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Claims Management

Claims Management

Workers Compensation is about the health and recovery of a worker and must have the fundamental basis of achieving this in a safe manner. Simply, this is a health product requiring health solutions; the only difference is how it is funded.

Case Management

Working with our clients, Steadfast Workplace Risk partakes in every part of claims management, down to the granular level of case management.  It is our view that workers compensation is embedded in health, and that health is not embedded in workers compensation.

Steadfast Workplace Risk actively communicates and assists employers in return to work management (refer to our Return to Work section), liaising with both the treating doctors and service providers, in conjunction with the injured worker. This is a crucial component of the process in achieving a positive outcome, which has a direct relationship with premiums.

Steadfast Workplace Risk’s proactive approach includes having many round table discussions (Claims Review Process) as well as conferencing with relevant medical practitioners during the policy period. Our experience shows that face to face discussions provide correct information that may not otherwise be captured. These open communication forums are imperative to the effective management of claims, helping to result in earlier and durable return to work, lower claims costs and minimising impact so there are no surprises when receiving renewal premiums.

Return to Work is the key, and is principle based, however claims will not be managed successfully unless the claim is context specific. This being the case, Steadfast Workplace Risk conduct regular and active claim/strategic reviews.

Claim Reviews

Steadfast Workplace Risk claim reviews are based on the premise that our communication with stakeholders at each review point is clear and concise and continually evaluates the success of each claim.  To ensure progression of each strategy, continuous improvement is delivered by maintaining a follow up review process with the agent/insurer between every review, to help achieve our clients desired outcome.

To achieve our claims management philosophy Steadfast Workplace Risk will:

    actively communicate and support relevant Managers and Supervisors so they can develop appropriate return to work strategies, in conjunction with the injured workers, doctors and other service providers
    rovide a proactive approach which includes having many round table discussions with our clients, at all levels, as well as conferencing with relevant medical practitioners during the policy period
    utilise our early intervention model which includes national medical networks, injury and legal hotlines and imaging broking service, in conjunction with our claims experience, both conventional and self-insurance
    benchmark against Official Disability Guidelines (ODG). This provides evidence-based medicine around duration, treatment and medication utilising 10 million USA claims and 500,000 Australian claims, all of which are peer reviewed by other medical practitioners before being released
    align the incident notification process nationally together with the alignment of the liability
    notification forms if practicable, to identify trends within the business

Steadfast Workplace Risk conduct regular, active reviews with our clients, agents/insurers, legal providers and other key stakeholders such as rehabilitation or medical providers, promoting:

    regular and scheduled meetings with all identified contacts
    continual communication with management to oversee and align management and performance
    identification of progress against goals and achievement of the return to work plan
    changing risks and barriers to be identified and managed
    constant screening
    review of liabilities and auditing of appropriate payments under relevant sections of the Workers Compensation Act, if required.