Case study: Workers Compensation
The client is a Melbourne transport company with over 1,200 employees.
Insurance House was introduced to this client via their WorkCover Insurer who had flagged the company as being in urgent need of assistance with their workers compensation program.
Assessing the situation:
Insurance House responded by conducting a comprehensive health check across their client’s workers compensation program. As a result of this comprehensive review, Insurance House identified several inadequacies in their client’s claims management processes including:
- Late lodgement of claims
- Outstanding compensation due to failure to submit certificates
- No injury management processes
- No Return-to-Work planning
The Insurance House Solution:
Insurance House implemented a strategic claims and injury management program for the client.
The program outlined a detailed strategy and Service Level Agreement that included the implementation of the following activities by Insurance House:
- Assisting with disputes including attending all conciliation conferences held by the Accident Compensation Conciliation Service (ACCS)
- Creation of preferred provider panels
- Quarterly performance reporting
- Development of an injury management program for managers
- Development of a Workers Compensation legal obligations handout to be provided to injured workers at claim lodgement
- Co-ordination and attendance at quarterly insurer claims review meetings.
A Service Guarantee included face to face, phone, email and video conferencing support, in addition to:
- 24 hour/7 days a week telephone assistance
- Return of telephone calls within 24 hours
- Respond to all correspondence within 3 days of receipt
- Claim reviews with key personnel at depots, including coaching and mentoring on early intervention and Return to Work (RTW) planning
- Face to face worker meetings on RTW
- Training for union delegates on workers compensation entitlements and worker/employer obligations.
At commencement of the program our client’s workers compensation premium for 2016/17 period was over $3M.
Positive changes implemented by Insurance House:
Our client now has a structured program with:
- A collaborative approach to injury management and RTW
- Manager/Supervisor ownership of injury management
- Well educated and informed workforce with regards to workers compensation
- A strong tri-party relationship across Insurance House, our client and the Claims Administration Agent, resulting in collaborative claims resolutions.
Mark Farrugia, Head of Workers Compensation,
Iain Lumsden, NSW Workers Compensation Manager
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