Workers Compensation Forum Working with Your Insurer Session

Workers Compensation Forum Working with Your Insurer

Session Outline • Role of the Insurer • Liability Decisions • Premium Cost Drivers • Communication Strategies

Role of the Insurer • • 7 claims agents 3 point contact Provisional liability Claim estimates Approve services & authorise payments Safe, durable, speedy RTW Injury Management Plan Regular contact

Liability Decisions • A no fault system – – – Worker Injury Work related Aggravation of pre-existing condition Journey & recess claims

Liability Decisions • • Initial notification Work. Cover medical certificate Claim forms Information provided during 3 point contact • Legislation & Work. Cover guidelines Responsibility of all parties to provide accurate information

Industry Performance - Employment Injuries • NSW Average – Incidence rate – 14 per 1000 workers – Frequency rate – 8. 5 per million hours worked • Community Services – Incidence rate – 18. 7 – Frequency rate – 13. 3 Incidence, frequency, time lost greater than NSW average but cost of claims less.

How is My Premium Calculated? WC premium based on risk • Industry – 3. 184% (non-residential care services) • Size/wages • Claims • DDL, GST Total premium – adjustment & renewal

What Impacts Claims Costs Claims costs are impacted by: • Number of claims • Severity of injury • Time off work • RTW outcomes & duration • Disputes OHS & RTW practices impact/drive premium

Communication Strategies Know your insurer and their services • Case Management Model Eg QBE Connect • Who is my case manager? • How do I contact them? • Initial contact process – online reporting • Issue resolution & escalation • Provide all relevant information • Trust their judgement • Be involved

Communication Strategies What additional services does my insurer provide? • @QBEConnect online claims analysis tool • National training calendar • Risk management services • Account management • Self insurance

What Is Our Common Goal? A FIT & HEALTHY WORKER