Insurer recovery through work performance report

The purpose of these reports is to:

• present insurer’s recovery through work performance
• ensure work participation remains at the forefront of insurer performance
• foster transparency of insurer performance.

SIRA intends to publish this performance report on the SIRA website on a quarterly basis to drive accountability and positive change within the industry.

Measures

The report is based on the following outcome measures:

• Stay at work rate (SAW) - number of workers who have remained at work in any capacity after their injury.
• Return to work rate (RTW)  - number of workers who have returned to work after having at least one day off work.
• Working rate (WR) - number of workers who have returned to work after having at least one day off work as well as workers who have continued to work.

The report presents a comparison of 13 week recovery through work rates over a period of:

• 5 quarters
• and 2 years.

These time periods include all workers who have sustained an injury in that period (quarterly or yearly). The metric also now excludes disputed and reasonably excused claims. This meant insurers were required to improve data collection and coding systems. As a result, there may be a difference in rates of 1-2% points compared to SIRA’s previously reported RTW rates.

It is difficult to compare insurer recovery through work rates, as insurer portfolios vary so greatly. However, insights from the comparison of an individual insurer recovery through work rates, can be gleaned from trends over time.

Context

Recovery through work measurement framework

In 2021, SIRA introduced the Recovery through work measurement framework. This framework fulfils SIRA's commitment to measure actual work participation across schemes, moving away from payment based or claim closure approaches.

The framework aims to measure a person’s outcomes (lag metrics) and experience (lead metrics) of the recovery through work process. These metrics are based on the evidence of modifiable factors that affect work participation and are categorised into four domains, the personal, workplace, healthcare and insurance and compensation domain.

Influencing factors

• Insurer/claims service providers recovery through work performance can be dependent on a range of factors including; the type of portfolio held by the insurer such as the size of the policy holder and the industry in which the holder conducts its business, the nature of injury and the availability of suitable work, the quality of claims management practices and/or insurers and claims services providers recently entering the market.
• External factors may also influence recovery through work performance including: the changing nature of work, ongoing impacts related to macro events such as COVID-19 pandemic, rising interest rates, lower standard of living, disruption to supply chains, a decline in the labour force.

Open data

SIRA is preparing to move the current Open data portal to a new portal in June 2024, where the return to work and working rate pages will be updated as per the refreshed recovery through work metric specifications.

Further enhancements such as 13 week rolling time series and stay at work metrics will be announced as they become available on Open data.