icare PIAWE remediation update

Following a review of scheme agent files in 2019, and utilising the newly implemented single icare IT system, we identified initial PIAWE miscalculations made by scheme agents between 2012 and 2018. 

Though the issue is only identified in older claims – prior to the 2019 PIAWE reforms – since the beginning of 2020 we have been correcting the problem.  

In March, we commenced recruitment of highly-skilled technical specialists from our scheme agent partners and set up a team of dedicated resources to review the large number of historic claims. 

Since then we have:

• established protocols and processes for undertaking end-to-end thorough reviews of the historic claim files to ensure accuracy and timeliness;
• initiated a robust quality assurance program and peer review process to assure those that may be affected that the review is done right; 
• consulted with industry stakeholders and experts including unions, business groups, SIRA, WIRO and the WCC to assist with this work; and
• commenced the first full review and remediation of historic claims.

While we’re still in the early stages, probing into the history of each claim payment has found that about five per cent of these historic claims are likely to need underpayments corrected. This also indicates that the total value of the underpayments is significantly less than first anticipated. The vast majority of payments are correct based on the information at hand, including those corrected throughout the life of the claim. A further five per cent were identified as an overpayment. 

We are now expediting the remediation process to ensure that any payments owed to customers are made as quickly as possible. For the five per cent of impacted customers we have identified so far, they will receive a letter from icare detailing the amount owed and payment options as soon as possible.