Sustainable return to work is key for icare

It’s been almost four years since the inception of icare (Insurance and Care NSW) to bring about a fairer and improved experience to our customers – the people and businesses of NSW.

In the case of workers insurance, we’ve set our focus on delivering long-term sustainable return to work outcomes for injured workers, which has been one of the most contentious concerns with historical return to work (RTW) practices and data.

There is often a focus on RTW rates as the measurement of success. To this, the most recent data for the 0-26 week RTW rates for the Nominal Insurer shows a variation from headlines numbers from three years ago.

We are working with our claim service partners to closely monitor and improve this and have initiated a number of activities already, including:

  • Better return to work data accuracy and reporting to earlier identify claims at risk of exceeding expected durations
  • Changes to front-end claims management to ensure that any claim with an expected duration beyond two weeks will receive a dedicated case manager
  • Ensuring medical case conferences take place within 7 days of a claim exceeding its expected duration
  • Improving customer communications through new SMS functionality allowing customers to nominate a preferred callback time
  • Ensuring the right number of front-line resources are in place to improve the customer experience.

Read more about our commitment to claims management improvements.

Weekly income benefits a strong indicator of RTW success

Some qualified published data shows the RTW decline to be much more pronounced than what we see, and we are working with State Insurance Regulatory Authority (SIRA) to align data collection practices. We believe payment of weekly income benefits are a key indicator of RTW and one of the strongest gauges of the experience of injured workers.

Using this, our current data at 30 June 2019 shows the RTW rates after 13 weeks is 71 per cent or at 26 weeks is 79 per cent. This is a decline at the same period three years ago - 13 weeks was 78 per cent or at 26 weeks it was 87 per cent.

This means that today injured workers are taking longer to get back to work. But importantly, we are seeing that once they return they stay there. This is evidenced by an increase in the overall number of weekly payment expenses in the short term ($200 million) offset by an overall improvement in the medium to long term ($367 million), equating to an overall financial benefit to the scheme.

Also, due to our overall management of the scheme, including saving more than $1.7 billion in costs since icare’s inception in 2015, average premiums for businesses remain stable at 1.4 per cent of wages. The Nominal Insurer funding ratio based on our latest valuation (30 June 2019) is 109 per cent at 80 per cent probability of adequacy, just outside our target of 110 to 130 per cent. 

We will continue to drive to improve RTW outcomes and it is promising that we are seeing an overall upward trend over the last few months since the new IT system for the claims model has bedded down. This means we are closer to reaching our goal of delivering better short term and sustainable long term RTW outcomes.