icare Workers Insurance claims performance data

Latest figures published June 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: 82% at 26 weeks

The 26-week return-to-work (RTW) rate increased slightly to 82% in March 2020.

While it is too early for the impact of COVID-19 to be seen in the RTW rate, it’s anticipated suitable employment opportunities for workers will be reduced in some workplaces as a result of the pandemic and related business disruption. We will be working with our service partners to ensure all avenues for workers to return to work will be investigated over the coming months.

The steady improvement to RTW rates in late 2019 reflects a number of initiatives we undertook with our service partners.

This work with our service partners  is continuing and reflects our efforts to deliver long-term sustainable return-to-work outcomes for injured workers

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

Graph shows from 1 March 2018 – 31 March 2020. Note: Return-to-work data is based on reporting month and weekly payment transaction dates. Note: The reporting month is the month that is 26 weeks after the claim has been reported. The data we use to report the RTW rate is different to that used and reported by the State Insurance Regulatory Authority.

  • View data for return to work from January 2018
    Months RTW at 26 weeks
    January 2018 86%
    February 2018 85%
    March 2018 84%
    April 2018 84%
    May 2018 83%
    June 2018 83%
    July 2018 82%
    August 2018 80%
    September 2018 80%
    October 2018 79%
    November 2018 80%
    December 2018 80%
    January 2019 80%
    February 2019 81%
    March 2019 80%
    April 2019 80%
    May 2019 79%
    June 2019 79%
    July 2019 79%
    August 2019 79%
    September 2019 81%
    October 2019 82%
    November 2019 82%
    December 2019 81%
    January 2020 81%
     February 2020  81%
     March 2020  82%

Liability decision timeliness: 99% within 7 days

In March 2020, some 99% of liability decisions were made within seven days (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.

We experienced two periods of decline in liability decision timeliness since January 2018, both related to the introduction of new technology where we experienced implementation problems. Since working through the backlog these issues created, the timeliness of initial liability decisions has continued to improve.

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 March 2018 – 31 March 2020. March 2018 – July 2019 (inclusive) captures all claims in the scheme. August 2019 – March 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

Active claims: 44,530 for March 2020

After rising slightly in February, the number of active claims lowered in March 2020.

This drop in the number of claims lodged in March was influenced by the COVID-19 pandemic with reduced numbers of workers attending work, particularly in industries such as hospitality, parts of retail and arts/entertainment. 

This graph shows the number of active claims per month. Contact icare for details.

Data shows from 1 March 2018 – 31 March 2020.

  • View data for active claims from January 2018
    Months Active Claims
    January 2018 38,408
    February 2018 37,935
    March 2018 39,841
    April 2018 36,750
    May 2018 37,500
    June 2018 38,290
    July 2018 42,131
    August 2018 42,821
    September 2018 41,279
    October 2018 41,047
    November 2018 42,529
    December 2018 40,866
    January 2019 39,936
    February 2019 38,700
    March 2019 39,495
    April 2019 39,443
    May 2019 43,702
    June 2019 42,385
    July 2019 46,756
    August 2019 45,031
    September 2019 45,096
    October 2019 48,046
    November 2019 46,997
    December 2019 46,416
    January 2020 44,055
     February 2020 45,443
     March 2020 44,530 

Claim payments: $193 million for March 2020

Total claims payments increased in March 2020. A decrease in medical payments from February was offset by an increase in weekly payments.

The steady growth in claim payments over 2018 and 2019 was driven by growth of the Nominal Insurer (NI) scheme, quicker payment of weekly benefits and to some extent the decline in return to work up until mid-2019.

The increase in claims payments over the last three months of 2019 reflects adjustments based on reviews of claim files made earlier in the year.

Medical costs have continued to put pressure on claims servicing costs and on average have gone up by 40 per cent since 2015. This is due to the increase in the number of medical episodes per claim and in the number of charges per medical episode.

To address this, we are implementing a medical strategy to enhance medical decision-making protocols and ensure there is an evidence base for treatment requests. We are also working with healthcare service providers to ensure the latest evidence better informs the treatment provided to injured workers. 

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

Graph shows from 1 March 2018 – 31 March 2020

  • View data for claim payments from January 2018
    Months Weekly Claim Payments Medical Claim Payments Total Claim Payments
    January 2018 $54,200,000 $48,000,000 $157,600,000
    February 2018 $50,700,000 $45,900,000 $138,200,000
    March 2018 $53,300,000 $55,700,000 $162,100,000
    April 2018 $52,400,000 $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 $68,200,000 $54,700,000 $170,700,000
    May 2019 $74,900,000 $59,100,000 $189,700,000
    June 2019 $68,900,000 $51,300,000 $169,100,000
    July 2019 $81,800,000 $74,600,000 $215,300,000
    August 2019 $75,600,000 $64,300,000 $192,300,000
    September 2019 $77,600,000 $60,200,000 $194,700,000
    October 2019 $90,900,000 $64,600,000 $219,600,000
    November 2019 $79,600,000 $62,700,000 $209,400,000
    December 2019 $93,400,000 $60,900,000 $218,400,000
    January 2020 $81,900,000 $49,000,000 $180,200,000
     February 2020 $78,600,000 $56,600,000 $186,300,000
     March 2020 $87,800,000 $48,400,000 $193,300,000

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

The percentage of calls answered within 60 seconds (defined as Grade of Service) remained steady at 90% in March 2020 and average time to answer was below 30 seconds for the fifth consecutive month.

Changes to call routing made late in 2019 continue to improve our customer service, with calls being answered more accurately by case managers and their team members. In addition, a significant increase in outbound calls and proactive case management has resulted in less inbound calls from customers seeking information on the progress of their claim.

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 March 2018 – 31 March 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

Net Promoter Score: +13 for Workers Insurance

The Net Promoter Score (NPS) for workers insurance remained steady at +13 in March. The NPS  for injured workers increased slightly in March 2020 to +16 while the NPS for employers decline slighty to -6.

Several initiatives to ensure the needs of our employer customers are being met are now part of the ongoing management of claims. This has included remediation of outstanding wages and a backlog reduction resulting in faster response times as well as a program of continuous improvement to the claims management system.

The introduction of the Authorised Provider Model this year has been designed to further meet the needs of larger employer customers by providing greater choice of claims management service provider. 

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

Graph shows 24 months from 1 March 2018 – 31 March 2020.

  • View data for the Net Promoter Score from January 2018
    Months WI NPS Employer NPS Injured Worker NPS
    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

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

Glossary

Return to work
Return to work is defined as the proportion of claims that are eligible for a weekly benefit compared with those that are no longer receiving a weekly benefit payment at or on 26 weeks after the injury date. The data we use to report the RTW rate is different to that used and reported by the State Insurance Regulatory Authority.
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.