What changes are happening to my workers compensation insurer?
In 2000, the NSW Government announced a program of reforms to improve the NSW workers compensation Scheme. These reforms are aimed at producing a sustainable financially viable Scheme that is fair and affordable for employers and improves outcomes for injured workers.
These reforms have delivered substantial benefits to the Scheme so far. As well as significant improvements in the Scheme’s valuation, WorkCover has increased the focus on claims management to deliver better services to injured workers and employers.
To sustain the delivery of better services, the insurance management arrangements in the Scheme need to be improved.
The NSW Government is introducing a new workers compensation insurance framework in NSW which will make providers of insurance claims and policy services accountable to a new insurance entity. Previously, six insurers provided claims and policy management services to NSW employers and workers, but now there is a new single insurance entity (trading as the ‘NSW WorkCover Scheme’) to replace the six insurers. This new entity will appoint Agents to deliver policy and claims services on behalf of the NSW WorkCover Scheme.
In March 2005, WorkCover released a tender for suitable organisations to provide workers compensation claims and policy services in NSW under commercial contracts to assist improve service delivery and outcomes for injured workers and employers. Ten organisations, including five former workers compensation insurers, responded to the tender. The tender process to select Agents has been completed and seven Agents will begin operating early next year.
The seven Agents that have been awarded contracts are:
- Allianz Australia Ltd
- Cambridge Integrated Services Pty Ltd
- CGU Insurance Ltd
- Employers Mutual Ltd
- Gallagher Bassett Services Workers Compensation New South Wales
- GIO Insurance Ltd
- QBE Insurance Ltd.
Why was my policy selected for transfer to a new Agent?
WorkCover has introduced changes to the delivery of services to employers and injured workers. Over time, you will see a permanent and consistent improvement in the level of service provided.
The nature of the workers compensation insurance system requires change to be introduced in controlled stages to avoid destabilising the system. To implement these new arrangements, a number of claims and policies will be transferred from their existing insurer to another Agent.
Your policy has been selected for transfer based on our information that your organisation:
- has a basic tariff premium less than or equal to $200,000
- is not a national or grouped employer
- is not a private household employing staff, or
- is not a residential strata scheme.
If this information is incorrect you should have been excluded from the switch, contact your new Agent.
The majority of employers will remain with their existing insurer.
I don’t want my policy to move to another Agent. What can I do?
These changes are designed to improve medical and return to work programs and the service employers and workers receive.
The appointment of Agents under contracts will increase the level of competition and improve service standards within the Scheme. Over time, employers will experience an improved level of service in the management of their claims and policies.
Some policies must be transferred to assist with the establishment of the new Scheme arrangements. After 29 June 2006, following the 12-month market freeze, employers may move their policy to an Agent of their choice upon renewal of their policy.
Will moving my policy disadvantage me?
No. As workers compensation premiums are set by a formula established by law, they are not affected by switching Agents. If your circumstances have remained the same but your new premium is different, contact your new Agent. Under the new contract arrangements, Agents are expected to provide good customer service and assistance to employers in the management of their workers compensation issues.
Can I appeal the decision to be transferred to a new Agent?
By law, WorkCover may transfer claims and policies to new Agents. Your policy was selected based on our information that your basic tariff premium is less than or equal to $200,000, and that your company is not a national or grouped employer, a private household employing staff or a residential strata scheme. If this information is incorrect and you should have been excluded from the switch, contact your new Agent.
When can I choose my own Agent?
The freeze will be lifted after 29 June 2006, allowing employers to renew their workers compensation policy with the Agent of their choice from renewal expiry date.
Although employers may move their policy to a different Agent when the freeze is lifted, new claims lodged during the freeze period will remain with the initial Agent.
When the freeze is lifted, there will be increased competition in the market and employers will have greater choice of Agents.
My policy has moved to an Agent I have been with before. I wasn’t happy with their service, so may I choose my own Agent?
Agents will be working hard to provide improved service delivery to employers and workers. During the market freeze – on and from 2 July 2005 up to and including 29 June 2006 – employers will not be able to transfer their policies. However, when the market freeze is lifted after 29 June 2006, employers will be able to choose their own Agent on policy renewal.
I am unhappy with the way the new Agent manages my claims, their estimates are too high and they have a huge impact on my premium. What can I do?
All Agents have a complaints management system in their operation. You should request to speak the Agent’s complaints coordinator who will help you resolve the issue. If the matter is still not resolved to your satisfaction you may refer the complaint to WorkCover. In addition, your right of appeal regarding estimates remains unchanged. Contact your Agent to resolve it. If you are unsuccessful or need further assistance, contact WorkCover on 13 10 50.
Will my premiums change?
No. As workers compensation premiums are set by a formula established by law, they are not affected by switching Agents. If your circumstances remain the same but your new premium is different, contact your new Agent.
The introduction of these changes will coincide with the implementation of an improved premium system.
How will the premium review changes affect me if I move to another Agent?
Workers compensation premiums are set by a formula established by law – they are not affected by switching Agents.
The introduction of these changes will coincide with the implementation of an improved premium system.
How will I know who is dealing with my workers’ claims?
Two weeks prior to the transfer of a claim, WorkCover will notify affected employers and workers of the changes and provide new Agent contact details. Your new Agent will be provided with information about your worker’s claim, including the case manager, the injury management plan and return to work expectations. Current claims with a date of injury after 1 January 2004 – will remain with the previous insurer.
What will happen to the discounts I currently get from bundling my insurance requirements?
Workers compensation premiums are set by a formula established by law – they are not affected by switching Agents. If your circumstances remain the same but your new premium is different, contact your new Agent.
By law, Agents can’t provide discounts on your workers compensation insurance when you bundle your other business insurances.
If you were receiving a discount from packaging your insurance in the past, it should not have included your workers compensation insurance.
What is the temporary freeze on the voluntary movement of policies?
With the introduction of the new Scheme arrangements there will be a temporary freeze on the voluntary movement of policies from one Agent to another Agent on and from 2 July 2005 up to and including 29 June 2006.
Policies due for renewal during the freeze period must be renewed with the employer’s current Agent.
When the temporary freeze is lifted, employers may move their policy to an Agent of their choice upon policy renewal. A new employer taking out workers compensation insurance for the first time, can choose their preferred Agent.
If my new Agent doesn’t perform, can I move my policy?
Under the contractual arrangements, Agents are expected to provide improved service delivery to employers and workers. WorkCover will actively monitor their performance and it is anticipated that from 2007 WorkCover will publish Agents’ performance results.
When the market freeze is lifted, employers will be able to move their policies on renewal to an Agent who best meets their business needs.
How do I know who is the best Agent for me?
In 2007, WorkCover is planning to publish Agents’ performance results. These results will include, among other things, information on return to work outcomes and service delivery.
I am currently being audited – will changing Agents affect the outcome?
No. All Agents have a responsibility to report wage audit results to WorkCover.
I currently have an appeal lodged with WorkCover’s Appeals Branch – will changing Agents affect the outcome?
No. Your policy transfer will not impact on a current appeal. The appeal will progress in the usual way. Agents have been instructed to ensure any files with a current appeal are treated as a priority.
How will WorkCover ensure my policy history is transferred?
Arrangements are in place to ensure that your policy details are transferred in a seamless manner. WorkCover will oversee this process and have stipulated strict requirements for the transfer of files. Policies selected for transfer will be switched at renewal and the new Agent will issue a renewal notice.
Does my accountant/broker/legal representative know my file has been transferred?
WorkCover has provided general information to accountants, brokers and the law society about the changes.
If your policy renewal is usually sent to your accountant/ broker/legal representative, they will receive the information on the transfer of your policy.
How long before I’m contacted by my new Agent?
WorkCover will notify employers affected by policy transfers, in writing, approximately six weeks prior to moving to their new Agent. The letter will include details of the transfer and an information pack to assist you in understanding the new Scheme arrangements.
Your new Agent will send your renewal notice around four to six weeks prior to the expiry of your current policy.
My policy was switched to another Agent, but the claims stayed with the original Agent. How will my premium be calculated?
All relevant claims information will be provided to the new Agent administering your policy. Your premium is calculated at renewal and includes the cost of claims in your premium experience rating.
Why did my policy move to a new Agent and some claims remained with my previous insurer?
Wherever possible, WorkCover has linked the policy and claims together and will transfer both to the new Agent. However, the rule for transfers of claims mean that a new claim with a date of injury after 1 January 2004, or a claim reopened after 1 January 2004, will remain with the previous insurer.
When the market freeze is lifted I want to move my policy to another Agent. What happens to the claims?
When the market freeze is lifted after 29 June 2006, employers are free to move their policy to another Agent upon renewal of their policy. However, if the claim was switched to a new Agent during the market freeze period, the claim will remain with that Agent. For example, if a claim is switched to Agent A in March 2006 and the employer moves its policy to Agent B in July 2006, the claim will remain with Agent A.
I did not receive an information pack and do not know who my new Agent is. What should I do?
If you have not received an information pack and are uncertain of who your new Agent is, contact WorkCover on 13 10 50 – they will confirm who your new Agent is and resend the information pack to you.