OUTCOME FOCUSSED CLAIMS MANAGEMENT

PERIOD:
  • MAY-JULY 2004
CHALLENGE:
  • NSW Insurer advised this company two months before renewal that their end of year adjustment and next year’s renewal premiums were likely to be approx $1 M above their budgeted amounts (i.e. $2M in total)
  • Clients “need” therefore was to reduce premiums by approximately $1M against WorkCover forecast of $6M expenditure in each year
  • The projected premium rate was almost 50% above tariff rate Client lacked understanding of  workers compensation premium drivers and management principles
ACTION:
  • Developed short term intensive management plans for each claim where there was an opportunity to achieve immediate reductions in estimated claim costs and future premiums
  • Provided intensive claims management leadership over a six week period leading up to the end of the policy year (on-site contractor)
  • Directed their insurer and other service providers on a daily basis
  • Reviewed claim status and options with managers, insurer and service providers weekly
  • Co-ordinated and identified suitable duties options for injured workers
  • Followed though to ensure future claim cost estimates recorded by the insurer were reduced to the lowest level achievable at the date of premium calculation
RESULTS:
  • $1.5M reduction in adjustment premium
  • $1.3M reduction in new year’s deposit premium
  • Benchmarking to determine next year’s objectives and actions required to achieve premium improvement
  • Understanding that outcome stiII sees them paying premiums that are higher than industry rate
  • Understanding that estimate bashing alone is not a total solution