EML appointed as single claims agent for NSW workers’ comp

On April 26, Insurance & Care New South Wales (icare) announced a new and improved service delivery model, with Employers Mutual Limited (EML) being appointed as the single claims agent for the NSW workers’ compensation scheme effective 1 January 2018.

Currently, workers’ compensation claims are managed by five claims agents appointed by icare:

• Allianz Australia Workers’ Compensation (Allianz)
• CGU Workers’ Compensation (CGU)
• EML
• GIO General (GIO)
• QBE Workers’ Compensation (QBE)

But with all current scheme agent contracts expiring on 31 December, icare undertook a selection process for their new model, and the result of their agent selection process is as follows:

• EML has been appointed as the single claims agent and will be responsible for managing ‘all new claims’ across the scheme from 1 January 2018. It is unclear whether a claim will be considered ‘new’ based on the date of injury or date of claim lodgement.
• Allianz and GIO have been retained by icare as transition agents and will retain responsibility for the management of existing claims; this appointment is until 31 December 2018.
• CGU and QBE will conclude their role as icare scheme agents on 31 December 2017. No announcement has been made as to who their claims will be transitioned to after this date.

There has been no confirmation as to whether the current market freeze expiring on 29 June 2017 will be extended. However, an extended market freeze would be beneficial to manage the transition to these new arrangements.

How will this impact you?

All NSW employers will be impacted by this announcement, and a number of questions have been raised:

• What impact will the removal of a competitive market place have on service delivery?
• How can icare guarantee that return to work performance will not be impacted by this change, thus increasing premiums in 2018?
• How will claims be transitioned from the current agent to the new agent?
• How will claims reviews operate when an employer has EML for all new claims, and either Allianz or GIO for existing claims?
• What happens if an injured employee has an aggravation of an older claim? Will they have two case managers at two different agents managing medical expenses?
• Will EML be able to handle the increased claims workload?
• What options do employers have to minimise the impact to the national operations?

How Aon can help

We are able to act as your“agent transition manager” over the next 12 months, to ensure the financial impact of this change is reduced and service to injured employees is not impacted. We will also ensure that an optimal workers’ compensation strategy is adopted in the short and medium term.

You can find out more about our workers' compensation solutions here, and if you would like to discuss further, please contact your Client Manager or one of our experts listed on the right.