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Long Duration Claims Craig Stewart State Claims Manager Workers Compensation Claims WA (Occupational Health Society of Australia (WA Branch)

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Presentation on theme: "Long Duration Claims Craig Stewart State Claims Manager Workers Compensation Claims WA (Occupational Health Society of Australia (WA Branch)"— Presentation transcript:

1 Long Duration Claims Craig Stewart State Claims Manager Workers Compensation Claims WA (Occupational Health Society of Australia (WA Branch)

2 2 Agenda Costs Aligned to Duration Causative Factors What Can Employer’s Do What Are Insurers Doing

3 3 Cost Increase Aligned to Duration CGU Insurance Limited 2013 Not to be reproduced or copied without express consent from CGU Insurance Limited Duration BandingPercentage Increase of Costs <1 Week (Claims received 2012/13 year)0% 1 - 5 Weeks (Claims received 2012/13 year) 234% 5 - 13 Weeks (Claims received 2012/13 year) 163% 13 - 26 Weeks (Claims received 2012/13 year) 83% 26 - 52 Weeks (Claims received 2012/13 year) 81% >52 Weeks (Claims all current years) 64%

4 4 Causative Factors for Longer Duration – New Lodgements Employer Self Managing Delay in lodgement Pending liability Disputed Liability CGU Insurance Limited 2013 Not to be reproduced or copied without express consent from CGU Insurance Limited

5 5 Causative Factors for Longer Duration - Flags/Barriers Pain Feature Related Occupational Psychological Emotional Social Lifestyle Physical Other CGU Insurance Limited 2013 Not to be reproduced or copied without express consent from CGU Insurance Limited

6 6 Causative Factors for Longer Duration - RTW Employer based RTW with no set time frames RTWP not focused to achieve an outcome Knowing when to appoint an external provider Interstate workers Principally controlled worksites Visa workers CGU Insurance Limited 2013 Not to be reproduced or copied without express consent from CGU Insurance Limited

7 7 What Can An Employer Do Pre-employment medicals aligned to the role Set up preferred providers Liability, provide factual information, not hearsay Manage by the Act not emotionally CGU Insurance Limited 2013 Not to be reproduced or copied without express consent from CGU Insurance Limited

8 8 What Can An Employer Do If you are managing internally set a $ limit Learn how to identify flags and manage them Make key decisions around RTW at the right time CGU Insurance Limited 2013 Not to be reproduced or copied without express consent from CGU Insurance Limited

9 9 What Are Insurers Doing Liability Triaging Set clear action plans Utilise appropriate resources Case Conferences with GP’s IME reviews CGU Insurance Limited 2013 Not to be reproduced or copied without express consent from CGU Insurance Limited

10 10 What Are Insurers Doing Settlement strategies Does surveillance work Communication Work with and educate employers CGU Insurance Limited 2013 Not to be reproduced or copied without express consent from CGU Insurance Limited

11 11 Questions


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