icare insights — psychological claims update

Throughout the year, we provide updates on key measures and data used by icare to monitor the Nominal Insurer Scheme operations. This insight is from our independent actuaries, Finity.

The latest quarterly analysis of NSW workers insurance claims data has found the number of psychological claims continues to rise.

Data from the June 2019 report shows psychological claims increased to five per cent of all claims reported, and payments to psychological claims are almost nine percent of total claim payments.

This shows psychological claims are costing more than the average physical injury claim. This is due to the complexity of psychological claims where treatments can be more costly and good return to work outcomes more difficult to achieve. Figure 1 below shows the increasing trend from 2015 for both the number and payments to psychological claims.

Line graph showing data from December 2015 to June 2019. The graph shows the increasing trend from 2015 for both the number and payments to psychological claims.The graph shows in June 2019 psychological claims increased to a high of five per cent of all claims reported. At the same time the graph shows in June 2019 payments to psychological claims are almost nine percent of total claim payments. This shows psychological claims are costing more than the average physical injury claim.

Figure 1: Psychological injury as a percentage of payments and reported claims

Since our last report on the significant increases in psychological claims, icare has begun implementing a three-year strategy to help tackle the issue. Programs include:

  • a multi-disciplined assessment model supporting timely decision making on more complicated claims 
  • expanding the use of restorative mediation for eligible claims 
  • targeted reduction of low value care for anxiety/depression and post-traumatic stress disorder
  • expanding the role of the Medical Support Panel to provide advice and support in mental health claims.

View icare’s latest Workers Insurance claims performance data.

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