MAIC prosecution secures CTP claim fraud conviction

A claimant has been convicted in the Southport Magistrates Court for attempted fraud and providing false or misleading documents, following criminal prosecution initiated by the Motor Accident Insurance Commission (MAIC).

The case involved a two-year Compulsory Third Party (CTP) insurance claim in which the claimant alleged severe ongoing pain, physical restrictions and an inability to return to work following a motor vehicle accident. Based on these claims, the claimant sought substantial damages, including compensation for economic loss.

During the investigation, surveillance evidence revealed the claimant engaging in activities inconsistent with their reported symptoms and claimed incapacity, including gardening, performing physical tasks at home, and undertaking driving-related work. An orthopaedic specialist reviewed the surveillance footage and concluded that the claimant’s presentation during medical examinations did not align with the observed activities and did not demonstrate an incapacity for work.

The claimant pleaded guilty to attempted fraud under section 87T(1)(a) and providing false or misleading documents under section 87U(3) of the Motor Accident Insurance Act 1994. The Court sentenced them to five months’ imprisonment, wholly suspended for 12 months, and recorded convictions for both offences. The Court highlighted that fraudulent claims undermine public confidence in the scheme and increase insurance premiums for Queensland motorists.

The Queensland CTP insurance scheme exists to provide fair compensation and access to medical and rehabilitation support for people injured in motor vehicle accidents.

CTP insurance fraud is when someone deliberately lies or gives false information in their claim. This might include claiming for an injury when they weren’t involved or injured in a crash, lying about how an injury happened or how it affects their life, or providing false or misleading information to support their claim. The overwhelming majority of claimants are honest, helping to ensure the scheme remains stable, fair, and affordable for everyone in the community.

While fraud is rare, it has serious consequences. Fraudulent claims make vehicle registration more expensive because CTP insurance is part of the registration fee. CTP insurance fraud is a criminal offence in Queensland, with penalties including fines, imprisonment, and recorded convictions that can impact future employment opportunities. Fraudulent claimants may also be required to repay significant sums of money.

MAIC plays a key role in safeguarding Queensland’s CTP insurance scheme by investigating CTP insurance fraud  allegations. MAIC initiates criminal prosecutions and collaborates with licensed CTP insurers, who play a critical role in detecting fraudulent claims and gathering initial evidence.

Queenslanders are encouraged to report suspicious or dishonest behaviour related to CTP insurance claims. For more information or to report visit our CTP insurance fraud webpage.