Workers Compensation Scheme Update - SA. Rob Thomson CEO WorkCoverSA

Transcription

1 Workers Compensation Scheme Update - SA Rob Thomson CEO WorkCoverSA

2 Workers compensation scheme update SA What we ll cover today Snap shot of the SA Scheme Challenges and opportunities New directions and key projects

3 Snapshot of the Scheme Modes of insurance Registered employers pay a levy which is collected by WorkCover and have their claims managed by Employers Mutual Approx 50,000 registered employers Self-insured employers fund and manage their own claims Private self-insurers and Government/Crown

4 Financial performance of the Scheme

5 Return to work performance - any capacity

6 Results and drivers summarised

7 Profile of registered employers Levy by employer size Less than $2,000 Less than $10,000 $10,000 to $100,000 $100,000 to $500,000 More than $500,000 Likelihood of claim 1 claim in every 73 years 1 claim in every 27 years 1.3 claims per year 6 claims per year 27 claims per year % of employers Total number of employers Total base levy Total remuneration Number of claims Claim frequency per $m wages 50,000 approx $625m approx $21m approx 19,000 approx 0.9

8 Challenges and opportunities: Legal challenges to 2008 reforms Supreme Court found in WorkCover s favour for three major challenges: - Creek - Yaghoubi/Campbell - Davey Yaghoubi/Campbell has changed the assumption that Medical Panel decisions cannot be overturned

9 PwC John Walsh vocational rehabilitation report Key findings: Fee structures do not encourage short-term and targeted vocational rehabilitation Vocational rehabilitation market should be defined by quality and skill Strong regulatory influence is required Limited upfront strategic case management and early referral Capability enhancement required by the claims agent

10 Vocational rehabilitation action plan Our action plan covers four key areas: better defining quality and skill within the rehabilitation industry improving regulatory influence ensuring capability improvements in case management; and changing fee structure to reward improved outcomes.

11 Our Goals New directions and key projects New strategic direction Goal 1 Injured workers remain at work or return to work at their maximum capacity Goal 2 Employers, workers and providers meet their obligations and actively work together to deliver workplace injury prevention and injury management outcomes Goal 3 A financially sustainable Scheme Goal 4 A professional, achievement focused organisation

12 Employer incentives experience rating approach Bonus Penalty Scheme ceased from 1 July 2010 A replacement that suits South Australian employers is needed Proposed system encourages the right OHS and return to work behaviours Amendment Bill is currently before parliament Commence 1 July 2012, subject to parliamentary process

13 Employer incentives experience Key features: rating (cont) Insurance-based system introduces premiums, premium calculation notices, certificates of currency Experience rating to apply to employers who pay more $20,000 base premium and $300,000 remuneration Retro-paid loss option available for large employers ($500,000 premium or more)

14 Tenders for claims management and legal services WorkCover has sought Expressions of Interest for future claims management and legal respondent services The last procurement for claims management was in 2005 with the contract being awarded to Employers Mutual Minter Ellison was appointed to the legal services contract in 2006 Both contracts expire in December 2012

15 Cultural and organisational shifts Cultural shifts for the Scheme: - Remain at or return to work - Conveying the health benefits of work - Increasing the professionalism of the industry Organisational shifts: - Internal organisational review more commercial focus - Increased focus on improved outcomes

16 Fostering professionalism WorkCoverSA s industry scholarship program Certificate IV in Personal Injury Management in SA

17 Any questions?