The State Insurance Regulatory Authority (SIRA) in NSW has escalated enforcement actions against insurance fraud in workers' compensation and compulsory third party (CTP) schemes in NSW, culminating in a recent series of prosecutions involving both claimants and employers. Since January 2024, SIRA recorded 11 prosecutions involving either fraudulent conduct or failures to hold compulsory workers' compensation cover, with further matters before the courts or under investigation.
Recent workers’ compensation matters have involved claimants who continued working while receiving benefits or used false documentation to support their claims. On Dec. 13, 2024, Andrew Leslie was prosecuted under sections 192E(1)(b) and 192G of the Crimes Act 1900 (NSW). The court found he received workers’ compensation payments totalling $147,566.40 while in full‑time employment, which was not disclosed to the scheme. Leslie was given a 12‑month Intensive Corrections Order supervised by Community Corrections and ordered to repay $147,566.40 and $26,000 in prosecutors’ costs.
On May 15, 2025, David Stevens was convicted under section 235C of the Workplace Injury Management and Workers' Compensation Act 1998 (NSW) for presenting counterfeit Certificates of Capacity. The court imposed a $1,500 fine, a 12‑month Community Corrections Order and payment of $3,595.63 in professional fees. In a separate matter on Sept. 18, 2025, Tyson Cloos was prosecuted under section 192E(1)(b) of the Crimes Act for obtaining $39,675 in workers’ compensation while holding a secondary job. He received a 12‑month Community Corrections Order, including 100 hours of community service, and was ordered to repay $39,675 and pay $3,000 in professional costs.
SIRA has also pursued employers that did not obtain or maintain mandatory workers’ compensation insurance under the Workers Compensation Act 1987 (NSW). On Jan. 28, 2025, MOS Insulation Pty Ltd and its director, Moshin Nabi, were prosecuted under section 155 for failing to obtain a workers’ compensation policy. The court fined the company $9,900, ordered a Double Avoided Premium of $11,000 and $5,500 in prosecutors’ costs. Nabi was personally fined $5,500.
On Aug. 13, 2024, Hospicare Pty Ltd was prosecuted under section 155 for failing to maintain a workers’ compensation policy. The court imposed a $1,000 fine, prosecutors’ costs of $2,991.33 and Double Avoided Premiums of $9,558.12. On the same date, Archi Glass Pty Ltd faced proceedings for a similar breach and was fined $500, with $2,805.56 in prosecutors’ costs.
On June 19, 2025, Kalwars Auto Pty Ltd was prosecuted under section 155 for failing to maintain a workers’ compensation policy. The company was fined $1,250 and ordered to pay $1,000 in professional costs.
Within the CTP scheme, SIRA has finalised four fraud‑related prosecutions since August 2024, mostly concerning statements about work capacity or employment status after motor vehicle accidents. In October 2024, Tina Pour‑Zahrouni was prosecuted under section 6.41 of the Motor Accident Injuries Act 2017 (NSW) for claiming she was unable to work after a crash while employed full‑time. She received $55,698.06 in benefits from GIO. Pour‑Zahrouni admitted the conduct and agreed to repay $40,457.06. The court imposed a 12‑month Intensive Correction Order, a $1,100 fine and $6,203.03 in prosecution costs.
On May 8, 2025, Issa Abid was convicted under section 192E of the Crimes Act 1900 (NSW) for dishonestly obtaining payments by deception. Abid submitted false certificates and declarations to a CTP insurer while representing that he was unemployed, receiving $135,166.01 in weekly loss‑of‑income benefits. The amount was repaid before sentencing. The court imposed a 12‑month Intensive Correction Order, ordered payment of $12,620.49 in prosecution costs and directed Abid to submit fingerprints to police.
On Nov. 6, 2025, Zheng Liang was prosecuted under section 192E(1)(b) of the Crimes Act for falsely representing that he could not work while employed, receiving $4,853.41 in compensation. The court imposed a 15‑month Community Corrections Order and ordered payment of $6,000 in professional costs. On Nov. 13, 2025, Rajbir Singh was prosecuted under section 6.40 of the Motor Accident Injuries Act 2017 (NSW) for making a false and misleading statement. The court fined Singh $1,000 and ordered $4,000 in professional costs.
SIRA has described these matters as evidence that “SIRA will not tolerate those that attempt to abuse the system that is designed to support the people that need it the most.”
The NSW actions sit within broader industry concerns about insurance fraud levels in Australia and other markets. The Insurance Council of Australia (ICA) has reported that its members detected $560 million in opportunistic motor and property insurance fraud in 2023. Undetected fraud is estimated at around $400 million a year, which industry stakeholders link to higher claims costs and pressure on pricing.
Internationally, Reinsurance Group of America’s (RGA) 2024 Global Claims Fraud Survey found that 74% of respondents viewed fraud case numbers as either steady or increasing compared with previous years. The survey, with 60% of responses from the Asia‑Pacific region including Australia, groups fraud into organised, deliberate, and opportunistic categories and estimates that claims‑stage fraud affects about one in 30 claims. According to the survey, 35% of respondents reported an increase in claims fraud, and 39% reported no change. For underwriting fraud, 85% of respondents reported either no change or an increase, with 17% reporting a rise. Respondents most often identified consumers as the primary source of fraud, with intermediaries, some medical practitioners, and internal or industry‑related actors also named.
