Claims Management

Internal company policies and procedures are required to facilitate effective management of your workers compensation claims.  Below is a brief overview of the claims process.

For assistance in positively influencing your claims, consider CCI's Workers Compensation & Injury Management Manual.  The manual provides you with detailed information in relation to the legislation and provides recommendations to assist you to develop processes to achieve effective claims management outcomes.

Members click here for further assistance.

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Claims Life Cycle

Worker sustains an injury.
Worker notifies the Employer.
Worker sees a GP. Worker completes a 2B form. Worker provides the medical certificate to the Employer
Employer date stamps documents. Employer has 3 days to provide the Claim to the Insurance Company. Employer speaks to GP - confirms injury, treatment, estimate timeframes and prognosis. Employer advises the GP of the alternative duties that they have available. Employer documents a RTW plan and forwards a copy to all parties.
Insurance company has 14 days to make a decision on liability (accept/pend/decline).
Insurance company needs  more information.   Insurance company pends claim		Insurance company accepts liability.
Insurance company   investigates claim  Insurance company has 10 days to make a decision		Employer monitors the Workers recovery
Insurance company Accepts claim		Employer monitors the RTW plan
	Employer reviews the RTW plan. Is the goal achievable? When will it be achieved? Can the Employer support the long term goal?
	Workers' injury stabilises GP issues final medical certificate/settlement.

How can CCI help you?

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 (08) 9365 7415