KEY POINTS:
ACC's fraud unit is criticised in an independent report for being aggressive, secretive, inconsistent and out of step with the rest of the organisation.
The review found the fraud unit generally followed appropriate investigation processes, but raised concerns over the application of those processes.
Concerns included reports that fraud staff might be accessing information which ACC was not privy to and that they were not fully aware of claimants' injuries or rehabilitation plans.
Some claimants had been investigated for doing household chores or volunteer work despite those activities being approved as part of their rehabilitation.
Other reports suggested triggers for investigations were inconsistent, with several of them coming from malicious phone calls from an estranged partner or family member.
There were also reports of an overbearing and unduly aggressive approach to some claimant investigations, which was not well aligned with a responsive social insurance organisation such as ACC. The review made several other criticisms about the unit.
It found there was a general lack of communication within various fraud teams, which might be leading to lost opportunities. Other sectors of ACC found the unit somewhat secretive and non-transparent.
It found there was a perception from other parts of ACC that the presence of former police officers and private investigators had negatively affected the group's interaction with the rest of the business.
The report found there were mixed views about the skill level within the unit, including a perceived lack of clinical expertise.
There were also concerns that investigations put the focus on prosecution.
It said the overriding conclusion was that the unit did not fit well with ACC's new direction as an important, responsive social insurance organisation.
The review - prepared by management consultants Doug Martin and Chloe Anderson and fraud examiner Barry Jordan - made several recommendations including that the unit change its name to the "investigation unit".
"The name 'fraud unit' is perceived as predetermining the outcome of an investigation as identifying fraudulent activity when there could be many other explanations and outcomes."
It also recommended establishing a new training and development adviser position to ensure national consistency in investigative processes and standards.
- NZPA
