Insurance influence could see lower safety pay
A workers’ compensation expert says bonuses that the insurance industry is paid by some state governments could actually result in injured workers' claims being rejected.
Workers compensation schemes are administered by state government bodies in Victoria, News South Wales and Queensland, meaning that companies pay a levy to the relevant body, such as WorkSafe, which then pays private insurers to assess individual claims.
Victoria's ombudsman Deborah Glass is conducting a probe into the state's workers’ compensation scheme, trying to find out if workers are being unfairly denied claims.
She is also looking at whether WorkSafe Victoria was rewarding insurance companies for limiting payouts.
The investigation came about due to the weight of public pressure thrown at the ombudsman's office, with 370 complaints about the workers compensation scheme last year alone.
At the same time, disputes lodged with the state's compensation mediator have risen significantly.
Former Workcover SA director and economist, Dr Kevin Purse, said it was well worth an inquiry.
“Quite often incentives are set for the agents to reduce claims costs,” he told reporters.
“So if you can get someone back to work, that'll save the scheme a lot of money, but you can also remove them from the scheme by other means.”
He said similar investigations should be taken up in the other states and territories.
He said it is possible that workers were having their payouts cancelled or limited because of governments’ financial incentives across Australia.
“It's clear on the one hand claims management abuses do occur, in delays in access to medical treatment and failure to assist workers to return to work,” Dr Purse said.
“What's less clear is the extent to which abuses occur.
“So I think it's timely to have an investigation like this that's been proposed by the ombudsman to try to get to the bottom of what's going on.”
Worksafe Victoria says it will cooperate with the ombudsman, and make comment when the investigation is over.