Claims Service Provider performance data

Latest figures published 18 December 2019.

As part of our commitment to transparency into the performance of the management of claims in workers insurance, we are now publishing return to work (RTW) rates and net promoter scores (NPS) for our Claims Service Providers — Allianz, EML and GIO. We will continue to publish this data on an ongoing basis.

To provide consistency for the return to work rate we have used the same calculation methodology for each Claims Service Provider. See the 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 86 per cent for large employers and 75 per cent for small employers
  • EML manages 66 per cent of all the Scheme’s large employer claims, with Allianz and GIO having 18 per cent and 16 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. Claims with a duration less than 26 weeks have a combined worker and employer NPS result for Claim Service Providers of -3, while those more than 26 weeks have an NPS of -17.

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. We have also recently announced the Claims Service Providers that will be available to provide claims management services from early next year to eligible large business customers under our Authorised Provider model. In addition, our new online ihubs offer industry-specific resources to better support employers and brokers to navigate workers compensation. The Manufacturing ihub is the first of four being developed, with Construction, Transport and Health ihubs launching in 2020.

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 the icare service model on their system since July 2018. Allianz’s small employer claims were transitioned to GIO in late 2018.

For October 2019 the return to work rate at the 26-week mark was 85 per cent for Allianz. Since the beginning of 2018, Allianz’s RTW rate has been consistently ahead of the Scheme. Results have remained stable with rates between 83 and 87 percent throughout the Authorised Provider pilot. Allianz currently has a three per cent share of employers eligible for the Authorised Provider model. Allianz has focussed 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.
  • View data for the Allianz return to work graph
    Months 26 week Return to Work — Allianz
    January 2018 86.24%
    February 2018 86.46%
    March 2018 85.38%
    April 2018 84.38%
    May 2018 85.08%
    June 2018 85.06%
    July 2018 85.34%
    August 2018 85.59%
    September 2018 86.12%
    October 2018 85.75%
    November 2018 88.43%
    December 2018 84.60%
    January 2019 85.46%
    February 2019 86.20%
    March 2019 86.12%
    April 2019 86.48%
    May 2019 84.86%
    June 2019 84.83%
    July 2019 83.92%
    August 2019 83.87%
    September 2019 86.48%
    October 2019 84.63%
Allianz has a response rate for NPS surveys of 18 per cent for injured workers and 10 per cent for employers for October 2019. The Allianz NPS for injured workers has been consistently positive over 2019 throughout the Authorised Provider pilot. The employer NPS has likewise consistently remained in positive territory from October 2018 and throughout 2019 with a low of +9 and a high of +40. Allianz’s initiatives have focussed on employee capability and ensuring regular and meaningful communication.
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 0 32
    February 2018 -6 8
    March 2018 -3 1
    April 2018 -7 -1
    May 2018 -7 -3
    June 2018 -12 -2
    July 2018 -5 -8
    August 2018 7 -9
    September 2018 7 -16
    October 2018 6 14
    November 2018 7 37
    December 2018 16 40
    January 2019 27 30
    February 2019 21 29
    March 2019 14 29
    April 2019 10 17
    May 2019 12 21
    June 2019 13 15
    July 2019 11 21
    August 2019 10 24
    September 2019 0 12
    October 2019 3 9

EML

EML data covers claims that were lodged with the Claims Service Provider after 1 January 2018. EML is the default provider for icare and supports the largest portfolio of claims. EML had a period of instability to the service from February 2019 following the introduction of icare’s new claims technology platform. This has since been rectified and service and RTW rates are beginning to improve.

The 26-week return to work rate for EML was 81 per cent for October 2019. 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.

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
    Months 26 week Return to Work — EML
    July 2018 76.41%
    August 2018 78.01%
    September 2018 78.80%
    October 2018 78.15%
    November 2018 78.84%
    December 2018 78.92%
    January 2019 79.25%
    February 2019 80.22%
    March 2019 79.36%
    April 2019 79.47%
    May 2019 78.64%
    June 2019 78.40%
    July 2019 78.60%
    August 2019 78.60%
    September 2019 80.08%
    October 2019 81.19%

EML has a response rate for NPS surveys of 13 per cent for injured workers and 12 per cent for employers for October 2019. The NPS for injured workers has been relatively stable over this period and since April 2019 has been steadily rising. As a result of efforts by EML and icare to improve operational performance, the NPS for employers has steadily improved since April 2019.

The NPS scores for those claims managed in the Support Centre are +24 (workers) and +2 (employers) – these claims are triaged to that segment based on having a predicted time loss of less than two weeks and as typically the lowest duration claims across the Scheme they can impact NPS scores. Claims with a dedicated case manager have NPS results of +2 (workers) and -15 (employers). Specialised claims are unique – these claims have an NPS result of -16 (workers) and -48 (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

GIO

This data includes claims managed by GIO that were lodged prior to 1 January 2018 as well as new claims from employers granted an exemption to stay with GIO after that date. The GIO portfolio also includes a significant proportion of claims from Allianz, QBE and CGU that were migrated to GIO over 2017 and 2018. This contributed to some instability in mid-2017 and mid-2018.

The graph below shows for October 2019 the 26-week RTW rate for GIO was 88 per cent. GIO currently has a five 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.  Over the past 21 months this RTW rate has been relatively stable between a low of 83 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.
  • View data for the GIO return to work graph
    Months 26 week Return to Work — GIO
    July 2018 84.51%
    August 2018 85.76%
    September 2018 88.52%
    October 2018 88.11%
    November 2018 89.43%
    December 2018 89.85%
    January 2019 90.41%
    February 2019 89.59%
    March 2019 87.47%
    April 2019 87.89%
    May 2019 88.29%
    June 2019 89.41%
    July 2019 87.57%
    August 2019 87.06%
    September 2019 87.44%
    October 2019 87.91%

GIO has a response rate for NPS surveys of 16 per cent for injured workers and five per cent for employers for October 2019. 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 injured workers has remained relatively stable over this period with a low of -3 and a high of +20. At the same time, GIO’s NPS for employers has remained below zero with some improvement in this result over recent months.

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

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.