acc to provide So as long as there own ass is covered with the acc levy/abatement papers the rest dont exist as far as they concerned leaving the claimant to provide any actual what one does re working information to the fraud squad when they are set apon claimants. with the use of shonky assessment reports gained with the in my opinion, via the specifically set up to EXIT RIS unit-**** any rehab-thats all they doing-The RIS unit using a planned preordained mechanism with an intent provided by acc to the Toadies and ACC to then do over claimants for fraud.
as for any offense-i believe you are correct if the paperwork is all done. and acc advised of your activity and the tax issues all in hand.
I have been congratulated by ACC in writing for my self employment efforts but unbelievably ACC refused in writing to have any of my duties in self employment in any manner of record within my file.
Congratulated but we dont want to know what you doing just cover the ass of acc's enterprising schemes of deceit, with the abatement data and forget the rest-what the f time here as amazingly when that info should have be in the assessors hands to be informed of but acc dont want that do they as then they cant then claim via the de Plessis and the Kennedys and the Campbells /Stoners etc etc of acc toady fame,further complemeted with deceit ,by the notably famed Branch advisors such as Mallard and Heggarty that injures of claimants have mysteriously disappeared after many years-up to twenty five years of acc input to arrive at malingering and sitting on your ass taking there money So then can they as IS BEING DONE IN CHRISTCHURCH -as a production line staffed and managed by ACC remotely controlled RIS robots to MANY claimants at the present time..
the set up seems to be nail the claimant with malingering then side move via the assessor to injurys no longer exist so acc have no liablity thus exit.
Some have in the right word here-*****d this process up-seems a few well made recordings were never in whoever set up the plans little mind as a problem area.
There be a few more Bronwyns like tapes appearing one assumes when the going gets going.Oh deary me-did assessor/acc say that seems they told lies then dont it ;)/>/>/>
It is a MUST to record COVERTLY and****them all over later B)/>/>/>/>
a pp for Mini
your tax issues are a mere play time and drop in the pond within the roaring ocean gales of the ACC.

you have no idea of what really is the hard yards with the ACC.


MAYBE a thread of its own re the RIS unit otherwise known as FARAA,
= '' F Any Rehab At All'',unit showing the rehabilitation back to work things they achieve for claimants returning to independence.WHICH AFTER ALL IS WHAT THE RIS-actually should mean-return to independence ''SERVICE'' ;)/> .

Edited
****'s
and the big word l left out ''SERVICE.''

This post has been edited by David Butler: 13 February 2013 - 01:00 PM

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#13 User is offline   netcoachnz 

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Posted 13 February 2013 - 12:46 PM

Thanks 'Huggy' and 'David Butler' for your helpful comments. Much appreciated.
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