The NSW workers’ compensation scheme run by icare is “failing terribly” and hasn’t been in a worse position for more than 30 years, according to an insurance brokerage.

An independent review of the scheme is being carried out by the State Insurance Regulatory Authority (SIRA), and a submission from Oxley Insurance Brokers takes aim at claims management processes and key agent EML’s ability to handle the necessary volume of work.

While a submission from the National Insurance Brokers Association remains confidential, insuranceNEWS.com.au has been told the Oxley submission is representative of brokers’ views.

The submission author, whose name is redacted, says they have worked in the workers’ compensation industry for 33 years.

“I must be completely honest and frank, and what we are experiencing now is the worst I have seen,” they write.

“I have never experienced so much anger and frustration in the industry than I am dealing with now.”

Oxley criticises the selection of EML as single agent for new claims, and highlights “the complete lack of effective claims management”.

The submission says there is also a dearth of communication, experience, knowledge and skill.

“As soon as you create an environment that seems to treat an injured worker and employer (who is the client) like a claim number rather than a person, everything goes pear-shaped.

“We are now dealing with a scheme that has reverted to ‘processing of claims’ rather than ‘management of claims’ and the main reason that I believe this has occurred is volume and EML’s inability to cope with the number of claims that they are now responsible for.

“The sooner we can have two or three ‘claims agents’ back in operation the quicker this system will turn around.”

Many submissions to the review highlight the slow response of EML, and the difficulty of contacting the same person more than once.

“We have no direct phone number or no direct email addresses where we can contact anyone at EML and this call centre mentality will never work in an environment that deals with people that are in desperate need of assistance and help,” the Oxley submission says.

icare CEO and MD John Nagle says he is disappointed by Oxley's submission but welcomes the SIRA review.

“We are disappointed in the Oxley Insurance Brokers submission and note that we have strong engagement and support across the broker community but we understand that some organisations have struggled with the level of change,” he told insuranceNEWS.com.au. 

“As the state’s social insurer we strive to deliver better outcomes for the customers we serve and the communities we protect.

“As part of this review we welcome the feedback of our stakeholders via submissions and have already proactively engaged with some who had previously shared their submissions with us. We look forward to receiving the findings of the full report.”