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Workers Compensation Forum Working with Your Insurer.

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Presentation on theme: "Workers Compensation Forum Working with Your Insurer."— Presentation transcript:

1 Workers Compensation Forum Working with Your Insurer

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

3 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

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

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

6 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.

7 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

8 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

9 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

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

11 What Is Our Common Goal? A FIT & HEALTHY WORKER

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