Since the transition to icare, as the nominal insurer, a lot has changed in the way workers compensation operates in NSW. One of the major changes will take effect from 1 January 2018 with EML acting as the sole appointed claims service provider.

The aim for iCare with this new model is to simplify the claims process by combining automation and human expertise to achieve optimal outcomes for all employers and injured workers.

Below we have summarised the benefits and principal changes the new claims model will bring.

Notifying an Injury

A new online notification portal available from 1st January will simplify the submission of notifications and expedite the triage process. Claims can be lodged by employers, workers and appointed brokers or advisors.

Claims can also be lodged by contacting iCare’s Support Centre or via email.

Triage Process

The new claims model has a one of its core principles to timely assign the right level of support to workers and employers for their individual circumstances.

Once notifications and information have been submitted. EML will evaluate risks factors such as the type of injury, occupation, industry as well as Phyco-social and situational factors such as the injured worker’s motivation to return to work and employer ability to accommodate suitable duties in the workplace.

Through the questions asked and answered in the notification portal, EML will be able to ascertain the level of management required and quickly allocate the claim to a specialist who is most capable of providing the employer and worker the support they need.

Minor claims will be managed within the Support Centre team and more complex claims will be managed by highly-trained and experienced Case Management Specialists.

Liability Acceptance

One of the major changes this new model will bring is that provisional liability will be accepted quickly for minor injury/claims provided the employer agrees the injury/claim is work related.

This will enable workers to get appropriate treatment or support much faster and by doing so the RTW time will often be improved.

For more complex claims, a Claims Management Specialist with the support of a Technical Specialist and will gather and evaluate sufficient information taking into consideration the individual circumstances of the claim to make fair liability decision.

For further information, please refer to:

Source: icare

Title: Benefits of the New Claims Model

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