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icare highlights rising medical costs

June 4, 2019

Insurance and Care NSW (icare) says rising medical costs will be a key focus as an auditor's report for the state’s workers' compensation scheme shows a significant increase in payments to private hospital services.

The payments per active claim for the first 12 months of an accident increased to $5000 in September compared to $3000 four years earlier, data from the Finity Quarterly Monitoring report shows. Smaller rises were reported for surgical operations, anaesthesia and public hospitals.

Workers' compensation nominal insurer (NI) arrangements covered in the report are managed by icare, which has published insights from the actuarial data on its website.

The data also shows psychological claims jumped 28% to 2908 last year, compared to the previous 12 months.

The increase was driven by the healthcare and social assistance sector, where claims jumped 65%, and in white-collar industries such as financial and insurance services.

“Whilst our overall claims and claims that receive weekly benefits have remained relatively stable, the issue of rising medical costs in NSW, particularly for private hospital services, is a key focus area,” an icare spokeswoman told insuranceNEWS.com.au.

“Due to regulated medical expenses in NSW, costs can be much higher in NSW compared to other states for similar services.”

The increase in psychological claims reflects a trend seen across the board and is not restricted to the state insurance scheme, icare says.

About 15,000 claims were lodged per quarter in the three years from June 2015. Initial increases last year reflect the inclusion from September 2017 of notification-only claims, where there is no time away from work.

“The report states that subsequent removal of notifications from the data means reported claim numbers ‘will remain broadly consistent with 2017 levels allowing for real wages growth’,” icare says.

The number of claims to start receiving weekly benefits in the quarter of an accident declined last year relative to the previous three years.

But the overall number of claims to receive weekly benefits in the first year of injury is expected to remain relatively stable compared to historical levels, icare says, with the actuarial data still incomplete for the second half of last year.

“A key element of the icare nominal insurer claims model is to support better return to work outcomes and we are continuing to ensure we support our customers with the right level of care for sustainable outcomes,” the spokeswoman says.

“icare will continue to share insights each quarter, providing updates on key measures used to monitor the operation of the NI scheme.” 

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