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icare changes reporting after SIRA pressure

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NSW state insurer icare has changed the way it reports return-to-work outcomes, moving away from a previous measure that the regulator has criticised for potentially driving “perverse behaviours”.

Latest statistics released today are based on codes used by insurers to record whether a person is “working” or “not working”. Previously, return-to-work outcomes used calculations based on the cessation of weekly payments.

“The return-to-work rate based on work status codes is the measure that icare will now report in its regular workers insurance claims performance data,” the insurer said today.

State Insurance Regulatory Authority (SIRA) Chairman Carmel Donnelly told a NSW Parliamentary inquiry into workers’ compensation last month that using the right metrics to measure performance is critical, and the focus should be on “real return to work”.

“That is pivotal, and it has been clearly illustrated recently that if you measure and reward on ending weekly benefits, if you measure and reward on cutting someone off benefits you create perverse behaviours, rather than a focus on the early co-ordinated support that will deliver return to work,” she said.

icare in a previous submission on the issue says the payment-based metric is a practical measure focused on financial outcomes that translates directly into scheme performance, while the metric SIRA prefers is focused on the social outcome.

The insurer continues to work with actuarial experts to investigate how both measurements can be improved to more accurately reflect actual return to work, it says today.

The 26-week return-to-work rate based on the status code measure was 80.6% in June, compared to 80.4% a month earlier but a deterioration from 88.8% in July 2018.

Using the cessation of benefits measure, the rate was 80.8% in June, down from 81.6% a month earlier and compared with 81.9% in July two years ago and 85.6% at the start of that year.

The rate has come under increasing pressure since March as a result of COVID-19 and business disruptions. The effects include a reduction in available suitable duties, with impacts varying across industries.

Manufacturing appears to be remaining stable while industries including accommodation, cafes and restaurants, retail trade, cultural and recreational services have seen declines that are expected to continue over coming months.

“We are working with our service partners to provide every available opportunity for workers to return to paid employment as the economy recovers,” icare says.

The insurer says the net promoter score for workers insurance increased in June to a record +23. The NPS for employers reached a high of +8, while for injured workers it was +28 for the first time since September 2018.