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That's better: icare's return to work rate rises

NSW state insurer icare says return to work (RTW) rates and liability decision timeliness have improved after it took action to lift performance.

The 26-week RTW rate reached a 15-month high of 82% in October and November after slipping to 79% in the middle of last year.

The results reflect initiatives undertaken with service partners, icare says. These include targeted claim reviews, assigning a dedicated case manager for those likely to go beyond two weeks, and ensuring case conferences take place within seven days of a claim exceeding its expected duration.

“There are many factors that impact return to work over time, and we remain committed to delivering sustainable RTW outcomes for our customers,” a spokeswoman told insuranceNEWS.com.au.

“It’s our aim to continually improve the 26-week RTW measure, which is considered one indicator to the future financial health of the scheme.”

In December some 99% of liability decisions were made within seven days, exceeding a target of 95%, while the average 4.1 days for initial decisions was the lowest for two years.

“While we have reduced the number of claims where we accept full liability at first decision, the number of claims where we accept provisional liability has increased,” icare says. “This enables quicker time to treatment and more time to investigate before liability decisions are made.”

The latest figures, for October and November, show an increase in claims payments, which icare says reflects adjustments based on reviews of claim files.

Medical costs have continued to put pressure on claims servicing costs and on average have gone up by 40% since 2015. This is due to more medical episodes per claim and an increase in the number of charges per episode.

A strategy to enhance medical decision-making protocols and ensure there is an evidence base for treatment requests is now being implemented.