icare Workers Insurance claims performance data

Latest figures published September 2020.

We're committed to creating a fairer workers insurance scheme for employers and injured workers in NSW. As part of this commitment, we regularly publish a range of data to provide transparency into the performance of the management of claims.

You can find a description of the terms used in the graphs below in our glossary.

You can also view our Claim Service Provider performance data.

Return-to-work rates

icare monitors return-to-work rates in two ways based on:

  1. Work status codes: this is the measure reported by SIRA (view SIRA's workers compensation system dashboard) and shows the 12-month rolling average return-to-work rate
  2. The cessation of weekly payments: this measure shows the three-month rolling average return-to-work rate.

We show both measures below.

Return to work (work status code measure): 80.6% at 26 weeks

The return-to-work rate based on work status codes was 80.6 per cent in June 2020 and has shown slight improvement month-on-month since March 2020.

Work status codes are used by insurers to record the current work status of a worker. This primarily relates to whether a worker is 'working' or 'not working'.

This graph shows the percentage of all claims where the injured employer returned to work at or before 26 weeks based on work status code. Contact icare for details.

Graph shows from 1 July 2018–30 June 2020. Note: Return-to-work (work status code measure) data is a 12-month rolling average based on work status codes and is consistent with the measure reported by the State Insurance Regulatory Authority (SIRA). icare acknowledges data integrity issues with work status codes and associated key data fields required for the calculation of this metric and is continuing its work to address these issues.

  • View data for return to work (work status code measure) from July 2018
    Months Return to work at 26 weeks
    July 2018 88.8%
    August 2018 88.2%
    September 2018 87.7%
    October 2018 87.2%
    November 2018 86.7%
    December 2018 86.2%
    January 2019 85.6%
    February 2019 84.9%
    March 2019 84.2%
    April 2019 83.3%
    May 2019 82.1%
    June 2019 81.2%
    July 2019 80.8%
    August 2019 80.6%
    September 2019 80.6%
    October 2019 80.4%
    November 2019 80.3%
    December 2019 80.1%
    January 2020 80.0%
    February 2020 79.9%
    March 2020 80.1%
    April 2020 80.2% 
    May 2020 80.4% 
    June 2020 80.6% 

Return to work (cessation of weekly benefits measure): 80.8% at 26 weeks

The 26-week return-to-work (RTW) rate based on cessation of weekly payments declined to 80.8 per cent. The rate has come under increasing pressure since March 2020, which is a result of COVID-19 and related business disruptions including a reduction in available suitable duties.

The impact of COVID-19 on return-to-work rates is being felt differently across industries. The manufacturing industry for example appears to be remaining stable, while industries including accommodation, cafes and restaurants, retail trade, cultural and recreational services have been experiencing declining return-to-work rates since the pandemic began in March 2020 and this is expected to continue over the coming months.

This graph shows the percentage of all claims where the injured employer returned to work at or before 26 weeks based on reporting month (the month 26 weeks after the date of injury) and weekly payment transaction dates. Contact icare for details.

Graph shows from 1 July 2018–30 June 2020. Note: Return-to-work data (cessation of weekly benefits) is based on reporting month (the month 26 weeks after the date of injury) and weekly payment transaction dates.

  • View data for return to work (cessation of weekly benefits measure) from January 2018
    Months Return to wok at 26 weeks
    January 2018 85.6%
    February 2018 85.1%
    March 2018 84.5%
    April 2018 83.9%
    May 2018 83.2%
    June 2018 82.7%
    July 2018 81.9%
    August 2018 80.4%
    September 2018 79.8%
    October 2018 79.2%
    November 2018 80.0%
    December 2018 79.9%
    January 2019 80.2%
    February 2019 81.1%
    March 2019 80.2%
    April 2019 80.4%
    May 2019 79.5%
    June 2019 79.3%
    July 2019 79.3%
    August 2019 79.4%
    September 2019 80.8%
    October 2019 81.7%
    November 2019 82.2%
    December 2019 80.9%
    January 2020 81.0%
    February 2020 81.0%
    March 2020 81.7%
    April 2020 82.0% 
    May 2020 81.6% 
    June 2020 80.8%

Refining work status code-based return-to-work measurements

icare is continuing to work with actuarial experts to investigate how both return-to-work measurements can be improved to more accurately reflect actual return to work. This includes the following suggested changes to the method for the calculation of the return-to-work measure based on work status codes as reported to SIRA:

  1. Using the 'date of injury' as the starting date rather than the 'date of notification', which can be some time after the injury was sustained, for the calculation of return-to-work rates. Measuring from the 'date of injury' provides a more complete view of a worker's journey from injury to return to work. Using the 'date of injury' does have a slight adverse impact on the reported return-to-work rates as there is additional time in the calculation between when an injury is sustained and when a claim is lodged.
  2.  Measuring return to work based on 'individual accident month' rather than the '12-month rolling average based on reporting months'. Using 'individual accident month' figures would allow for earlier indication of performance, remove lag from rolling averages and observation of claim cohorts based on their accident periods.

icare is also currently working on metrics that have closer ties with actuarial valuations to replace the current cessation of weekly payments-based return-to-work measure.

Return-to-work rates since January 2018 (accident month using work status code)

icare experienced a deterioration in return to work rates in 2018 due to operational challenges including data integrity issues which icare is continuing to address.

Improvements in claims performance and data accuracy throughout 2019 resulted in an improvement in return-to-work measures. As noted above, the COVID-19 pandemic has presented challenges for injured workers returning to work due to related business disruptions including a reduction in available suitable duties.

We are working with our service partners to provide every available opportunity for workers to return to paid employment as the economy recovers.

The graph below shows these phases of return to work by accident month using work status code.

This analysis has been shared with the State Insurance Regulatory Authority.

This graph shows the percentage of all claims where the injured employer returned to work at or before 26 weeks, by the month they were injured, based on work status code. Contact icare for details.

The months in the above graph are accident months. For example, December 2019 captures workers that were injured in the month of December 2019 and therefore have reached 26 weeks since injury by June 2020. In addition, work status code-based metrics tend to have small upward adjustments as more data comes through for the latest months. For example, the December 2019 figure is likely to increase slightly over the coming months. The September 2019 accident month reached 26 weeks post-injury at March 2020 when COVID-19 business restrictions began, and as such this is the first COVID-19 impacted accident month.

  • View data for return to work (by accident month) from November 2017
    Months Return to work at 26 weeks
     November 2017 88.8%
     December 2017 85.4%
    January 2018 82.4%
    February 2018 81.0%
    March 2018 82.0%
    April 2018 82.0%
    May 2018 81.5%
    June 2018 81.5%
    July 2018 80.7%
    August 2018 81.7%
    September 2018 80.1%
    October 2018 78.5%
    November 2018 78.2%
    December 2018 78.0%
    January 2019 79.1%
    February 2019 79.8%
    March 2019 81.0%
    April 2019 81.3%
    May 2019 81.4%
    June 2019 79.5%
    July 2019 79.9%
    August 2019 81.6%
    September 2019 81.7%
    October 2019 81.2%
    November 2019 80.6%
    December 2019 80.0%

Liability decision timeliness: 99% within 7 days

In June 2020, the number of initial liability decisions made within seven days remained at 99 per cent (the average was four days).

While we have reduced the number of claims where we accept full liability at first decision, the number of claims where we accept provisional liability has increased. This enables quicker time to treatment and more time to investigate before liability decisions are made.

This graph shows the percentage of all claims where the Liability Decision was made within seven days, and the average days to initial liability decision. Contact icare for details.

Graph shows 24 months from 1 July 2018–30 June 2020. March 2018 – July 2019 (inclusive) captures all claims in the scheme. August 2019 – June 2020 only includes EML claims.

  • View data for liability decision timeliness from January 2018
    Months Liability decision timeliness (decision within 7 days) Average days to initial liability decision
    January 2018 72% 8.3
    February 2018 74% 8.6
    March 2018 97% 5.0
    April 2018 98% 6.1
    May 2018 98% 5.2
    June 2018 98% 5.5
    July 2018 99% 5.5
    August 2018 98% 6.0
    September 2018 99% 5.3
    October 2018 99% 4.8
    November 2018 98% 5.4
    December 2018 97% 5.4
    January 2019 97% 5.0
    February 2019 79% 7.0
    March 2019 67% 8.5
    April 2019 84% 6.5
    May 2019 92% 5.5
    June 2019 89% 6.1
    July 2019 94% 5.3
    August 2019 95% 5.0
    September 2019 98% 4.7
    October 2019 98% 4.7
    November 2019 99% 4.7
    December 2019 97% 3.8
    January 2020 99% 3.7
    February 2020 99% 4.0
    March 2020 99% 4.1
    April 2020 99% 3.9 
    May 2020 99% 4.2 
    June 2020 99% 4.1

Active claims: 44,484 for June 2020

The number of active claims increased in June to 44,484 after three consecutive months of declining claim numbers. This increase reflects the growing number of workers attending work following the reduction in COVID-19-related restrictions, particularly in industries such as hospitality and retail.
This graph shows the number of active claims per month. Contact icare for details.

Data shows from 1 July 2018–30 June 2020.

  • View data for active claims from January 2018
    Months Active claims
    January 2018 38,411
    February 2018 37,938
    March 2018 39,843
    April 2018 36,752
    May 2018 37,500
    June 2018 38,290
    July 2018 42,132
    August 2018 42,821
    September 2018 41,279
    October 2018 41,048
    November 2018 42,527
    December 2018 40,864
    January 2019 39,937
    February 2019 38,698
    March 2019 39,489
    April 2019 39,437
    May 2019 43,701
    June 2019 42,383
    July 2019 46,749
    August 2019 45,040
    September 2019 45,105
    October 2019 48,020
    November 2019 46,977
    December 2019 46,291
    January 2020 43,779
    February 2020 45,357
    March 2020 44,843
    April 2020 43,760
    May 2020 42,927
    June 2020 44,484

Claim payments: $207 million for June 2020

Total claims payments increased in June 2020 with weekly benefits and medical costs both increasing.

The increase in medical costs was expected as workers began to receive treatment that was delayed over April and May 2020 due to government restrictions, particularly on elective surgery.

This graph shows the amounts for different claim payments, weekly, medical and the total. Contact icare for details.

Graph shows from 1 July 2018–30 June 2020.

  • View data for claim payments from January 2018
    Months Weekly claim payments Medical claim payments Total claim payments
    January 2018 $54,300,000 $48,100,000 $157,800,000
    February 2018 $50,700,000 $45,900,000 $138,200,000
    March 2018 $53,300,000 $55,700,000 $162,100,000
    April 2018 $52,500,000 $42,700,000 $149,600,000
    May 2018 $61,000,000 $46,900,000 $166,500,000
    June 2018 $56,800,000 $51,000,000 $151,100,000
    July 2018 $61,200,000 $65,300,000 $191,200,000
    August 2018 $71,300,000 $69,400,000 $198,500,000
    September 2018 $63,000,000 $57,600,000 $175,500,000
    October 2018 $62,600,000 $54,600,000 $173,000,000
    November 2018 $66,400,000 $54,500,000 $187,100,000
    December 2018 $69,100,000 $53,000,000 $175,300,000
    January 2019 $67,500,000 $43,400,000 $167,500,000
    February 2019 $62,500,000 $46,900,000 $145,400,000
    March 2019 $66,100,000 $55,900,000 $169,000,000
    April 2019 $68,100,000 $54,700,000 $170,700,000
    May 2019 $74,900,000 $59,100,000 $189,700,000
    June 2019 $68,900,000 $51,200,000 $169,100,000
    July 2019 $81,800,000 $74,600,000 $215,300,000
    August 2019 $75,600,000 $64,300,000 $192,200,000
    September 2019 $77,600,000 $60,200,000 $194,700,000
    October 2019 $90,900,000 $64,600,000 $219,500,000
    November 2019 $79,600,000 $62,600,000 $209,300,000
    December 2019 $93,300,000 $60,800,000 $218,200,000
    January 2020 $81,600,000 $49,000,000 $179,900,000
    February 2020 $78,500,000 $58,400,000 $188,200,000
    March 2020 $88,000,000 $53,200,000 $198,700,000
    April 2020 $87,700,000  $56,400,000 $204,500,000
    May 2020 $87,700,000  $47,200,000 $188,100,000
    June 2020 $91,300,000 $51,000,000 $207,500,000

Service Levels (EML): 90% of inbound calls answered within 60 seconds

The percentage of calls answered within 60 seconds (defined as Grade of Service) was 90 per cent in June 2020. Average time to answer was below 25 seconds.

Changes to call routing in late 2019 improved our customer service, with calls being answered more accurately by case managers and their team members.

In addition, a significant increase in proactive case management has resulted in less inbound calls from workers seeking information on the progress of their claim, with initial contact with workers made in an average of 2.6 days in June 2020.

This graph shows the percentage of telephone calls answered within our target of less than 60 seconds, and the average call wait time. Contact icare for details.

Data shows from 1 July 2018–30 June 2020.

  • View data for service levels (EML) from January 2018
    Months Grade of Service — calls answered within 60 Seconds (%) Average time to answer (seconds)
    January 2018 29% 317
    February 2018 19% 467
    March 2018 59% 148
    April 2018 83% 32
    May 2018 76% 46
    June 2018 64% 70
    July 2018 70% 63
    August 2018 80% 36
    September 2018 75% 48
    October 2018 81% 36
    November 2018 79% 36
    December 2018 75% 45
    January 2019 70% 54
    February 2019 64% 65
    March 2019 68% 67
    April 2019 76% 53
    May 2019 83% 34
    June 2019 85% 31
    July 2019 85% 31
    August 2019 86% 30
    September 2019 85% 31
    October 2019 87% 30
    November 2019 88% 28
    December 2019 88% 28
    January 2020 91% 24
    February 2020 90% 26
    March 2020 90% 25
    April 2020 93% 23
    May 2020 92% 23
     June 2020 90% 25

Net Promoter Score: +23 for Workers Insurance

The Net Promoter Score (NPS) for Workers Insurance increased in June 2020 to a record high of +23. The NPS  for employers reached a record high of +8, while the NPS for injured workers climbed to +28 for the first time since September 2018. 

The increase in NPS was achieved, despite uncertainty for our customers around the consequences of COVID-19 on their claims.

Continued focus on customer interactions with emphasis on Grade of Service, customer enquiries resolved at first call and customer satisfaction measures have contributed to improved results.

This graph shows the Net Promoter Scores for Workers Insurance, Employers and Injured workers. Contact icare for details.

Graph shows 24 months from 1 July 2018–30 June 2020.

  • View data for the Net Promoter Score from January 2018
    Months Workers Insurance Net Promoter Score Employer Net Promoter Score Injured Worker Net Promoter Score
    January 2018 19 -6 24
    February 2018 19 -11 24
    March 2018 17 -9 25
    April 2018 14 -14 23
    May 2018 14 -13 24
    June 2018 14 -18 23
    July 2018 16 -16 25
    August 2018 16 -16 26
    September 2018 18 -19 28
    October 2018 19 -18 26
    November 2018 22 -25 27
    December 2018 21 -25 26
    January 2019 19 -26 24
    February 2019 21 -22 25
    March 2019 21 -20 26
    April 2019 18 -27 25
    May 2019 6 -31 20
    June 2019 6 -30 20
    July 2019 5 -26 20
    August 2019 8 -20 21
    September 2019 9 -17 21
    October 2019 12 -13 21
    November 2019 13 -10 21
    December 2019 13 -8 21
    January 2020 14 -4 21
    February 2020 13* -5* 15
    March 2020 13* -6* 16
    April 2020 15 -5 19
    May 2020 20 3 24
    June 2020 23 8 28

    * Due to a data sampling error in February 2020, this score has been weighted to create a normalised score.

Glossary

Liability decisions on time
Liability decisions that are made on individual claims within seven days.
Active claims
Claims that have had a payment or recovery activity in a particular month.
Claims payments
Gross expenses for claims payments—includes the two most costly expenses: weekly payments and medical expenses.
Weekly payments
The weekly payment amount is based either on weekly earnings or a maximum weekly compensation amount.
Average time to answer
The average time a customer has waited on the phone before their call is answered by support staff.
Grade of Service (GOS)
Calls from customers that have been answered within one minute by support staff.
Net Promoter Score
The Net Promoter score (NPS) is a metric that measures a customer's experience with us. It helps us and our business partners to understand and be accountable for how we engage with our customers, the workers and employers of NSW.