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Assessing the situation:
Insurance House responded by conducting a comprehensive health check across their client’s workers compensation program. As a result of this comprehensive review, Insurance House identified several inadequacies in their client’s claims management processes including:
- Late lodgement of claims
- Outstanding compensation due to failure to submit certificates
- No injury management processes
- No Return-to-Work planning
The Insurance House Solution:
Insurance House implemented a strategic claims and injury management program for the client.
The program outlined a detailed strategy and Service Level Agreement that included the implementation of the following activities by Insurance House:
- Assisting with disputes including attending all conciliation conferences held by the Accident Compensation Conciliation Service (ACCS)
- Creation of preferred provider panels
- Quarterly performance reporting
- Development of an injury management program for managers
- Development of a Workers Compensation legal obligations handout to be provided to injured workers at claim lodgement
- Co-ordination and attendance at quarterly insurer claims review meetings.
A Service Guarantee included face to face, phone, email and video conferencing support, in addition to:
- 5 days a week telephone assistance
- Return of telephone calls within 24 hours
- Respond to all correspondence within 3 days of receipt
- Claim reviews with key personnel at depots, including coaching and mentoring on early intervention and Return to Work (RTW) planning
- Face to face worker meetings on RTW
- Training for union delegates on workers compensation entitlements and worker/employer obligations.
Premium Benefit
The significant reduction in claims costs resulted in our client’s premium reducing from xxxxxxx% to xxxxxxx%.[FT1]
Positive changes implemented by Insurance House:
Our client now has a structured program with:
· A collaborative approach to injury management and RTW
· Manager/Supervisor ownership of injury management
· Well educated and informed workforce with regards to workers compensation
· A strong tri-party relationship across Insurance House, our client and the Claims Administration
Agent, resulting in collaborative claims resolutions.
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