Previous improvement updates

As we have made improvements at icare we have provided updates to show progress.

    Previous updates

  • October 2021

    We are now publishing dashboards that show how the icare Improvement Program is progressing against recommendations made by reviews including:

    • the icare and State Insurance and Care Governance Act 2015 Independent Review Report by the Hon Robert McDougall QC (McDougall Review).
    • the independent review by PwC of icare governance, accountability, and culture (GAC Review).
    • Other reviews, including the Standing Committee on Law and Justice, Parliament of NSW, the Independent Reviewer’s Report of the NSW Workers Compensation Nominal Insurer Scheme (Dore Report), Independent Review of icare – Probity and Procurement (RSM), NSW Treasury Independent Review of icare - Financial Sustainability (Cumpston Sarjeant), icare Governance Review (Effective Governance).

    As at 15 October 2021, 84 per cent of activities to address McDougall Review recommendations are 'in progress', 85 per cent of activities to address GAC recommendations are 'in progress' and 70 per cent of activities to address other recommendations are 'in progress'.

    View Improvement Program progress dashboard (PDF, 0.8MB)

    Verification of our progress will be undertaken by an independent assurer. The first report will be an assessment of our progress, available in early 2022. Ongoing, these independent assurer reports will be made available here on our website, which will include progress and confirmation of completed actions. 

    Risk and governance 

    Governance

    • Management Committee Charters revised.
    • Business planning and prioritisation process developed for implementation in FY2022.
    • Appointment of new Non-Executive Directors with extensive financial services experience: Virginia Malley and Kylie Willment.
    • Consistency and transparency in Board reporting through new standard templates.
    • Conflict of Interest process documented, implemented and Directors attested, with quarterly attestation from senior leaders.

    Risk and compliance

    • Risk Appetite Statement, Risk Management Framework training delivered for senior leaders.
    • Fraud & Corruption Policy training delivered for high priority teams.
    • Compliance Management Policy promoted to staff via icare intranet.
    • Risk Maturity Index developed, endorsed by the Board and baselined results presented to Group Executive Team.

    Procurement practices

    • Enterprise procurement dashboards were released on icare's reporting platform to support better planning across the organisation and better decision making when it comes to suppliers and contracts.
    • Tailored procurement training program was launched and delivered to all staff.
    • Revised procurement policies and delegations published on icare's intranet.
    • Electronic catalogues for stationery and travel procurement delivered to simplify frequent low value purchases.
    • The actions against recommendations from the audit on public disclosures of icare's contracts were completed and the review was formally closed by the Information and Privacy Commissioner.

    Customer insights

    • New customer experience measures included within customer surveys to better inform continuous improvement opportunities. 

    Performance 

    Performance of the Nominal Insurer

    • We continue to report the return-to-work rates on our website.
    • Training on medical payment and decision making has started, as have the first tranche of system enhancements to greater control medical approval and payment integrity.

    Claims management

    • Pilot commenced to enable the transfer of employers' claims between claims service providers on the icare platform.
    • Phase 1 of Customer (employer) Self Service platform has gone live, with over 55,500 customer self service transactions made. Phase 2 of the Self Service platform to enable mid-term policy changes is also now available for employers.
    • Extended the claims management contract for Allianz to 31 December 2022. 

    Culture and accountability 

    Culture

    • Embedding refreshed icare values with follow-up sessions with icare leaders.
    • Inspire, icare's leadership program across the organisation has commenced.
    • icare Culture survey to establish a culture baseline sent to icare employees and results pending. 

    Other remediation matters 

    Pre-Injury Average Weekly Earnings (PIAWE)

    Nominal Insurer, as of 1 October 2021
    • A total of 12,889 reviews have been completed by the program.
    • 463 claims had quantifiable underpayments totalling $3,870,625.
    • A total of 232,637 letters/emails were sent to workers as part of the direct mailout which has generated 14,924 enquiries.
    • Deloitte Recommendations: Implementation underway.
    Treasury Managed Fund, as at 8 October 2021
    • A total of 1,194 claims have been reassessed. Of these, there were 745 incorrect calculations, of which:
      • 297 are underdeterminations and are proceeding to an entitlement review to determine if an underpayment has occurred.
      • 448 are overdeterminations and have no payment owed to them.
    • To date, we have quantified 4 claims with underpayments, totalling $75,482.
    • icare is working with Government agencies to obtain all relevant information
    Dust Disease Care historical payments
    • PwC is reviewing and remediating claims with known underpayments.
    Service provider invoice record processing
    • The remediation program has completed.
    • Total of $13.2 million payments processed.
    • $11.2 million (85 per cent) relate to invoices received in 2021.
    • All invoices were reviewed and those that required a payment have been processed. 
  • August 2021

    The below is activity in addition to the June 2021 update which can be found below this.

    Risk and governance

    As at August 2021 we have developed our plans of action for all of the recommendations relevant to icare in the McDougall review, which will be delivered over future periods. Below are actions that have made progress towards delivery of specific recommendations in the month of August.

    Risk and compliance

    Supporting the delivery of recommendations 6, 14–16 (McDougall) and recommendations 4, 16–18, 20–28, 32–41, 43–48, 51, 52 ,54, 57, 58, 68 (GAC).

    • Since 30 June 2021, the following policies and processes have been reviewed and updated to ensure we are putting the steps in place to help our people make better risk-based decisions:
      • the Risk Management Framework
      • Risk Appetite Statement
      • Fraud and Corruption Control Policy
      • Delegations Policy and Instrument.
    • ICAC (Independent Commission Against Corruption) training was delivered to Board and GET members, further building our capability in risk management.

    Procurement practices

    Supporting the delivery of recommendations 9–12 (McDougall).

    • We are improving our procurement practices by making it easier to do business with icare through fair and transparent processes and productive partnerships. Since 30 June, the following procurement policies and processes have been established:
      • Aboriginal Procurement Policy to build better partnerships with Aboriginal communities.
      • NSW Government Small and Medium and Enterprises and Regional Procurement Policy to build better partnerships with regional and smaller business suppliers.
      • Developing training in Essential Procurement Requirements and Considerations to help provide awareness on requirements icare employees need to follow when procuring goods and services in accordance with the NSW Procurement framework.
      • Enhanced focus has enabled compliance of procurement requirements. 
    • We are building new tools to support employees to manage procurement and contract management.

    Governance

    Supporting the delivery of recommendations 19–24, 29–31 (McDougall) and recommendations 1–15, 31, 32, 53, 55, 56, 59, 60, 61, 63, 69, 72 (GAC).

    • We have reviewed the charters and membership of all our management committees which clarifies accountability for decisions and increases monitoring of scheme and organisational performance. These committees monitor scheme performance and project delivery to established targets and objectives. They include the Group Executive Team and CEO and includes increased reporting to the Board.
    • The committees include a monthly meeting of the GET focussed on risk, as well as five sub-committees that govern business planning, scheme performance, customer outcomes, financial sustainability and risk and compliance.

    Performance 

    Performance of the Nominal Insurer

    We have established a multi-stream project to address key drivers that will support the delivery of recommendations 1–5 (McDougall) and recommendations 19, 49 – 52 (GAC).

    Pre-Injury Average Weekly Earnings (PIAWE)

    • We are giving all workers who received weekly workers compensation payments between October 2012 and October 2019 the opportunity to have their payments reassessed and any underpayments rectified.
    • In the Nominal Insurer, as of 6 August 2021 we have reassessed some 8,818 eligible claims. A total of 310 claims are found to have been underpaid to the amount of $3.4 million. Of these, 97 workers have accepted and received a payment. We have proactively contacted the other eligible claims.
    • In the Treasury Managed Fund, work has commenced with Government agencies and as at 6 August 2021 a total of 656 initial reviews have been completed with four workers identified as being underpaid their weekly entitlements to the amount of $76,000. We have proactively contacted the other eligible claims.
    • We have written directly to all eligible injured workers encouraging them to request a reassessment of their weekly benefits, with a total of 280,000 letters sent out across NSW.
    • In support of this mailout, a state-wide communications and engagement campaign, including radio, digital, print advertising and community engagement, has been completed to further encourage workers to request a reassessment of their weekly benefits.
    • The first stage of the Deloitte assurance review of the PIAWE review and remediation program is complete. Download the Deloitte report (PDF 1MB).
    • A cross-agency steering committee consisting of the State Insurance Regulatory Authority (SIRA), NSW Treasury and icare has been established and is overseeing the Deloitte assurance review and reviewing the PIAWE methodology more broadly.
    • icare proactively reported this issue to the State Insurance Regulatory Authority, NSW Treasury and relevant government bodies.
    • Participants have always had and will continue to have the ability for their entitlements to be reviewed at any time and icare will continue to review any participants' entitlements if they believe they are incorrect. 

    Dust Disease Care historical payments

    • A review of entitlements paid to Dust Disease Care participants has detected discrepancies in the interpretation of compensation payable under the 1942 and 1987 Workers Compensation Acts, which has caused some incorrect payment calculations.
    • icare has engaged a third-party provider to help develop its remediation strategy and is waiting on final advice from the provider before informing all affected people and estates and rectifying any underpayment of benefits.
    • Deloitte has been engaged to provide an assurance review over the proposed remediation approach before the commencement of the program. This will be published shortly.
    • An RFP is currently underway to identify a provider to complete the remediation program.
    • It is estimated this work will be completed by December 2021/early 2022.
    • Participants have always had and will continue to have the ability for their entitlements to be reviewed at any time and icare will continue to review any participants' entitlements if they believe they are incorrect. Participants can contact icare via email DDCenquiries@icare.nsw.gov.au or call 02 8223 6600.
    • As soon as icare identified the error the State Insurance Regulatory Authority, NSW Treasury and relevant government bodies were immediately notified.

    Customer

    Supporting the delivery of recommendation 6 (McDougall) and recommendations 15 and 42 (GAC).

    • We have launched an improved customer satisfaction measure that provides a greater depth of customer insight, which will be reported on once sufficient data has been received.
    • A new icare Customer Advocate, Melanie Howard-McDonald, has been appointed, charged with being the voice of the customer.

    Enterprise sustainability

    Supporting the delivery of recommendations 7, 27, 28, 32, 42 (McDougall) and recommendation 19 (GAC).


    Culture and accountability 

    Culture

    Supporting the delivery of recommendations 17, 18 (McDougall) and recommendation 62, 64-67, 70-71, 73-76 (GAC).

    • The plan to improve our culture is informed by the external reviews, and includes a number of initiatives to ensure we deliver schemes that are focussed on the people we serve.
    • Establishing a clear direction and foundation through a relaunch of the refreshed purpose, vision, strategy and values.
    • A comprehensive, integrated Leadership Development Program to support icare's cultural transformation with roll-out underway.
    • Refreshed performance management and remuneration framework in development.
    • Undertaking a baseline measure of culture in order to inform future planning and provide tangible measure of future progress. 

    Organisation reset

    Supporting the delivery of recommendations 6,9 (McDougall) and recommendations 29, 30 (GAC)..

    • Following an extended consultation period, new structures are being put in place.
    • Recruitment for vacant roles is underway.

    Other remediation matters

    As we progress through the improvement across icare we continue to review all our systems and processes to build confidence.

    This means that we'll continue to uncover and remediate any issues as they are found and publish our progress.

    Service provider invoice record processing

    As part of icare's ongoing remediation program a process error was identified in April this year that resulted in incorrect or duplicate invoice records related to claim services being incorrectly created in the claims management IT system.

    icare has established a multi-organisation program, including its claims service providers, to resolve the system issue and since May about 632,000 or 86 per cent of invoice records have been reviewed with the remainder to be complete next month.

    The error rate has been determined to be less than 1 per cent of all invoices issued in a given year, with icare paying over 3 million invoices totalling more than $1 billion each year. None were related to injured worker benefit payments.

    icare is committed to paying any incorrect invoices and will provide an update once the review is completed. When icare identified the error the State Insurance Regulatory Authority, NSW Treasury and relevant government bodies were immediately notified.


  • June 2021

    Risk and governance 

    Board governance

    • The Board recently endorsed recommended changes following a review to make sure all committees have a clear purpose, mandate and structure. Charters are being developed and memberships will be confirmed in due course.
    • The Governance Assurance Framework was implemented earlier this year to ensure an effective quality control process for all Board and Committee papers being submitted. This includes consistent paper structures, content guidance and a robust sign-off process. The Governance Assurance Framework will be regularly reviewed to ensure it is effectiveness.

    Management governance

    • Our new CEO, Richard Harding, has also introduced changes to the Group Executive Team to align icare leadership more closely with each scheme, and has established the new role of Group Executive Risk & Governance to establish clear executive responsibility for the key areas of risk, compliance and governance.
    • New scheme performance measurements and more frequent monitoring have been adopted to anticipate and address trends.

    Risk and compliance

    • In February an internal, independently managed Speak Up Hotline for employees was established for the reporting of any suspected wrongdoing, issue escalation and grievance handling.
    • New and updated Risk and Compliance policies and processes have been approved by the icare Board with implementation underway, including the Risk Appetite Statement, Risk Management Framework, Risk Management Policy,  and the Fraud and Corruption Control Policy. Implementation of the Obligations Register is under way, and the newly approved Delegations policy is expected to be implemented in July this year.
    • Our Conflicts of Interest Policy and declaration process was revised earlier this year and communicated to icare employees with face-to-face training provided to teams across icare. 
    • A new Chief Risk Officer was appointed in September 2020.
    • Since October 2020 the following policies and processes have been reviewed and updated to ensure we are putting the steps in place to help our people make better risk-based decisions to deliver better customer outcomes:
      • Business Continuity Management Policy
      • Material Outsourcing Policy
      • Policy Governance Framework
      • Incident and Issue Management and Reporting
      • Procurement Process development
      • Public Interest Disclosures (PIDs)
      • Speak up and Reporting Wrongdoing Policy
      • Privacy Policy
      • Privacy Management Plan
      • Gifts and Benefits Policy and Process
      • Travel Policy and process.

    Procurement practices

    • All contracts are now disclosed within GIPA compliance standards.
    • A new Group Executive steering committee has been established to support the icare-wide change program on procurement practices.

    Performance 

    Performance of the Nominal Insurer

    • We regularly publish performance data. View the claims performance data.
    • Data quality has been improved, including work status code data fields and data enhancements to recognise historic remediation activities.

    Claims management

    • We have increased the proportion of claims which are allocated to a dedicated case manager at lodgement.
    • We have revised the claims management decision framework.
    • We have empowered claims service providers to allow for greater use of Independent Medical Examiners.
    • We have expanded advisory services from icare's Medical Support Panel's to better support case managers.

    Pre-Injury Average Weekly Earnings (PIAWE)

    • We are giving all workers who received weekly workers compensation payments between October 2012 and October 2019 the opportunity to have their payments reassessed and any underpayments rectified.
    • In the Nominal Insurer, as at 18 June 2021, we have reassessed some 7,594 eligible claims. Out of these we proactively reviewed over 6,300 considered to be 'most disadvantaged or vulnerable'. We have paid $590,870 for 70 workers who were underpaid their weekly entitlements.
    • In the Treasury Managed Fund work has commenced with Government agencies and, as at 18 June 2021, 50 claims have been reassessed with six workers identified as being underpaid their weekly entitlements.
    • A communications and engagement campaign across NSW is underway to encourage eligible injured workers to request a reassessment. This has included radio, digital and print advertising encouraging workers to apply for a reassessment. In June 2021 we have written directly to over 70,000 impacted workers, with a further 210,000 letters to be sent.
    • Deloitte has been engaged to conduct an assurance review of the review and remediation program.
    • A cross-agency steering committee consisting of the State Insurance Regulatory Authority (SIRA), NSW Treasury and icare has been established and is overseeing the remediation program.

    Financial sustainability

    • In response to the McDougall Review recommendation we are working with SIRA and Treasury on a proposed updated Capital Management Policy for the Nominal Insurer in line with the Economic Funding Ratio approach. This is also being done for the Lifetime Care and Support policy.

    Culture and accountability 

    Culture

    • An integrated Culture Change plan has been developed along with the set-up of the Employee Culture & Engagement Council to support the culture, capability and accountability uplift across icare. 

    Organisation reset

    • Group Executive functions have been aligned to the schemes to bring end to end accountability to the senior management for the people we serve.
    • We are currently in the consultation period of an organisational restructure to bring the icare management structure in line with the schemes.

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