Workers insurance claims update

In January 2018, icare introduced the new insurance claims service model to the workers and employers of NSW.

It was a significant step in transforming the way workers insurance claims have been managed within the Scheme for 30 years.

This transformation aimed to deliver better treatment and care to the people of NSW and to provide a claims management scheme that is financially sustainable for the future.

Since then, icare and our claims service providers continue to remain focused on improving claims management service levels.

Earlier this year we also upgraded our claims management technology platform that, once embedded, will deliver the operational and customer benefits we are committed to deliver.

Through this time of change, we have been navigating periods where our ability to deliver services did not always meet our customers’ expectations. We value and continue to listen to customer feedback and this is being used to direct focus on areas of improvement.

Together, icare and our claims service providers have undertaken a review of the current service levels and claims management practices and have recently established a targeted four-month program to address any issues.

By the end of the year, the program will deliver consistency in our operations:

  • Improve customer communications through new SMS functionality allowing customers to nominate a preferred callback time.
  • Ensuring 98 per cent of liability decisions are made within legislative timeframes.
  • Timely decision making and payment of weekly benefit payments within seven days of claim notification.
  • Increasing front-line resources to improve the customer experience.Ensuring medical case conferences take place within seven days of a claim exceeding its expected duration.
  • Better return to work data accuracy and reporting to earlier identify claims at risk of exceeding expected durations.

In addition, we have recently made changes to front-end claims management by adjusting how we manage medical only claims and claims expected to last less than two weeks of incapacity. This ensures that any claim with an expected duration beyond two weeks will receive a dedicated case manager.

icare is fully committed to improving the customer experience and outcomes for injured workers and employers in the largest overhaul of the workers compensation claims management system in three decades.

Tagged in: