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Most popular questions

How claims influence your insurance premium

If your rateable remuneration exceeds $200,000, then your 2016/17 WorkCover insurance premium will be calculated taking into account your WorkCover claims between 1 January 2013 and 30 June 2015.

Claim costs

Claim costs are payments made in relation to a claim, including an estimate of future costs. This includes:

  • Compensation payments
  • Costs and expenses relating to the claim
  • Settlement payments
  • The estimation of future payments, expenses, and costs

All employers have their claim costs measured in the same way – measuring your performance compared to your industry.

For more information see the SCE Frequently Asked Questions

Future claim costs

WorkSafe uses a model to estimate the lifetime cost of WorkCover claims. The model uses the WorkSafe's experience over 25 years to estimate the average cost of a similar claim.

The main factor impacting an estimate is your return to work rate. If a worker returns to work and compensation ceases, the estimation of future costs is reduced. The longer a worker remains back at work, the more the estimate will fall, reflecting the reduced likelihood of the worker requiring further time off work to recover.

Each estimate is made after a three month delay, to allow all invoices and reimbursements for a claim to be received. This allows a more accurate cost calculation of the claim.

You can influence the estimated future claim costs by ensuring your WorkCover Agent has up to date claim information including:

  • Medical certificates
  • Requests for reimbursement
  • Return to work plans
  • Other documentation the WorkCover Agent requests

Rejected or closed claims

Rejected or closed claims may still have a cost estimate allocated to them. This is because claims can reopen, and workers may have the ability to appeal the rejection of their claim. A claim estimate will only be included in your premium calculation if compensation has been paid.

Employer performance

If you have had WorkCover insurance claims in the period between 1 January 2013 and 30 June 2015, WorkSafe will give you a performance rating. This rating will be displayed on the Premium Notice you receive in July.

This rating is an indication of your performance relative to other employers operating within the same industry, and is used to recalculate your premium rate.

The larger your rateable remuneration, the greater the weight that is given to your past experience.