Why has icare developed the Authorised Provider model?
The Authorised Provider model has been developed to meet the needs of eligible larger customers by creating greater choice of claims management service provider.
What was the Authorised Provider Pilot?
icare partnered with Allianz to pilot the Authorised Provider model with eligible larger customers for the purpose of testing the model from 31 December 2018 to 30 June 2019. icare used the pilot period to evolve the design and delivery of the Authorised Provider service to meet our customers’ needs.
What will the Authorised Provider deliver?
An Authorised Provider will deliver claims management services to eligible customers in accordance with the principles of icare’s claims management service model for the price of their premium. Authorised Providers have the ability to offer additional services tailored to meet eligible customer needs. These services will be negotiated directly between eligible customers and in some instances will involve a fee from the Authorised Provider.
Which organisations will be able to act as an Authorised Provider?
icare will appoint Authorised Providers based on standards governed by icare. More information about this will be communicated to you later in 2019.
When will the Authorised Providers be operational?
To allow a smooth transition, icare will implement a phased approach and introduce a small number of Authorised Providers for first quarter 2020.
What is the phased approach for eligible customer to choose an Authorised Provider?
icare will deliver a phased approach to allow for a smooth delivery for our eligible customers to nominate and transfer to an Authorised Provider.
During first quarter 2020 onwards, the following eligible customers will be able to nominate and transfer to their choice of Authorised Provider for new claims management. Claims lodged prior to transfer to the Authorised Provider will remain with their existing provider until all claims are on the centralised icare platform.
- Customers where base tariff premium (BTP) exceeds $1,000,000 or;
- Customers that are part of a Group, where its Group BTP exceeds $1,000,000
During second quarter 2020 onwards, the following eligible customers will be able to nominate their choice of Authorised Provider. These eligible customers can transfer to their choice of Authorised Provider for new claims management at renewal date on or after 30 June 2020. Claims lodged prior to transfer to the Authorised Provider will remain with their existing provider until all claims are on the centralised icare platform.
- Customers where base tariff premium (BTP) exceeds $500,000 or;
- Customers that are part of a Group, where its Group BTP exceeds $500,000
Can customers granted an exemption to remain with Allianz or GIO still remain with their current scheme agent claims provider if they do not meet eligibility criteria?
Yes. If a customer has been granted an exemption to remain with Allianz or GIO, these customers can remain with their current scheme agent claims provider.
How do eligible customers nominate and transfer to an Authorised Provider?
Eligible customers make a nomination to arrange a transfer to their nominated Authorised Provider. Customers in a Group policy can only nominate and transfer to an Authorised Provider as a Group. This nomination must be made in writing by an authorised representative of their organisation to their current claims management provider and icare prior to renewal date, once the Authorised Providers have been appointed.
Will my existing claims transfer to the Authorised Provider?
Claims lodged prior to a transfer to an Authorised Provider will remain with the existing provider. icare is building the technology to have all claims on a single system. The migration of claims will be phased to allow for a smooth delivery and more information about this will be communicated to you in late 2019.
When will I be eligible to have my claims managed by an Authorised Provider?
Eligible customers can exercise their choice to have their claims managed by an Authorised Provider in line with our phased approach. More information about this will be communicated to you later in 2019.
When will other employers be eligible to have claims managed by an Authorised Provider?
Customer eligibility criteria may change in the future as we continue to assess performance and customer feedback.
Can I choose to move from one Authorised Provider to another?
Yes. Eligible customers will be able to transfer between one Authorised Provider to another at the renewal date of their policy.
Who has icare communicated this information to?
icare is communicating this information to the market including scheme agents, brokers and employer customers.
Do all policies under a group policy need to be included with the Authorised Provider?
Yes. As is standard practice in NSW, all policies within a Group must be managed by the same claims 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 eligibility criteria, that policy will transfer to the icare appointed claims provider EML, at the next renewal.
When will the icare claims management platform be available?
icare is working on delivering the icare claims management platform to be available to all our customers. Presently the platform is not available to all eligible customers. icare will provide more information later in 2019 on the progress of platform delivery.
- How can I find out more information?