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Injured researcher left short by ANU private injury insurance

By on March 19, 2013 in Insurance claims, Insurance companies

ANU (Australian National University) PhD researcher Daryl Wesley suffered serious injuries during a fall in the Northern Territory, while researching Aboriginal rock art. The ANU private injury insurance left him short by > K10,and Mr Wesley warned PhD researchers were being left out on a limb because, unlike staff, they do not have access to [...]

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The importance of an accurate injury claim form

By on March 5, 2013 in Insurance claims, Legal cases, Tips & Tricks, Workplace injury, WorkSafe Vic, WTF

We have said it many times, the best and only ways to preserve evidence of your work injuries are by reporting all of them promptly to a doctor or other medical provider (i.e. hospital), by accurately filling in the injury claim form, and by photographing any visible marks, cuts, bruises, swellings, including any casts (plaster), [...]

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Workcover claim accepted – but surgery, procedures, imaging, specialists and treatment denied

By on March 3, 2013 in Case manager (follies), Entitlements, Insurance claims, Resources, WorkCover, WorkSafe Vic

Workcover insurance companies quite often tell us and our treating doctors that they will not pay for procedures that the doctor, even the most expert of experts, says are medically appropriate and necessary. In Victoria this is in accordance with Division 2B of Part IV of the Act aworkcovervictimsdiary often hears from  injured workers whose [...]

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Narrow minded case managers:10 red flags of a bogus workcover claim

By on February 1, 2013 in Articles & Research, Case manager (follies), Insurance claims, WTF

A couple of weeks ago, workcovervictim stumbled upon a bizarre and utterly narrow-minded write-up by a large workers comp insurance company  (name omitted for obvious reasons) featuring a “sample workcover claim” to “assist case managers to recognise the bogus workcover claims”, which are, of course so rampant. 10 red flags of a bogus workcover claim [...]

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Ten deadly sins of workcover claims-handling

By on October 17, 2012 in Case manager (follies), Insurance claims

My partner has been a member of the Yahoo risk management forum called RiskList: http://finance.groups.yahoo.com/group/RiskList. which he highly recommends as a lot applies to workcover. Around May this year, an interesting discussion was kicked off, calling for nominations of the “7 Deadly Sins” of claims handling. And although the discussion was predominantly California-based, some good [...]

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One of the worst workcover claim handling we heard of

By on September 20, 2012 in Case manager (follies), Insurance claims, nurses, Shame files, WorkCover

We received an email from a former case manager who shares with us a candidate [case manager] for the worst claim handling she ever saw. This  claim also turned up in a workers compensation claim file audit. A case manager was handling claims for a statewide private hospital chain. And oh Boy, all of the [...]

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Non-existent epilepsy used to decline my claim: Injured worker

By on September 13, 2012 in Insurance claims, Stories, WorkCover, WTF

This is quite and amazing story from a recently injured worker who had her claim declined because an insurance company quack claimed her injury resulted from of an epileptic fit. Sarah writes:    Sarah has since undergone brain scans by a competent medical specialist who can find no evidence of epilepsy It is no secret [...]

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The culture of zero lost time injury and team safety bonus – a gutting story

By on September 13, 2012 in Insurance claims, OH&S, Shame files, Stories

I would like to tell you what has happened recently, writes an injured worker . As  I now have  time to write this  account of what happened,  I apologize if it may be long winded , but  letter writing is not a strength that I normally exercise. But I now must,  in pursuit of  my [...]

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How workcover insurers intervene early on potential catastrophic claims

By on August 18, 2012 in Articles & Research, Case manager (follies), Insurance claims, WTF

One of the biggest cost drivers in workers compensation is seemingly “average” workcover claims that take a turn for the worst and result in several years of medical treatment and disability. In a recent article in the Business Insurance online magazine the common threads of “creeping catastrophic” claims are discussed, and frankly some of those [...]

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Mental injuries are receiving more attention for workers compensation

By on August 15, 2012 in Bullying & Stress, Comcare, Compensation, Insurance claims, Legal cases, Psych

Things can happen at work that can really stress people out. If something really bad happens, that stress can be more serious and lead to depression or post-traumatic stress disorder. Someone who suffers from such a condition may have difficulties functioning in everyday life, and that includes going to work. Mental injuries are receiving more [...]

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Many injured workers miss out on workers compensation

By on August 7, 2012 in Compensation, Insurance claims, Stuff, WorkCover

We are really sick and tired of hearing unsupported and unconvinced charges of injured worker fraud and malingering that are advanced by insurers, employers, and the media and supported by the workers compensation insurance. These allegations also stigmatise injured workers and make them less likely to report injuries and file claims, as is evidenced by [...]

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A human rights perspective: Injured workers caught in U.S style race to the bottom

By on August 7, 2012 in Compensation, Corruption, Insurance claims, Insurance companies, Legislation, Media, Politics, Premiums, Serious injury, WTF

You’d be forgiven for mistaking this article (Reexamining workers’ compensation: A human rights perspective (pages 483–486)for one highlighting any of the workers compensation schemes in operation throughout Australia (especially in NSW).  Injured workers are truly caught in a race to the bottom – sadly,  we’ve almost hit rock bottom, if not already.  This paragraph in [...]

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Protect yourself from insurance company medical assessors

By on July 16, 2012 in Compensation, Corruption, Fraud & Abuse, Insurance claims, Insurance companies, Legislation, Medical Exam (IME), WorkCover NSW

One of the IWSN’s main contributors and veteran of a fixed assessment process, Gail, has some sound advice for all injured workers in NSW, and elsewhere.  We know that insurers routinely doctor shop until they get the answers that best suit their own purposes and not those of the injured worker. This advice is especially [...]

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$1.6 Billion wasted on paper shuffling by WorkCover

By on May 14, 2012 in Fraud & Abuse, Insurance claims, Insurance companies, Politics, WorkCover, WTF

Just in from – and we wonder where  all the money is going? How can any government in good conscience see a quarter of the amount paid in benefits to injured workers siphoned off to private insurers to simply manage claims? $1.6 Billion wasted on paper shuffling by WorkCover Figures obtained by The Greens show [...]

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Terminating an injured worker can cost a medium employer K70-300 in increased premiums

By on May 12, 2012 in Employment, Insurance claims, unfair dismissal, WorkCover

Thanks to our star contributor (and soon to be Author), @trinny61, we were alerted to this interesting HR article. It states that if an employee who is receiving compensation for an injury is terminated and ceases to work, the employer’s premiums could “go through the roof”. The risk is most significant in NSW, Victoria and [...]

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Workers compensation insurers and their snooping

By on April 12, 2012 in Case manager (follies), Insurance claims, Surveillance, WorkCover

It can be easy to take the privacy of your personal medical information and private life for granted when no one is actively snooping around in them. But if you get injured at work, you may find your privacy invaded by workcover insurance companies ravenous for any evidence that can be used to deny your [...]

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