use Win32::OLE qw(in with);
use Win32::OLE::Const 'Microsoft Word';
use Win32::OLE::Const 'Microsoft Office';  # mso constants
use Win32::OLE::Variant;

my $picture = $document->Shapes->AddPicture (
      'C:\lost-as-usual.bmp', 
      msoFalse, # link to file
      msoTrue,  # save with document
      100, 100, 100, 100, 
      $document->ActiveWindow->Selection->{Range}
    );
$document->SaveAs("$dir\\where-is-my-pic.doc", {
                                 'FileFormat' => wdFormatDocument
                                 });
$doc -> Close();