Workers Compensation. What Your Rights Are, Lodging a Claim, How Premiums are Calculated, What You Can Do as an Operator

Transcription

1 Workers Compensation What Your Rights Are, Lodging a Claim, How Premiums are Calculated, What You Can Do as an Operator

2 Presenters Tim Meadows Industry Manager Logistics Kara Thomson Senior Associate Peter Meighan State Relationship Manager NSW

3 Tim Meadows Industry Manager - Logistics NatRoad Conference 2016

4 Your accident insurance policy Protects your business and helps your workers when injuries happen Gives you peace of mind so you can get on with running your business When an injury happens we ll help you Understand the claim Manage your injured worker s recovery Get your worker back to work

5 Who do you need to cover? Stop! There s some questions to ask. Individual Pay As You Go (PAYG) Are they an individual person? Companies are not covered. Are they an employee for the purpose of PAYG? Australian Taxation Office Does the ATO consider them a worker? We use the same rules.

6 Claim numbers by industry 14,000 12,000 10,000 Statutory Claims Common Law Claims 8,000 6,000 4,000 2,000 0 WorkCover Queensland data

7 Injury by type WorkCover Queensland data

8 Transport in Queensland

9 What to do if an injury occurs Immediately after an injury During recovery Plan for their return The actual return to work Review and improve Talk to your employee. Don t blame, support them Get them medical assistance early intervention is key Offer return to work options: light or alternative duties Keep talking to the worker about their progress Develop a list of duties based on their skill set Get input from the worker and doctor Supervisors and co-workers need to understand the injured person s limitations supportive culture Injured employee s feedback can be useful to improve your systems or processes

10 Recovery health benefits of work The longer someone remains off work the less likely it is they will ever return. 20 days off 45 days off 70 days off 70% chance of ever returning 50% chance of ever returning 35% chance of ever returning

11 What can you do? Prevent injuries Suitable duties to encourage return to work Support your workers Lodge claims quickly to get medical treatment early Open and regular communications

12 Common Law and Risk Management Kara Thomson Senior Associate

13 Introduction Transport is a high risk industry. Common law involves the proving of negligence. 281 common law claims in 2014/15. Average damages across all industries in 2014/15 was $138,257 (per claim).

14 Common Issues in Transport Taking out insurance in Queensland or somewhere else? Remember, there are penalties if you do not hold insurance.

15 Common Issues in Transport Contracting with third parties. Who bears responsibility in the event something goes wrong? Be aware that as an employer you owe a non-delegable duty of care to your workers. Do not simply rely on a principal contractor or third party.

16 Risk Management Assess the risks. Understand the risk and implications. Control the risk. Review and enforce. Retain documentation confirming your risk management process.

17 Example 1 Delivery of 1,000kg when consignment note stated 600kg. Loading dock decommissioned. No response by contractors despite being aware of problems. Principal Contractor Major Transport Company Large Transport Company End Sub- Contractor

18 Example 2 Truck driver with almost 30 years experience. Injury when alighting from truck slipped on step. Truck 8 months old. No training or instruction on how to alight from truck.

19 Thank you

20 NSW Workers insurance: Recent changes to premium & claims Legislation

21 NSW SIRA & ICARE State Insurance Regulatory Authority (SIRA) workers compensation insurance motor accidents compulsory third party (CTP) home building compensation. Insurance & Care NSW (icare) NSW Workers Compensation Scheme Lifetime Care and Support Authority Dust Diseases Authority NSW Self Insurance Corporation (SICorp) NSW Sporting Injuries Compensation Authority. NATROAD CONFERENCE

22 BACKGROUND CLAIMS Work Capacity Guidelines Amalgamation of the previous guidelines to form one reference document. The guidelines are effective from 1 st August Guidelines for Claiming Compensation Benefits (2013) 2016 GUIDELINES FOR CLAMING WORKERS COMPENSATION Guidelines for Work Capacity Decision Internal Reviews Guidelines for the Provision of Domestic Assistance NATROAD CONFERENCE

23 INITIAL NOTIFICATION MINIMUM INFORMATION Worker Employer NTD Injury Notifier Name Contact Details (Phone and Address) Business Name Business Contact Details Doctor Name Medical Centre/Hospital Name Date and Time of the Injury Description of the Injury How the injury happened Name Relationship to the worker Contact Details NATROAD CONFERENCE

24 WORK CAPACITY A worker is not required to attend more than one appointment with the same type of specialist or healthcare provider. Earning Capacity Assessment A worker is not required to attend more than four appointments as requested by the insurer. Orthopaedic Surgeon WORK CAPACITY ASSESSMENT Occupational Physician These provisions are for a single work capacity assessment. Consider the worker s individual circumstances for fair notice. Independent Medical Consultation NATROAD CONFERENCE

25 REASONABLE EXCUSE Notification is received. We no longer can close a claim as notification only. Notification Only claims will become a new category of Reasonable Excuse. Worker and Employer to confirm (verbal or in writing) that there are no payments and this is a notification only. Provide written confirmation to worker, explaining how they can make a claim. Reasonable Excuse decision applied. Claim can now be closed. NATROAD CONFERENCE

26 PROVISIONAL PAYMENTS Reasonable excuse only applies to weekly payments. Medical expenses cannot be refused on the basis of reasonable excuse. Provisional medical payments can commence whilst we investigate a claim. Provisional payments do not mean we have admitted liability on a claim. NATROAD CONFERENCE

27 BACKGROUND POLICY & PREMIUM The key principles for the reforms: Deliver easier to understand premium Provide safer workplaces Improve RTW & recovery at work outcomes Reduce administrative red tape Deliver sustainability & certainty Changes apply to all policies with an average performance premium (APP) of $30,000 or great (experience rated) On 15 th August icare announced that from early 2017 all policies will be renewed directly with icare and Scheme Agents will only manage claims NATROAD CONFERENCE

28 SUMMARY OF CHANGES Calculation Item Previous Current Basic Tariff Premium (BTP) A (APP) S-Factor A A Employer Cost of Claims Rate (ECCR) A A Industry Cost of Claims Rate (ICCR) A A Experience Premium A A T CAPPS A (Expanded) Claims Performance Rate (CPR) n/a A Employer Safety Incentive (ESI) n/a A Employer Safety Reward (ESR) n/a A Return to Work Incentive (RTWI) n/a A Claims Costs: Premium Calculation Paid + Estimates Paid Weeklies Hindsight Adjustment Premium A A NATROAD CONFERENCE

29 INCENTIVES Expanding the Employer Safety Incentive (ESI) ESI% discount on APP (at renewal calculation) Introduction of an Employer Safety Reward (ESR) ESR% discount on APP (nil premium impacting claims over 4 years) Performance Discount (PD) Sliding scale from 20% to 0% based on CPR Applied automatically by the Agent on adjustment NATROAD CONFERENCE

30 THANK YOU