Workers’ Compensation Claim Fraud in Canada

The Employers that fund Workers’ Compensation systems in Canada spend about $10 Billion annually on Workers’ Compensation claims.*  10% of the cost of claims is spent on fraudulent transactions** meaning that Employers spend $1 billion on claim fraud each and every year.

Research has found that 25% of disability insurance claims contain some element of fraud.***  In 2017, there were 761,000 Workers’ Compensation claims processed in Canada.* If one in four involved some degree of fraud then the average claim fraud resulted in $5,235 of claims costs – costs that unfairly drove up Workers’ Compensation premiums.

The fact is that the majority of workers filing workers’ compensation claims are honest, only taking from the system to which they are entitled.  Unfortunately, those workers seeking to defraud, take benefits disproportionately meaning that a minority of dishonest claimants account for significant increases to the overall costs of the system.  

Historically, the problem for employers concerned with workers’ compensation claim fraud has been the early identification and defence against those claims that pose the greatest risk for fraud or runaway claims costs.  ForensIQ Risk Intelligence has developed its Technology, Training and Consulting services to answer this need, empowering our clients to Predict which claims pose the greatest fraud risk, take steps to Deter fraud before it occurs and Detect fraud if it does occur.

* – 2017 Detailed Key Statistical Measures (KSM) Report –AWCBC
** – MPI, NICB and others
*** – St. Francis Xavier University Research Study