Today we will cover Overview of the Scheme Recent developments Insured sector experience Asbestos Compensation Fund WorkCover Tasmania Initiatives 2
Scheme Overview In : 7 Licensed Insurers 11 Self Insurers Tasmanian State Service Total Written Premium $145,000, FTE workers new claims reported (or 66%) of claims received weekly benefits Total claims payments $147 million Total weekly benefits $49 million Lump sum benefits $41 million Medical and related benefits $46 million Average claim size $ Average medical and related benefits $5400
Recent 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 resolve Primary Treating Medical Practitioner Role introduced July 2010 – Requires medical professionals to spend more time with injured workers at the initial consultation to ensure claimants are being treated appropriately – Resulted in an increase in above-medical-excess claims, but we think these relate to claimants with more minor injuries Impairment assessment guides v3 introduced October 2011 – The 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 fusion – The scheme actuaries have allowed for a 4% increase in lump sum costs as a result 4
Coverage Wages increased by 3% in real terms (i.e. after adjusting for inflationary increases). This is the first real increase in wages since
Total claim numbers Total claims have reduced over the ten year period shown, with a sizable reduction in the last year 6
Above 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 role The above excess proportion has increased from 60% to 90% 7
Above excess claim frequency Above excess claim frequency is currently estimated at around 0.80 claims per $m wages 8
Claim payments After 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) 9
Claim payments (cont’d) After some stability in lump sum and legal costs, both payment types were considerably higher in 2012/13 Lump sums impacted by some very large payments in the year There is also a timing impact due to the 2009 amendments – Redemptions delayed due to the two year rule that is only now being reached 10
Lump sum numbers The number of redemptions has decreased in the first two years following accident – catch up is now evident Offsetting this, the number of impairment benefits have increased Potentially reflects claimants receiving their impairment benefit in advance of the redemption 11
Premium rates Suggested 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 12
Implications for profitability While achieved premium rates have increased, the scheme actuaries estimate that insurers (as a whole) continue to make losses on this business 13
Asbestos Compensation Fund
Established on 1 October 2011 Insurers, self insurers and the Tasmanian State Service pay a levy of 4% of premium to pay for the Fund 58 claims reported since inception – 34 claims accepted 19 ‘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 future – 6 ineligible for compensation and 3 reported with incomplete information About 2/3rds of accepted claims were ‘fatal’ i.e. mesothelioma and lung cancer 15
Asbestos Compensation Fund (cont’d) Just over $10 million paid by the Fund by 30 June 2013 Almost all of this (98%) is in respect of lump sum payments and funeral benefits Very little has been paid in medicals or weekly benefits 16
New WorkSafe Tasmania Initiatives
Fair 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 Scheme The 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?
Workplace Bullying in Tasmania The WorkCover Tasmania Board established a working group charged with investigating – the prevalence of workplace bullying in Australia and Tasmania the role of workplace cultures in preventing and responding to bullying the 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 bullying the most appropriate ways of ensuring bullying culture or behaviours are not transferred from one workplace to another possible improvements to the national evidence base on workplace bullying
Scope of Survey The 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 Survey Stage Two – Workplace Bullying Depth Interviews Stage Three – Workplace Bullying Organisational Research It is important to note that a proportion of the sample has been collected to date and preliminary findings are not yet available.
New Initiatives to Support Role of Primary Treating Medical Practitioner Accredited Medical Practitioners Online Medical Mentoring and Advisory Service Medical Practitioner's Handbook
Accreditation Medical Practitioner Online (AMPO) Integrated approach to management of accredited medical practitioners: Register Apply for accreditation Access training and reading materials Complete assessment Code of Conduct Access a range of resources Manage accreditation Participate in ad hoc training
Accreditation Medical Practitioner Online (AMPO) Training content: WorkSafe Tasmania and the scheme Roles and responsibilities of the Primary Treating Medical Practitioner Certification including case study Benefits of return to work Evidence based practice
New Medical Practitioner Handbook Developed by WorkSafe Tasmania in consultation with medical practitioners Developed for accredited medical practitioners involved in managing patients with a workplace injury or illness Aims to: Provide a holistic and practical understanding of the injury management process & its philosophies Highlight the role and responsibilities, and those of others involved in the injury management process Explain WorkCover Tasmania’s expectations of the role in the management of patients with a workplace injury or illness.
Medical Practitioner Handbook Divided into three main sections: 1.Preparing for the consultation – Injury management – People involved in the injury management process 2.During the consultation – Clinical framework principles of injury management – Workers Compensation Medical Certificates – Assessing the injured worker 3.After the consultation – Planning the worker’s treatment and return to work – Other health care professionals