ICARE NSW Agent Model Changes

Dear Clients, Colleagues and Partners,

NSW announcement: New claims service providers appointed by icare

Following the recent workers’ compensation claims tender process, the schemes Nominal Insurer, icare, have announced changes to the existing claims management model.

What are the changes?

The new claims model will have a greater range of Claims Service Providers (CSP’s). This is in response to the rise in mental health issues and the increase in psychological claims. Eligible employers (those with an average performance premium above $500,000) can choose between a generalist CSP, or one with additional specialist capabilities. This includes service providers with expertise in managing psychological claims. icare are expecting specialised providers to offer tailored approaches to particular claim types which is expected to lead to better quality service for injured workers and employers which ultimately should lead to reduced claims duration and costs.

Why is icare changing the model?

Icare are seeing a significant rise in psychological claims that take longer for a worker to recover from. In response to this they are creating a claims model that will provide specialists in managing these claims. It is anticipated workers will be provided with better care which will get injured workers back to health and work faster.

Who are the new providers?

There is a mix of current and new CSP’s. Allianz, EML, GIO and QBE remain as CSP’s with new providers DXC, you may recall them as Exchanging a few years back, and Gallagher Bassett who are also being reintroduced back in to the NSW scheme. The CSP’s with dedicated teams and resources that will offer specialist support to injured workers with psychological injury claims will be referred to as ‘general providers with specialist capabilities’. They will be Allianz, DXC, EML and GB. CSP’s GIO and QBE are ‘generalist providers’ and will deliver general claims and injury management services

Generalist CSP: can manage all claim types Generalist with specialist capabilities: can manage all claim types but need to manage psychological claims with a dedicated psychological claims case manager.

Specialist: Providers can only manage psychological claims. Icare are currently working towards having a specialist only provider on the panel as they transition to the new model. Others may be added in future. The mix of providers creates a competitive market which aims to improve how claims are managed which will improve return to work rates, customer satisfaction and the financial sustainability of the scheme.

When does the new claims model commence? Contracts will commence on 1 January 2023 with the changes being managed through a staged transition process. Allocation of claims is expected to begin in the second quarter of 2023.

What does this mean for employers? The expansion of CSP’s gives employers more choice of claims providers. The intention over time will be to reduce the employer threshold (average performance premium) to enable more choice for a larger number of employers. Employers with choice can choose their CSP as soon as the provider is onboarded. This is expected to be in the second quarter of 2023.

What do you need to do?

At this stage,nothing. If your claims are moving to a new CSP you will be informed well ahead of time. Your current provider will continue to manage your claims until the day of the move.

Your injured workers who may be impacted by the change will also be communicated to by the CSP. Fortunately for our clients, you have the benefit of your Workers Comp Savings consultant managing your claims. You will experience very little disruption should you be advised your claims are moving to a new CSP.

If you have any questions, please do not hesitate to call Kyle, Daryl, Kylie and Matt.

Appreciate your ongoing support.