Skip to main content

The successful management of your WorkCover claims and insurance premium all comes down to strategy. Your plan must work with – or at least in parallel with – what your WorkSafe agent is trying to achieve.

In Vitoria there are five claims agents (Allianz, CGU, EML, Gallagher Bassett and Xchanging) but from 1 July this will reduce to four when CGU exits the scheme. You will likely have dealings with staff in their premium departments regarding matters such as rateable remuneration, or case managers in their claims departments regarding claims lodged by your employees if they are injured.

You don’t need to be your case manager’s best friend, but you want a professional relationship with them. You’ll achieve better outcomes when you are constructive and collaborative and show them consideration. I’ve worked with enough case managers to know that employers who are painful to deal with get poor service. Their phone calls are less likely to be returned, and their problems are, well … their problems, not the agent’s.

How to raise your issue with the agent

If you’ve ever experienced frustrations with your case manager, it’s okay to make this known. Discuss any service issues early on so they can be addressed – most WorkSafe agent staff will appreciate the feedback. But berating an already overworked case manager is unlikely to get you the red carpet treatment in the future.

Rather than taking your frustration out on the agent, do what you need to do to get the strategy outcome you need. Before going into a review meeting with your case manager, decide on the three things you want to achieve. For example, you may want:

  1. the worker to attend an independent medical examination
  2. the WorkSafe medical advisor to contact the worker’s THP
  3. the case manager to invite the injured worker to their office for a worker interview.

During the meeting, communicate any concerns about the case and your desires concerning the future strategy in a professional manner. Focus on why your request helps both you and the worker to comply with your respective obligations. Don’t waste too much time speculating on the worker’s motivations. Just stick to the facts. Aim to have a productive meeting that wraps up with the actions you want taken as the next steps.

How to deal with failure to respond

Of course, sometimes your requests will be ignored, or some other issue at the agent’s end will cause significant problems at your end. Unfortunately, it’s not unheard of for employers to have such issues with case managers. High caseloads, vacancies in teams and professional inexperience shouldn’t be your problems, but sometimes they are.

Again, a level-headed and professional approach is always best. Communicate your concerns via email and state when you expect to receive a response. By close of business the following day is a reasonable timeframe for non-urgent communications. If a task is important but time-consuming, be fair and give the agent up to a week. But if the timeframe has elapsed and you still haven’t heard back from them, escalate the query to their team leader or your account manager.

How to escalate serious complaints

In instances of serious and ongoing service issues, contact the agent’s customer service team. Each WorkSafe agent has a team dedicated to handling complaints from workers and employers. Their objective is to resolve the issue and provide the complainant with an outcome. They won’t always tell you what you want to hear, but you can expect the issue to be addressed.

Moving forward

We’ve found that when trying to overcome service issues with your agent, a collaborative approach works best. It’s a reality that you can’t simply cancel your service. If you have employees, it’s likely that you are required by law to have WorkCover insurance. So you may as well try and get along with the people you need to work with.

Ultimately, if the service from your current agent does not meet your expectations and the issues cannot be resolved, your only option may be to consider transferring your policy to another agent. Don’t hesitate to contact Mark Stipic Consulting to discuss your service and your needs in this space as we can recommend an appropriate agent for your business.

About Mark Stipic Consulting

Mark Stipic Consulting are trusted advisors to decision-makers at employers, helping them achieve the goals of reduced injuries, claims and premiums. Mark Stipic is #TheWorkCoverGuy and author of WorkCover that Works, the only book of its kind written specifically to help employers reduce their injuries, claims and WorkCover premiums.

When you’re ready, here are two ways Mark Stipic Consulting can help you and your business take control of your WorkCover situation:

  1. Get a copy of Mark’s book WorkCover that Works. It will show you how to reduce your injuries, claims and WorkCover premiums.
  2. Request a free, no obligation 30-minute strategy call. We will help you address your most pressing challenges and connect you with potential solutions if appropriate.