Claims Service Provider performance data

Latest figures published July 2020.

As part of our commitment to transparency into the performance of the management of claims in workers insurance, we now publish return-to-work (RTW) rates and net promoter scores (NPS) for our Claims Service Providers — Allianz, EML and GIO. To provide consistency for the return-to-work rate we have used the same calculation methodology for each Claims Service Provider. See return-to-work methodology below. The data presented below represents different portfolios of claims, details of which are provided under each Claims Service Provider. icare data indicates that RTW rates are generally better for large employers (more than $500k in Base Tariff Premium) than for small employers (less than $30k in Base Tariff Premium).

Note that:

  • 26-week RTW Scheme rates are 85.7 per cent for large employers and 76.3 per cent for small employers
  • EML manages 65 per cent of all the scheme's large employer claims, with Allianz and GIO having 19 per cent and 15 per cent respectively
  • Both Allianz and GIO have portfolios that are almost 100 per cent made up of large employer claims, with EML's claims mix being 26 per cent large employers and 74 per cent small and medium employers.

The NPS data uses a three-month rolling score and the NPS graphs below show responses from workers and employers rating their experience with each Claims Service Provider. NPS scores can be impacted by the duration of the claims in the portfolio.

icare and Claims Service Providers have a number of initiatives aimed at improving RTW rates and customer experience across the workers insurance scheme — see our latest monthly workers insurance claims performance data.

From 1 February 2020 Claims Service Providers Allianz and GIO began offering claims management services to eligible large business customers under our  Authorised Provider Model with QBE starting on 1 May 2020. We will start publishing QBE claims performance data later this year once we have enough data to measure its performance.

In addition, our online industry hub (ihub) offers a range of knowledge articles and tools to help employers and brokers make better informed decisions about workers insurance and to help keep their workplace safer. The ihub is full of workers insurance information with additional resources to help employers in the manufacturing, construction, health and transport industries navigate workers compensation.

 

Overall RTW results: 85.7 per cent at 26 weeks for employers with Group Basic Tariff Premium (GBTP) or Basic Tariff Premium (BTP) over $500,000.

In determining overall return-to-work rates, different employer sizes impact the overall result. 

Large employers generally perform better in terms of return-to-work outcomes when compared to the overall scheme. For April, the 26-week RTW rate across the scheme was 85.7 per cent.

This graph shows the average percentage of all claims where the injured employer returned to work at or before 26 weeks. For numerical data contained within this graph, please contact us.
  • View data for the overall return-to-work graph
    Months 26-week Return to Work — Large Employers
    July 2018 86.1%
    August 2018 84.6%
    September 2018 85.3%
    October 2018 84.4%
    November 2018 86.1%
    December 2018 85.3%
    January 2019 85.2%
    February 2019 85.8%
    March 2019 84.9%
    April 2019 84.6%
    May 2019 84.7%
    June 2019 84.0%
    July 2019 84.3%
    August 2019 84.5%
    September 2019 86.4%
    October 2019 86.1%
    November 2019 87.0%
    December 2019 84.8% 
    January 2020   84.9%
    February 2020 84.9% 
    March 2020 85.1%
    April 2020 85.7% 

Allianz

The Allianz data covers claims managed for large employers that were granted an exemption to stay with Allianz under the Authorised Provider pilot. As an Authorised Provider, Allianz has been operating under the icare service model on their system since July 2018. Allianz's small employer claims were transitioned to GIO in late 2018. Following the pilot, Allianz began offering new claims management services to eligible large employers under the Authorised Provider Model from 1 February 2020.

For April 2020, the return-to-work rate at the 26-week mark was 82.9 per cent for Allianz. Since the beginning of 2018, Allianz's RTW results have remained stable with rates between 83 and 88 per cent throughout the Authorised Provider pilot. Allianz currently has a 19 per cent share of employers eligible for the Authorised Provider Model. Allianz has focused on early intervention, proactive and regular communication and collaborative claim reviews to deliver these results.

This graph shows the percentage of all claims managed by Allianz where the injured employer returned to work at or before 26 weeks. For numerical data contained within this graph, please contact us.

*To better enable a comparison of claims service provider performance, RTW rates represent employers with a GBTP or BTP over $500,000.

  • View data for the Allianz return-to-work graph
    Months 26-week Return to Work — Allianz — Large Employers
    January 2018 86.3%
    February 2018 87.3%
    March 2018 88.5%
    April 2018 87.9%
    May 2018 88.2%
    June 2018 86.6%
    July 2018 86.6%
    August 2018 86.1%
    September 2018 85.9%
    October 2018 85.7%
    November 2018 88.7%
    December 2018 84.4%
    January 2019 85.3%
    February 2019 85.9%
    March 2019 86.2%
    April 2019 86.3%
    May 2019 84.8%
    June 2019 84.9%
    July 2019 84.4%
    August 2019 83.9%
    September 2019 86.6%
    October 2019 84.7%
    November 2019 84.1%
    December 2019 84.1% 
    January 2020   85.8%
    February 2020 86.3% 
    March 2020 83.2%
    April 2020 82.9% 
The Allianz NPS for injured workers has been mainly positive over 2019 throughout the Authorised Provider pilot, with a score of +19 in May. The employer NPS has consistently remained in positive territory from October 2018 and throughout 2019, most recently sitting at +45. Allianz's initiatives have focused on employee capability and ensuring regular and meaningful communication. 
This graph shows Allianz's Net Promoter Scores for Worker on Scheme Agent and Employer Scheme Agent. Note: the NPS results for some months in 2018 and 2019 in the above graph and below data table have been revised from figures published on this page in December 2019. For numerical data contained within this graph, please contact us.
  • View data for the Allianz Net Promoter Score graph
    Months Worker Employer
    January 2018 -10 10
    February 2018 -4 8
    March 2018 -3 1
    April 2018 -7 -1
    May 2018 -8 -3
    June 2018 -12 -2
    July 2018 -5 -8
    August 2018 7 -9
    September 2018 7 -16
    October 2018 2 3
    November 2018 -3 23
    December 2018 7 33
    January 2019 15 29
    February 2019 16 31
    March 2019 12 22
    April 2019 4 15
    May 2019 5 19
    June 2019 2 16
    July 2019 2 20
    August 2019 1 22
    September 2019 -3 11
    October 2019 3 9
    November 2019 10 3
    December 2019 10 27
    January 2020 14 43 
    February 2020 32
    March 2020 16  38
    April 2020 14 35
     May 2020 19 45

EML

EML data covers claims that were lodged with the Claims Service Provider from 1 July 2018. EML is the default provider for icare and supports the largest portfolio of claims. There was a period of instability to service in early 2019 following the introduction of icare’s new claims technology platform. This has since been rectified and service and RTW rates are improving.

The 26-week return-to-work rate for EML was 81.7 per cent for April 2020. It has been relatively stable over the period, with a positive trend more recently as enhancements to the new claims technology platform, service levels and claims management improvements have been delivered. The 26-week RTW rate for EML large employers was 85.8 per cent for April 2020.

This graph shows the percentage of all claims managed by EML where the injured employer returned to work at or before 26 weeks. For numerical data contained within this graph, please contact us.
  • View data for the EML return-to-work graph
       26-week Return to Work — EML
    Months All Employers Large Employers
    July 2018 76.41% 82.8%
    August 2018 78.01% 81.5%
    September 2018 78.80% 83.7%
    October 2018 78.15% 82.6%
    November 2018 78.84% 84.2%
    December 2018 78.92% 84.2%
    January 2019 79.25% 83.6%
    February 2019 80.22% 84.6%
    March 2019 79.36% 83.8%
    April 2019 79.47% 83.1%
    May 2019 78.64% 82.3%
    June 2019 78.40% 82.5%
    July 2019 78.60% 83.6%
    August 2019 78.60% 84.0%
    September 2019 80.08% 86.1%
    October 2019 81.19% 86.1%
    November 2019 81.7% 87.2%
    December 2019 80.3%  83.9%
    January 2020 80.4%  83.6%
    February 2020 80.4%  83.4%
    March 2020 81.3%  84.6%
    April 2020 81.7% 85.8%

The NPS for workers on EML has been improving, achieving a two-year high of +18 in May. As a result of efforts by EML and icare to improve operational performance, the NPS for employers has also steadily improved since April 2019 to +3 in May 2020. 

The NPS for claims managed in the Support Centre (claims with a predicted time loss of less than two weeks) perform well with scores of +42 (workers) and +11 (employers) in May. 

NPS results for more complex claims managed by a dedicated case manager have also improved significantly to +17 (workers) and +5 (employers).

This graph shows EML's Net Promoter Scores for Worker on Scheme Agent and Employer Scheme Agent. For numerical data contained within this graph, please contact us.
  • View data for the EML Net Promoter Score graph
    Months Worker Employer
    April 2018 -5 -50
    May 2018 -4 -51
    June 2018 -8 -46
    July 2018 -4 -38
    August 2018 -1 -40
    September 2018 4 -38
    October 2018 5 -38
    November 2018 5 -31
    December 2018 5 -31
    January 2019 2 -28
    February 2019 5 -26
    March 2019 5 -25
    April 2019 0 -35
    May 2019 -6 -34
    June 2019 -4 -30
    July 2019 0 -26
    August 2019 3 -19
    September 2019 5 -16
    October 2019 8 -11
    November 2019 11 -8
    December 2019 11 -6
    January 2020 10 -1
    February 2020 9 -4
    March 2020  12 -8
    April 2020 15 -5
    May 2020 18 3

GIO

The 26-week RTW rate predominantly includes new claims from employers granted an exemption to stay with GIO after January 2018. GIO began offering new claims management services to eligible large employers from 1 February 2020 under the Authorised Provider model. Any new claims lodged from additional employers will be included in the 26-week RTW rate as they reach that stage of development.

The graph below shows for April 2020 the 26-week RTW rate for GIO was 88.3 per cent. GIO currently has a 10 per cent share of employers eligible for the Authorised Provider model. From September 2018 onwards the 26-week RTW measure for GIO is represented by 100 per cent of claims from large employers; prior to this GIO had a mix of claims from employers, with 20 per cent from large employers and 80 per cent from small employers. Since July 2018, GIO's RTW rate has been relatively stable between a low of 86 per cent and a high of 90 per cent.

This graph shows the percentage of all claims managed by GIO where the injured employer returned to work at or before 26 weeks. For numerical data contained within this graph, please contact us.

*To better enable a comparison of claims service provider performance, RTW rates represent employers with a GBTP or BTP over $500,000.

  • View data for the GIO return-to-work graph
    Months 26-week Return to Work — GIO — Large Employers
    July 2018 90.9%
    August 2018 90.7%
    September 2018 89.5%
    October 2018 88.7%
    November 2018 89.4%
    December 2018 89.8%
    January 2019 90.3%
    February 2019 89.4%
    March 2019 87.2%
    April 2019 87.7%
    May 2019 88.1%
    June 2019 89.2%
    July 2019 87.3%
    August 2019 86.8%
    September 2019 87.2%
    October 2019 87.6%
    November 2019 89.6%
    December 2019 89.5%
    January 2020 89.9%
    February 2020 90.1%
    March 2020 89.2% 
    April 2020 88.3%
In line with GIO’s claims portfolio, the majority of GIO's NPS responses are from small employers and are aligned to claims with a date of injury before 2018. The NPS for workers has ranged from a low of -3 and a high of +22. At the same time, GIO's NPS for employers has remained below zero, with a strong increase from -21 in January to -4 as of May. GIO continues to focus on stakeholder engagement strategies to deliver consistent, quality communication to workers and employers. 
This graph shows GIO's Net Promoter Scores for Worker on Scheme Agent and Employer Scheme Agent. For numerical data contained within this graph, please contact us.
  • View data for the GIO Net Promoter Score graph
    Months Worker Employer
    January 2018 -3 -33
    February 2018 0 -28
    March 2018 7 -24
    April 2018 7 -23
    May 2018 6 -20
    June 2018 5 -16
    July 2018 6 -9
    August 2018 18 -9
    September 2018 18 -8
    October 2018 19 -11
    November 2018 20 -25
    December 2018 18 -29
    January 2019 14 -24
    February 2019 11 -14
    March 2019 17 -24
    April 2019 11 -24
    May 2019 8 -29
    June 2019 2 -33
    July 2019 -2 -38
    August 2019 -3 -37
    September 2019 -3 -29
    October 2019 3 -26
    November 2019 4 -28
    December 2019 4 -24
    January 2020 -2 -21
    February 2020 -5 -7
    March 2020 0 -5
    April 2020 -5 -1 
    May 2020 22 -4

Return-to-work methodology

The 26-week return-to-work (RTW) rate is defined as the proportion of weekly benefit eligible claims that are no longer receiving weekly benefit payments at or beyond six months after the injury month. The RTW metric uses a three-month rolling average and reports on injuries incurred 26 weeks earlier.

Tied to financial outcomes, this methodology has been used in the Scheme for a number of years and differs from that used by the Claims Service Providers, and to that used and reported by the State Insurance Regulatory Authority (SIRA).

We are continuing to work with SIRA on consistency in data and methodology.

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