2Today we will cover Overview of the Scheme Recent developments Insured sector experienceAsbestos Compensation FundWorkCover Tasmania Initiatives
3Scheme Overview In 2012-13: 7 Licensed Insurers 11 Self Insurers Tasmanian State ServiceTotal Written Premium $145,000,000FTE workers8 400 new claims reported5 500 (or 66%) of claims received weekly benefitsTotal claims payments $147 millionTotal weekly benefits $49 millionLump sum benefits $41 millionMedical and related benefits $46 millionAverage claim size $17 500Average medical and related benefits $5400
4Recent developments WIMS went live 1 July 2012 Resulted in a higher than usual level of uncertainty in the data for the first six months following implementation. However a number of initial teething problems have now been sorted out with only a small number of issues left to resolvePrimary Treating Medical Practitioner Role introduced July 2010Requires medical professionals to spend more time with injured workers at the initial consultation to ensure claimants are being treated appropriatelyResulted in an increase in above-medical-excess claims, but we think these relate to claimants with more minor injuriesImpairment assessment guides v3 introduced October 2011The intention of the revised Guidelines was to provide clarification on the methodology to be applied in assessing Whole Person Impairment (WPI), but there have been concerns raised by insurers and doctors that the new Guidelines may result in higher WPI assessments, in particularly for injuries involving spinal fusionThe scheme actuaries have allowed for a 4% increase in lump sum costs as a result
5CoverageWages increased by 3% in real terms (i.e. after adjusting for inflationary increases). This is the first real increase in wages since 2009Note these figures have been inflated to 30 June 2013 values, in order to control for the impact of inflation. Any trend therefore reflects real growth (i.e. in excess of inflation).
6Total claim numbersTotal claims have reduced over the ten year period shown, with a sizable reduction in the last year
7Above excess claim numbers Above excess claim numbers have increased over the ten years, with the large increase in 2010/11 attributed to the Primary Treating Medical Practitioner roleThe above excess proportion has increased from 60% to 90%
8Above excess claim frequency Above excess claim frequency is currently estimated at around 0.80 claims per $m wagesNote, the increase in FY11 is believed to be as a result of the introduction in the Primary Treating Medical Practitioner role.
9Claim paymentsAfter increasing over the last ten years, weekly benefit payments have reduced a little in the last year (1% lower)Medical payments have also reduced in 2012/13 (5% lower)Note these figures have been inflated to 30 June 2013 values, in order to control for the impact of inflation. Any trend therefore reflects real growth (i.e. in excess of inflation).
10Claim payments (cont’d) After some stability in lump sum and legal costs, both payment types were considerably higher in 2012/13Lump sums impacted by some very large payments in the yearThere is also a timing impact due to the 2009 amendmentsRedemptions delayed due to the two year rule that is only now being reachedNote these figures have been inflated to 30 June 2013 values, in order to control for the impact of inflation. Any trend therefore reflects real growth (i.e. in excess of inflation).Note some really large settlements are impacting the 2013 year. And there are potentially more to come (there has been press about the recent largest ever award for common law damages recently).
11Lump sum numbersThe number of redemptions has decreased in the first two years following accident – catch up is now evidentOffsetting this, the number of impairment benefits have increasedPotentially reflects claimants receiving their impairment benefit in advance of the redemptionCommon law not shown as only four common law claims have been paid in the post-amendment period. One to monitor going forward.
12Premium ratesSuggested premium rates have increased by 4% p.a. since 2010/11 while achieved rates have increased 5% p.a.Achieved rates remain around 20% below suggested rates
13Implications for profitability While achieved premium rates have increased, the scheme actuaries estimate that insurers (as a whole) continue to make losses on this businessOur current estimated costs for the 2008 to 2012 years indicate that insurers could be making losses on this business of the order of around 5% to 20% of premium. We note however that this is an uncertain conclusion as substantial amounts of estimated costs for these years remain unpaid, and there is a higher than usual level of uncertainty for the two latest years due to the introduction of the 2009 amendments.
15Asbestos Compensation Fund Established on 1 October 2011Insurers, self insurers and the Tasmanian State Service pay a levy of 4% of premium to pay for the Fund58 claims reported since inception34 claims accepted19 ‘new’ claims, 15 ‘backlog’ claims (i.e. diagnosed prior to Scheme commencement)15 claims assessed as less than 10% WPI and therefore not eligible for compensation; these claimants’ diseases may develop such that WPI exceeds 10% in the future6 ineligible for compensation and 3 reported with incomplete informationAbout 2/3rds of accepted claims were ‘fatal’ i.e. mesothelioma and lung cancer
16Asbestos Compensation Fund (cont’d) Just over $10 million paid by the Fund by 30 June 2013Almost all of this (98%) is in respect of lump sum payments and funeral benefitsVery little has been paid in medicals or weekly benefits
18Fair and Sustainable Project The WorkCover Tasmania Board has initiated a project to define what constitutes a sustainable premium range for fair levels of compensation for workers in the Tasmanian Workers Compensation SchemeThe Fair and Sustainable Project, will assess and make recommendations on:what constitutes a sustainable workers compensation premium range for employers in the Tasmanian Workers Compensation Scheme?what constitutes fair levels of workers compensation for workers in the Tasmanian Workers Compensation Scheme?what constitutes fair and sustainable workers compensation coverage in the Tasmanian Workers Compensation Scheme?what proportion of Tasmania’s Workers Compensation Scheme costs should be paid directly to the worker?
19Workplace Bullying in Tasmania The WorkCover Tasmania Board established a working group charged with investigating –the prevalence of workplace bullying in Australia and Tasmaniathe role of workplace cultures in preventing and responding to bullyingthe adequacy of existing education and support services to prevent and respond to workplace bullying whether the existing regulatory frameworks provide a sufficient deterrent against workplace bullyingthe most appropriate ways of ensuring bullying culture or behaviours are not transferred from one workplace to anotherpossible improvements to the national evidence base on workplace bullying
20Scope of SurveyThe Board commissioned a survey commenced in late August and the survey continues to collect data through September and early into October.A three-stage survey methodology is being applied that includes:Stage One – Tasmanian Community Bullying SurveyStage Two – Workplace Bullying Depth InterviewsStage Three – Workplace Bullying Organisational ResearchIt is important to note that a proportion of the sample has been collected to date and preliminary findings are not yet available.
21Accredited Medical Practitioners Online New Initiatives to Support Role of Primary Treating Medical PractitionerAccredited Medical Practitioners OnlineMedical Mentoring and Advisory ServiceMedical Practitioner's Handbook
22Accreditation Medical Practitioner Online (AMPO) Integrated approach to management of accredited medical practitioners:RegisterApply for accreditationAccess training and reading materialsComplete assessmentCode of ConductAccess a range of resourcesManage accreditationParticipate in ad hoc training
23Accreditation Medical Practitioner Online (AMPO) Training content:WorkSafe Tasmania and the schemeRoles and responsibilities of the Primary Treating Medical PractitionerCertification including case studyBenefits of return to workEvidence based practice
24New Medical Practitioner Handbook Developed by WorkSafe Tasmania in consultation with medical practitionersDeveloped for accredited medical practitioners involved in managing patients with a workplace injury or illnessAims to:Provide a holistic and practical understanding of the injury management process & its philosophiesHighlight the role and responsibilities, and those of others involved in the injury management processExplain WorkCover Tasmania’s expectations of the role in the management of patients with a workplace injury or illness.
25Medical Practitioner Handbook Divided into three main sections:Preparing for the consultationInjury managementPeople involved in the injury management processDuring the consultationClinical framework principles of injury managementWorkers Compensation Medical CertificatesAssessing the injured workerAfter the consultationPlanning the worker’s treatment and return to workOther health care professionals