Purpose 1 - Leading insurer

Working with employers and employees to  minimise harm in workplaces, support return to work and recovery at work, and  deliver robust and transparent management of claims

Performance criteria Source
Funding ratio—The percentage of premium-related total assets to premium‑related liabilities PBS Component 1.4
Scheme is fully funded—Percentage and dollar value of insured scheme that is funded Corporate Plan KRA 2
Scheme liability is reduced—Percentage change and dollar value of total scheme liability Corporate Plan KRA 2

Result

The funding ratio of the  workers’ compensation scheme for the public sector (premium scheme) increased  to 84 per cent in 2015–16 from 76 per cent in 2014–15. This was above Comcare’s  target of 75 per cent at 30 June 2016.

Premium scheme assets  increased from $2 143.2 million to $2 307.1 million (by $163.9 million).

Premium scheme liabilities decreased from $2 825.7 million to $2 757.9 million (by $67.8  million or 2.4 per cent) in 2015–16.

Comcare’s objectives are to reduce the premium scheme liabilities to $1.9 billion by 30 June 2018, a  reduction of $1 billion from the baseline at 30 June 2014, and to return to  being fully funded (100 per cent funding ratio) by 1 July 2020.

Performance criteria Source
Commonwealth average premium rate PBS Component 1.4
Premiums are at an optimal level—Premiums as percentage of payroll Corporate Plan KRA 2

Result

The average Commonwealth premium rate decreased from 1.93 per cent of payroll (excluding GST) in 2014–15  to 1.85 per cent pf payroll in 2015–16. This is a 4 per cent reduction in the average Commonwealth premium rate.

Comcare’s premium rate target for 1 July 2016 was 1.5 per cent. Comcare’s objective is for premiums to be at an optimal level of 1.1 per cent of payroll (excluding GST) by 1 July  2018.

Performance criteria Source
Claims continuance rate (i.e. the percentage of claims with 4 weeks of incapacity that continued to 13 weeks or more of incapacity) PBS Component 1.4
Early return to work of employees—Percentage and number of employees on reduced income continuance—reported by time period 4, 13, 26 and 52 weeks Corporate Plan KRA 2

Result

In 2015–16, the  percentage of claims with four weeks of incapacity that continued to 13 weeks or more of incapacity was 54 per cent. This is the difference between the number of employees on reduced income at 4 weeks (716) compared to 13  weeks (388) as a percentage of claims.

The table below shows the percentage and number of employees on reduced income.

Table 8: Percentage and number of employee on reduced income 2015–16

Time period of reduced income Percentage Number of employees
≥ 1 day 100% 1216
4 weeks 59% 716
13 weeks 32% 388
26 weeks 21% 261
52 weeks 14% 169

Performance criteria Source
Current return to work rate (i.e the percentage of injured workers from Commonwealth Authorities with 10 or more days off work, who had submitted a claim 7–9 months prior to the survey, and who are working in a paid job at the time of the survey) PBS Component 1.4

Result

In 2015–16, the current  return to work rate of employees from Commonwealth Authorities was 80 per cent.  This represents employees with 10 or more days off work, who had submitted a claim 7–9 months prior to the survey, and are working in a paid job at the time  of the survey.

Performance criteria Source
Injured worker satisfaction with recovery and support service PBS Component 1.4
Injured worker satisfaction with services as part of the Comcare index PBS Component 1.4
High satisfaction with services—Percentage and number of employers and employees satisfied with the quality of claims management, and the quality of services provided to case managers in agencies Corporate Plan KRA 2

Result

In 2015–16, 74 per cent  (N = 302) of employees indicated they were satisfied with the quality of  Comcare’s claims management, compared to 69 per cent (N = 414) in 2014–15. This result is from the 2015–16 Comcare Return to Work Survey (previously the Injured Worker Survey), conducted in March 2016 with employees from the premium paying sector. This result is the aggregated score of the percentage of employees who responded ‘good’ or ‘very good’ in relation to nine service questions from their previous six months experience with Comcare.

In 2015–16, 58 per cent  (N = 89) of employer representatives indicated they were satisfied with the  quality of Comcare’s claims management, compared to 49 per cent (N = 61) in  2014–15. This result is from the Employer Case Management Survey, conducted in May 2016. Respondents were from premium paying agencies, and were rehabilitation case managers, return to work coordinators, workers’  compensation managers or in charge of injury management business units. This result is the aggregated score of the percentage of employers who responded  ‘good’ or ‘very good’ in relation to nine service questions.

Note: N is the number of  people who answered the questions.

Performance criteria Source
Timeliness of claims determination (i.e. percentage of new claims determined within 20 calendar days for injury claims and 60 days for disease claims) PBS Component 1.4
Timely processing of claims—Percentage and number of claims processed within agreed timeframes Corporate Plan KRA 2

Result

In 2015–16, Comcare determined 2789 new claims with 2653 (95 per cent) of these being determined within the  agreed timeframe. This is a significant improvement on Comcare’s performance of 77 per cent in 2014–15.

Performance criteria Source
Premium claims—Timeliness of determined claims payment (i.e. percentage of non-incapacity items paid or rejected within 7 calendar days for reimbursement to employees or trustees, and 28 calendar days for other payments) PBS Component 1.4 (premium claims)
Pre-premium claims—Timeliness of determined claims payment (i.e. percentage of non-incapacity items paid or rejected within 7 calendar days for reimbursement to employees or trustees, and 28 calendar days for other payments) PBS Component 1.5 (pre premium claims)
Accurate processing of payments—Percentage and number of sampled payments processed in accordance with agreed standards Corporate Plan KRA 2

Result

In 2015–16, 68 per cent of non-incapacity payments were paid or rejected by Comcare within the  timeframe. This is a significant increase on Comcare’s performance of 45 per  cent in 2014–15. This performance result includes both premium and pre-premium claims.

In 2015–16, the error rate of payments processed was 1.5 per cent, which was within the 2 per cent  agreed standard.

Performance criteria Source
Asbestos claims—Timeliness of claims resolution (i.e. percentage of primary asbestos claims resolved within 180 calendar days) PBS Component 1.6

Result

In 2015–16, 52 per cent of primary asbestos claims were resolved within 180 calendar days.

Performance criteria Source
Asbestos claims—Third party recovery rate (i.e. percentage of the value of asbestos claims settlements recovered from third parties) PBS Component 1.6
Maximise recoveries from third parties and debtors—Percentage and dollar value of asbestos claims settlements recovered from third parties Corporate Plan KRA 2

Result

In 2015–16, Comcare recovered 25 per cent of asbestos claim settlements from third parties. The total amount recovered in 2015–16 was $5.053 million. Comcare’s objective is to recover 10  per cent of asbestos claim settlements each financial year.

Performance criteria Source
Reduced administrative costs—Administration costs as percentage of overall scheme costs as reported by Safe Work Australia Corporate Plan KRA 2
Reasonable cost to process claims—Average cost per claim processed  

Result

In 2015–16, administrative costs made up 25.7 per cent of the overall scheme costs on the measurement basis used by Safe Work Australia. Comcare’s target was to reduce administrative costs to 23 per cent of overall scheme costs by 30 June 2016.

In 2015–16, the average cost per claim processed was $2736.