In 2014 a long standing self-insurer in South Australia had experienced an alteration in the nature of their business and thus a clear change in risk profile, size of workforce, as well as frequency and severity of claims. Following detailed financial assessment the decision was made to move away from self-insurance and back into the scheme as a registered employer.

As for all self-insurers a tail of claims continued to be active and required management to ‘close out’ the portfolio. WCD were engaged to perform the ongoing management of the long term claims as well as any arising from their current operations.

The contract was signed for a three year programme of work.

The targets were achieved in two years.

Initially no one believed it could be done.

WCD took on the challenge, led by one of our experienced SA consultants and supported by colleagues in the office. Further head office strategy and liaison was conducted by one of the WCD directors

The Challenge

To take on the ‘run off project’ as the client had decided an alternate approach to claims and injury management was required. In most cases this can be a very costly exercise, but WCD knew that with the right understanding of current processes within the company, these could be streamlined into much more efficient systems and thousands of dollars could be saved.

The Process

WCD set about contacting all providers and arranging the finalisation of payments and other outstanding financial issues. Further, the nature of communication with each claimant was altered to one of openness and a resolve to finalise these matters fairly and equitably to allow people to move on with their lives.

The previous regime had at times being adversarial and caught up in unnecessary and costly legal wrangling, which in fact lengthened the duration of claims, rather than moving them to a close. Key considerations in this approach included the:

  • Setting up revised systems and processes utilising a progressive approach to return to work
  • Development of a more efficient payment management system
  • Mobile meetings model to engage with claimants in environments which were ‘less threatening’ to them
  • Education of company representatives about the need to cooperate with new strategies and their benefits

WCD then commenced strategising all open claims and managing them to closure, most within 12 to 18 months for the long term claims. During this period IBNR matters arose and these were incorporated into the approach.

Triaging

The WCD triaging system picked up all new claims (SI or Scheme) and managed them, significantly reducing duration and assisting back to work outcomes. Not to work is not a merit in itself. The Health Benefits of Good Work are recognised by all WCD practitioners.

WCD has a national footprint so was able to managed claimants that had moved interstate effectively, utilising local WCD practitioners.

Sound Communication

All WCD staff identified themselves as working on behalf of the company and communicated their roles clearly to claimants and other stakeholders, reporting through to the Company Secretary and CFO.

WCD is renowned for excellence in file management, communication and tracking of claims.

Throughout the process, WCD maintained the Electronic Data Transmissions on behalf of the client with the regulator. Lines of communication with agents and insurers around the nation were also clearly established for the ongoing claims portfolio.

So What Was Special?

WCD embraced the company’s claims with the well-being of the workers foremost, always thinking of their future and the Health Benefits of Good Work. The workforce was ageing and many claimants were older, having been with the company for many years. WCD are specialists in the management of an ageing workforce and this was duly considered throughout the project.

The company saw a long term outcome believing that at the end of three years, they would have matters still unresolved, but all WCD practitioners believed that the portfolio could be resolved more promptly if resources were focussed and our methodologies followed.  WCD has a very strong internal culture and supports its case managers well.

WCD was very strategic utilising affirmative injury management techniques, supported by our IT system, ensuring all aspects of the project were maintained.

Communication at all levels of the organisation was regular and consistent. Results were being conveyed at agreed intervals to keep management informed.

WCD took the time to understand the organisational culture, the policies, agreements in place, internal payroll systems and preferred reporting, as the organisation was evolving commercially through a challenging period.

Sometimes in organisations, short term decisions are made to save money, but with this single objective in mind, no company is going to achieve overall financial success. WCD knows that with some claims, decisions must be made which seem to cost money short term. However our results historically speak for themselves in terms of ultimate outcomes being highly cost beneficial.

WCD has the maturity and expertise to ‘have the difficult conversations’ with both claimants and management. Further it is able to effectively dialogue with senior management within regulators, as well as insurers / claims agents to ‘bring about resolutions’.

The organisation is now in a position to make clear commercial decisions about how to progress in the future, secure in the knowledge that the objectives of the appointment has been fully achieved.