Delivering a new world-class icare claims service

Elizabeth Uehling, Acting Group Executive, Workers Insurance, discusses the benefits of the new claims model and shares a preview of further improvements coming later in the year.

Beth Uehling

Elizabeth Uehling, Acting Group Executive, Workers Insurance

The launch of the new claims management model on 1 January 2018 was the result of years' worth of research, feedback and design to deliver a new claims management model not only improves the experience for workers and employers, but is consistent with icare’s overall purpose and vision.

With EML providing the operational excellence and icare’s strategic insight, we designed a model that treats workers and employers with dignity and respect, empathy and fairness.  

By consolidating the number of claims management providers in the Workers Insurance Scheme last year, we are driving consistency of service across the Scheme. The launch of the new model on 1 January, introduces a planned change in the experience for customers, as well as the delivery of financially sustainable scheme for the businesses and people of NSW.  

Three months later, we have managed around 15,600 claims and 3,400 notifications, handled over 43,000 inbound calls and made around 46,000 outbound calls.

Implementing a new claims model can be challenging. Some elements of the service were initially not up to our expectations. We are aware that for the first few weeks, the service levels provided to customers as we stabilised the business were not up to the expectations that our customers expect from icare or EML. 

As an example, some customers were waiting too long to get through to a claims specialist to assist them.  EML and icare have worked together to improve this experience and now the average call waiting time is around 30 seconds. A huge improvement.  

We listened to feedback and know customers want better communication, single point of contact and consolidated reporting. Accordingly, we made changes and as the model continues to improve we are receiving positive feedback from injured workers and employers.  

We've made significant improvements to communication. Of the 46,000 outbound calls made so far, the majority of those were HUG (How You Going) calls where we check in with the injured worker and employer to make sure they are comfortable with progress and next steps on the claims journey.  

For simple notifications and claims enquiries, customers can rely on rapid responses from our Claims Advisors in the Support Centre. We understand there are situations when a single point of contact is needed by an employer. For employers who are dealing with multiple claims with varying degrees of complexity, a Client Services Manager will be assigned to provide specialised oversight and direction on the claim.  

We have made changes to the online portal to improve transparency. For example, the employer policy number input field is more prominent and to make it easier to identify the injured worker related to the claim, and we have changed our notification emails. The online portal has proved popular with customers. Available 24/7, the portal allows employers and workers to lodge at a time that suits them, which is often outside normal business hours. Around 60 per cent of claims are now lodged using the portal, with calls or emails to the Claims Support Centre making up the balance.  

Consolidated reporting has also now been implemented. In partnership with employers, we are co-designing a full suite of reports, which will be available in the future.  

Future improvements  

We are continually refining the claims model with a major technology upgrade planned for late 2018. This will further simplify claims management, with employers and workers able to play a more active part through the life cycle of the claim. This can be an injured worker keeping track of his or her treatment plan, or an employer keeping up to date with the latest information on single or multiple claims.  

We aren’t just focused on the new claims, but also looking at how we can help some of the 44,000 other injured workers with longer term claims challenges get back to health and work.  

With Scheme Agents we are piloting new and innovative interventions and case management techniques that help these workers get their health and lives back. Sometimes it’s as simple as providing them with a Fitbit or a similar device that will help to motivate them to get active. In addition, targeted life coaching and other innovative programs that support healthcare providers and GPs to help injured workers, are showing promising early results. That’s why we are taking a holistic view to claims management in the Scheme.