Our focus is to partner with all key stakeholders to achieve the best outcomes. We will work with our clients to develop tailored management strategies which provide optimal treatment and return to work outcomes.

The key characteristics of the Vero Workers Compensation Claims model are:

• Early notification of claims – Vero makes it easy to notify via the web, e-mail, fax or phone. Vero will not wait for the claim forms to be received before we start to manage a potentially high risk claim
• Early intervention actions focussed on getting people back to work safely and quickly
• Stakeholder involvement – Vero’s best outcomes are achieved by working closely with our customers
• Case streaming to ensure the most experienced resources focus on the claims that matter most
• Multi disciplinary team approach to bring a number of disciplines and perspectives to the table on every significant claim (see Claims Management Team diagram below)
• Pro-active reduction of inappropriate access to entitlements
• Service provider management that brings the best in the industry to the table and holds them accountable for their results
• Quality claims management relies on maintaining manageable case loads and your case manager will not handle more than 70 claims

We believe that the real difference in claims outcomes is gained through our unique claims management model and having the understanding that every claim is unique and requires different analysis, strategy and tactical planning to bring about the most effective resolution.

Claim Review Meetings

For corporate clients or clients with a significant number of claims we recommend convening Claim Review Meetings. These meetings:

• ensure that all parties are heading in the same direction
• are an opportune time to gain a greater understanding of your business; and
• are an opportunity to discuss any trends in workplace injuries which your business may be encountering.

As a component of Claims Review Meetings we also openly discuss the estimate recorded against each specific claim.

• Vero recognises that claims estimates are an important driver in an employer’s workers compensation costs
• Vero’s estimates are built on historical injury data, individual claim facts and client specific historical performance
• Estimates are regularly reviewed and updated whenever significant information has been received.

Our estimating strategy is transparent and the breakdowns of estimates are also available to the employer and broker via web based reporting.

Vero Workers Compensation believe that the keys to successful injury management are:

• Having a return to work focus
• Early and regular communication between all parties
• Early medical attention with a determination of diagnosis
• Agreed actions undertaken to manage the injury and claim
• Prompt determination of appropriate duties
• Prompt determination of claim liability
• Employer (including senior management) and insurer commitment to best practice injury management

How Vero Workers Compensation can help businesses with injury management:

• Establishing a partnership with the employer to manage the injuries together
• Providing qualified injury management resources, training, information and guidance
• A direct secure portal to claim data analysis (statistics and costs) via our web based reporting application

Our claims management model comprises of the following:

• Encouragement of early reporting
• Early Intervention strategies
• 3 point contact prior to determination of liability
• Case Streaming
• Multi-disciplinary team approach
• Provider management; and
• Strategies to manage liability

This is to ensure that we are working closely with our clients to achieve the best possible outcome on each and every claim.

At the heart of every productive relationship is good communication. Vero prides itself on keeping its clients informed every step of the way throughout the claims process. Vero will not settle one of your claims without your prior knowledge and you will be provided with every opportunity to influence the approach taken on each and every claim.

Early Intervention

• From the outset, strategies are designed to reduce the duration of a claim. This is achieved by:
• Eliciting and gathering information regarding individual claims (3 point contact- injured worker, employer, treating doctor)
• Carrying out meaningful analysis of that information to identify barriers to return to work (Multi-Disciplinary Team process)
• Creating strategies and tactical plans to overcome identified return to work barriers (Case Management Plans)
• Partnering with clients to openly discuss and determine strategies throughout the duration of the claim.

3 point contact

• Prior to determination of liability in relation to a new claim lodged, we endeavour to conduct ‘3 point contacts’. This is with the:
• Treating medical practitioner
• Employer; and
• Worker

All attempts will be made for these contacts to be made within 3 days of notification of the claim, however, all three of these contacts may not be required in situations of a minor injury.

This contact is to ensure that all accounts of the event and current status are taken into consideration to allow the appropriate determination of liability to be made as quickly as possible. The contact also allows any parties to raise any concerns in relation to the claim in which they may not have felt appropriate to place formally on the claim forms.

Case Streaming

Most claims require only administrative intervention. Based on this, Vero Workers Compensation employ Low Risk Case Management Coordinators to deal with these claims quickly and efficiently. This claims streaming allows the High Risk Case Management Coordinator to manage a small caseload of larger more complex claims.

Having low caseloads provide Vero’s case management coordinators with the time to build strong and positive working relationships with all the stakeholders in the claim.

Multi-Disciplinary Team Approach

Vero’s multi-disciplinary team meets throughout the life of a claim to review strategy.

This allows us to achieve superior claims outcomes through the use of multi-disciplinary teams.

Input from specialist sources on each claim allows us to analyse and determine the most effective claims management strategies, thereby maximising return to work outcomes and managing liability exposures.

Our multi-disciplinary teams include:

• Injury Management Advisors
• Case Management Coordinators
• Technical Advisors
• Other parties may be involved on a case by case basis.

However, in specific circumstances it may be deemed that additional skill sets are required and the involvement of one or more of the following will be incorporated into this team:

• Medical Practitioners
• Risk Managers
• The employer
• The broker
• Legal Specialists
• Investigators.

As a coordinated unit working together, case management becomes more effective through the close interaction of experts guiding the management of each claim.

Provider Management

Vero will partner with clients to work with preferred providers that have an established track record of success. Their performance is formally monitored through Service Level Agreements and regular review meetings to drive accountability and improvement.

Medical and allied health costs are monitored via the multi-disciplinary team approach.

Managing Liability

The containment of workers’ compensation costs throughout the claims process is critical to the efficiency of businesses and improvement of the ‘bottom line’. Our claims management model adopts a liabilities management strategy encompassing:

• Dispute & Litigation Management
• Recoveries Specialists
• Fraud Detection
• Provider Management
• Consistent and realistic claims estimating

A key part of reducing liability exposure is the involvement of our Technical Claims Unit who provide specialist input into the management of all major claims, claims involving fraud or significant litigation.

For more information regarding our approach to claims management contact a Vero Workers Compensation specialist.