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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 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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