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icare releases claims performance data

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NSW state insurer icare has released workers’ compensation claims performance data as it aims to increase transparency.

The scheme is subject to an ongoing independent review by the State Insurance Regulatory Authority, with many submissions highlighting concerns.

“You’ve told us you expect us to be more transparent and we are listening,” icare says on LinkedIn.

“We’re publishing claims management data to provide more transparency into the performance of the NSW workers’ compensation scheme.”

The data shows that as of July 31, the return to work (RTW) rate after 26 weeks had declined to 79%.

“We have experienced challenges embedding our new operational model, including achieving the right scale with our new claims partner,” icare says. “This has had a negative impact on the RTW rate since January 2018.”

icare says it is working closely with service partners to improve the rate.

Liability decision timeliness is at 97% within seven days.

“We’ve experienced two distinct periods of decline in liability decision timeliness since January 2018,” icare says.

“Both were due to the introduction of new technology where we experienced implementation problems.

“Since working through the backlog these issues created, the timeliness of initial liability decisions has improved and exceeded the target of 95% of decisions made within seven days, with the majority of decisions made within five days.”

The total number of active claims has remained “relatively stable” since January last year, with an average of 38,000 to 40,000 active claims each month.

There has been “some growth” in claim payments this year, driven by growth of the Nominal Insurer, quicker payment of weekly benefits and a decline in return to work.

“In the 2017 and 2018 calendar years, we paid on average $61 million per month for weekly benefits and have paid an average of $70 million per month for the 2019 calendar year-to-date,” icare says.

“Medical costs continue to put pressure on claims servicing costs and on average have gone up by 40% since 2015.”

Click here to see the full statistics.