Person on claim Social and economic wellbeing: PoC satisfaction with quality of injury (PoC) RAW/RTW, health outcomes, management or rehabilitation. employment. PoC satisfaction with quality and Duration of claims process, timeliness of treatment. of decisions. PoC satisfaction with outcomes: Consistency in claims management health, social, financial and and decisions by claims managers. work outcomes. PoC perception of Fewer unnecessary referrals to health relationship/communication with claims and medical advisors, resulting in manager: proactive, timely, responsive, reduced unintended harm. collaborative. Employers Productivity: absenteeism, Costs associated with making presenteeism. reasonable work adjustments. Employee turnover, separation costs. Satisfaction of employers with relationship management. Premium costs. Insurer or agent Claims manager performance in: Appropriate utilisation of in-house (including claims expertise and external communication and relationships management rehabilitation providers. teams) assessment and risk identification Length of claims, number of days between lodgement and developing a claims and injury eligibility decision. management or rehabilitation strategy Claims manager performance relating to implementing services PoC’s: monitoring and review proportion who achieve a timely and sustainable RTW dispute resolution, and number with an appropriate realisation of improved (evidence-based) injury claims impact. management/rehabilitation plan in place, and Staff turnover and absenteeism in claims management and proportion with sustainable rehabilitation teams. recovery/RTW. Claims manager job satisfaction. Disputation level. Relative allocation of time to project Proportion of claims with GP/employer management, communication and case conferences. training and development vs Cost-effectiveness of treatment and rehabilitation. Consistency of claims management Strength of partnerships with and decisions with insurer or workers’ agent protocols. compensation schemes, and other stakeholders. Fewer unnecessary referrals to health and medical advisors, resulting in reduced costs, and reduced unintended harm. Relevant, evidence-based education and training carried out by claims managers, including nationally recognised qualifications. Workers' Performance against key Strength of partnerships. compensation performance indicators. Affordability, efficiency and system Stakeholder satisfaction with sustainability of the workers’ compensation schemes. arrangement.
Person on claim (PoC) Social and economic wellbeing: RAW/RTW, health outcomes, employment. Duration of claims process, timeliness of decisions. Consistency in claims management and decisions by claims managers. PoC perception of relationship/communication with claims manager: proactive, timely, responsive, collaborative. PoC satisfaction with quality of injury management or rehabilitation. PoC satisfaction with quality and of treatment. PoC satisfaction with outcomes: health, social, financial and work outcomes. Fewer unnecessary referrals to health and medical advisors, resulting in reduced unintended harm. Employers Productivity: absenteeism, presenteeism. Employee turnover, separation costs. Costs associated with making reasonable work adjustments. Satisfaction of employers with relationship management. Premium costs. Insurer or agent (including claims management teams) Claims manager performance in: communication and relationships assessment and risk identification developing a claims and injury management or rehabilitation strategy implementing services monitoring and review dispute resolution, and realisation of improved claims impact. Staff turnover and absenteeism in claims management and rehabilitation teams. Claims manager job satisfaction. Relative allocation of time to project management, communication and training and development vs Consistency of claims management and decisions with insurer or agent protocols. Fewer unnecessary referrals to health and medical advisors, resulting in reduced costs, and reduced unintended harm. Relevant, evidence-based education and training carried out by claims managers, including nationally recognised qualifications. Appropriate utilisation of in-house expertise and external rehabilitation providers. Length of claims, number of days between lodgement and eligibility decision. Claims manager performance relating to PoC’s: proportion who achieve a timely and sustainable RTW number with an appropriate (evidence-based) injury management/rehabilitation plan in place, and proportion with sustainable recovery/RTW. Disputation level. Proportion of claims with GP/employer case conferences. Cost-effectiveness of treatment and rehabilitation. Strength of partnerships with workers’ compensation schemes, and other stakeholders. Workers' compensation system Performance against key performance indicators. Stakeholder satisfaction with workers’ compensation schemes. Strength of partnerships. Affordability, efficiency and sustainability of the arrangement.