WorkSafe are the administrators of Victoria’s Worker’s Compensation insurance scheme. They appoint Agents to manage WorkCover insurance for employers on their behalf. Agents provide expert advice and support to both the employer and the injured worker. Therefore, Agents are not the insurers, WorkSafe are the insurer, and the legislator. Agents manager your WorkCover claims on behalf of WorkSafe.
The five Agents currently are: (I say currently because they tender their contracts every five years and are audited regularly to ensure they are fulfilling their role as per WorkSafe’s standards)
- Allianz Australia Workers Compensation (Victoria) Limited
- CGU Workers Compensation (Victoria) Limited
- EML Vic Pty Ltd
- Gallagher Bassett Services Workers Compensation Vic Pty Ltd
- Xchanging
These five Agents are required to register employers for WorkCover insurance, calculate and collect their premiums, administer, and manage worker claims for weekly payments and medical and like expenses. They are also required to facilitate and mange return to work, assist employers with injury and claim prevention and provide information and education to employers and workers about their obligations under the Act.
Agents manage claims using a Claims Management model. They typically have teams of Case Managers who work with employers and injured workers from the moment a claim is lodged, through until the claim is closed. So, depending on where a claim is at in the return to work process, will depend on which type of Case Manager will be allocated to the claim. It could be a Claims Processor, a Case Manager, a RTW Specialist or a Long Term Case Manager.
Some Case Manager’s run a case load of up to 100 claims. Have a think about that for a minute. That is a lot of claims, so do not be surprised and do not blame your Case Manager if you or your injured worker does not hear from them for long periods at a time. At the same time however, you do not want to let your injured worker slip through the WorkSafe / Return to Work system.
So, what do you do?
- Do not be afraid to contact your Case Manager as often as you need to.
- If you are having trouble with your injured worker, ask your Case Manager to contact them and help them to get back on track.
- Ask your Case Manager questions as often as you need to, but please be respectful and supportive of them, remember they have huge caseloads.
- Let your Case Manager know as soon as you identify duties, implement a return to work plan or your injured worker’s capacity changes.
- If you have several injured workers, or if you have a difficult worker, you can ask your Agent for regular file reviews. File reviews will allow for strategies to be put in place to generate better outcomes for all involved. They will also give you information on cost, duration and likely outcome of each claim.
Your Case Manager is there to help you and your injured worker. Remember they are your friend, so communicate with them and use them as often as you need to.
If you find you are still struggling with a claim or you would like further advice and assistance with how best to manage return to work for your workplace, please do not hesitate to get in touch with Return to Work Plus.
tennille@returntoworkplus.com.au