icare's claims service providers offer eligible employers consistent claims services that deliver fair and equitable outcomes for both injured workers and employers.
Claims service providers under the Authorised Provider model
The three providers are Allianz, GIO and QBE.
EML remains the default claims service provider for the Nominal Insurer scheme. They will continue to provide new claims management services to eligible employers who do not nominate a different claims service provider. Eligible employers can also nominate to transfer to EML as their chosen claims service provider.
All claims service providers are expected to make consistent claims decisions that deliver fair outcomes in line with the Claims Management Decision Framework.
In addition to the services eligible employers receive for the price of their premium, they may negotiate value-added services directly with their chosen claims service provider. In some instances, value-added services may involve an additional fee that is not included in the price of their premium.
Employer eligibilityEligible employers:
- Have an Average Performance Premium (APP) or Basic Tariff Premium (BTP) that exceeds $500,000; or
- Are a part of a group with a Group Average Performance Premium (GAPP) or Group Basic Tariff Premium (GBTP) that exceeds $500,000.
Eligible employers also include employers who have new claims currently managed by Allianz or GIO.
How to nominate a claims service provider
Eligible employers can transfer to a different claims service provider on their policy renewal date with 14 days' notice.
Once icare accepts the nomination, the claims service provider will contact the eligible employer to arrange their transfer.
Any claims lodged prior to transferring to claims service provider will remain with the existing provider until icare migrates all historical claims data onto icare's claims management system.
Eligible employers requiring more information on how to nominate or transfer to a different claims service provider should contact us at AuthorisedProvider@icare.nsw.gov.au.
icare's claims management system
All claims service providers manage new claims on icare's claims management system.
icare will progressively transfer historical workers compensation claims to the icare claims management system over time.
Until then, historical claims will continue to be managed by the existing claims service provider.
Can I transfer twice in a 12-month period?
No. Eligible employers will remain with their selected claims service provider for the next 12-month term of their policy and cannot transfer again until the transfer opportunity arises at their following policy renewal date.
Will claims service providers operate under the same policy and premium model?
Do all policies under a group policy need to be included with the same claims service provider?
Yes. As is standard practice in NSW, all policies within a group must be managed by the same claims services provider.
What happens if one of the policies under a group is divested?
If a policy is no longer part of your group, and joins another group, the policy will transfer to the claims provider presently managing that new group.
If the policy is no longer a grouped policy and does not meet the Authorised Provider model eligibility criteria, that policy will transfer to icare's default claims services provider, EML, at the next renewal.
What employer reporting does icare provide?
icare provides a monthly Cost of Claims report that consolidates an employers your workers insurance claims in one place, regardless of which agent is managing them.
If you would like to receive the monthly Cost of Claims report or have any questions regarding reporting, please email WIreporting@icare.nsw.gov.au.
All claims lodged on icare's claims system, regardless of claims service provider, will now carry the icare insurer identifier (701). Given your claims may be managed by more than one claims service provider, to identify the claims service provider managing the claim in your monthly Cost of Claims report, please refer to the 'managing_entity_name' (column CY).
An employer may choose to use cost centres to track their claims, the Cost of Claims report includes cost centres for claims lodged on icare's system, where the cost centre has been advised to the claims service provider. You can include your cost centre when lodging a claim via the authenticated claims portal or update a cost centre on a claim by directly notifying your case manager at the time of lodgement or shortly afterwards. We are currently working on a solution to update cost centres in the Cost of Claims report for existing claims not on icare’s system.
For any other reports that you currently receive from your claims service provider, please engage your new Authorised Provider prior to transferring to arrange these.