Engagement and Insurer Services
Engagement & Insurer Services assess applications for self-insurance licences and ensure ongoing compliance with legislative requirements and policy guidelines. Insurer services advisors have an ongoing relationship with self-insurer representatives as they are required to monitor the ongoing financial viability and licence conditions that allow self-insurers to operate in the Queensland workers’ compensation system. The advisors also undertake audits of claims and rehabilitation standards of self-insurers by undertaking file reviews and report findings and recommendations for improvement.
Engagement & Insurer Services also educates and engages with employers, Rehabilitation and Return to Work Coordinators (Coordinators), workers, unions and medical and allied health practitioners throughout Queensland. The use of webinars has opened many doors allowing free and easy access to training for Coordinators, but also online education for medical specialists undertaking Guidelines for Evaluation of Permanent Impairment training used in workers’ compensation claims determinations. The goal of the webinar education strategy is to provide stakeholders with accessible support, current information and resources needed to fulfil their roles. This will lead to best practice rehabilitation and sustainable return to work across all industries.
Data and evaluation
The Data and Evaluation Branch provides reporting and analysis of scheme claims measures. Data is used to inform business decisions, provide monitoring for insurers and for national comparative performance monitoring. Data and Evaluation is responsible for the quality of the data captured and endeavour to provide clear and insightful business intelligence to reveal patterns, anomalies, key variables and relationships. Data and Evaluation meet regularly with insurers, publishes statistical reports annually and holds actuarial updates to ensure our stakeholders are kept up-to-date with key trends in the scheme.
Medical Assessment Tribunals
Medical Assessment Tribunals comprise a panel of medical specialists who are convened to make medical decisions about workers' compensation claims. Access to the Tribunal is through referral by insurers. The Tribunal's aim is to provide independent, expert medical decisions on complex medical matters to assist insurers and workers to manage their injury. The administrative functions of the Medical Assessment Tribunal are managed by a dedicated Tribunal Services team.
Workers’ Compensation Policy Services manages the development and review of policy and legislation that supports the scheme. The team leads, coordinates, implements and evaluates strategic policy, research, legislation and other initiatives that achieve high quality outcomes in workers’ compensation in Queensland and contribute to the continual development and implementation of strategies and initiatives that support government priorities.
The unit also manages investigations for breaching obligations with the Act (such as fraud against an insurer), files complaints where there is evidence to commence an action against a person, and manages judicial review matters.
Review and appeals
The Review and Appeals Unit provide an independent review process for employers and injured workers who are dissatisfied with a decision of an insurer with respect to a workers’ compensation claim or premium matter. The unit also manage the legal process where an injured worker or an employer is dissatisfied with a decision of the Review Unit and they appeal this decision to the Queensland Industrial Relations Commission or Industrial Magistrates Court.
- Last updated
- 16 July 2018