While the NSW Government races to digitally transform its departments, a little-known state government entity, called WIRO, has been setting impressive new customer service standards in the Workers Compensation sector for seven consecutive years.
When the Workers Independent Review Office, was established by Kim Garling in 2012, it was paperless and digital, with a focus on collecting data to improve outcomes for injured workers involved in disputes with their insurers.
“We established online and cloud systems from the start,” said Garling. “We knew it was important to collect information about the Workers Compensation system to help us make improvements and to help desperate workers quickly.’’
Garling, known as the ‘unofficial Ombudsman’ for Workers Compensation in NSW, also advises the government on ways to improve the Workers’ Compensation Scheme.
“Our priority was to establish a customer response team to allow injured workers to resolve their disputes, so they could put food on the table and pay their rent or mortgages,” he said. “Insurer response times had been woeful up until WIRO was established.”
Garling’s team generally respond to calls when injured workers are not paid benefits, are refused travel allowances, or experience difficulties paying medical expenses.
“We are involved in important work because by the time an injured worker calls us, they are suffering and often have little, or no mental or financial capacity, to cope with further delays,” he said.
Not all the calls to WIRO are straight forward.
“We had a man badly injured who had to be flown by helicopter hundreds of kilometres to the hospital. The insurer refused to pay the man’s travel expenses to return home. It took us to remind them of their obligations before the issue was resolved,” he said.
WIRO also helped an injured plumber who was worried about deadly snakes surrounding his home.
“The poor fellow had young kids and lived in the country where the brown snakes posed a real risk to his young family’s safety,” he said. “We were able to convince the insurer to organise for the grasses around his property to be cut back.”
In responding to injured workers Garling’s customer service team has established an industry-wide standard of 48-hours for an initial response from an insurer – with most disputes resolved within seven days.
Garling credits the fast response to his co-operative relationship with insurers. However, the fact that WIRO publishes quarterly data on its website regarding insurer response times to complaints is certain to have helped.
Published data includes the name of the insurer, the number of complaints made against them and the time it took to resolve the matter.
In the past seven years the office has provided impressive responses to 45,000 complaints and approved online legal funding for 100,000 matters.
“The insurer response is important because it means there are significant cost savings in the system for both sides if we can resolve a matter and it doesn’t escalate to the Workers Compensation Commission,” said Garling.
But Garling, a former president of the NSW Law Society, admits his biggest challenge was getting hundreds of Workers Compensation lawyers to apply online for funding to represent injured workers in legal matters.
“I never imagined the legal fraternity would adapt to the digital environment so quickly,” said Garling, smiling. “As legal practitioners, we are not highly regarded for our digital abilities.”
WIRO provides online grants to lawyers to represent injured workers in NSW in matters where its own legal experts feel that an insurer is acting outside of legislation.
The scheme is funded through the workers compensation premiums and is now recognised globally as an efficient way of funding legal aid and managing the behaviour of those in the system.
The funding model and the customer service response has seen Garling become a sought-after speaker at the World IAIABC insurer conference.
But Garling’s most important achievement is yet to be realised. Since its inception, WIRO has captured every piece of legal and medical information from the claims, for the purpose of data analysis.
“We now have enough gathered enough information for our Hyper Anna powered platform to analyse the vast amount of legal and customer data and provide insights into the worker’s compensation scheme.”
“I expect this will highlight issues like the behaviour of doctors when they assess injured workers – as well as the behaviour of insurers and the performance of lawyers,” said Garling.
“And we will be able to quantify the disruption caused when matters escalate to the Workers Compensation Commission,” he said.
Garling is unapologetic about publishing performance-related data.
“Anecdotally I can tell you that the Catholic self-insurer and the Northern Co-operative Meat Company at Ballina, have engaged in some of the very worst behaviours when dealing with their own injured staff,” he said. “But we should see some new insights into the behaviours of all the insurers over the coming months.”
The constant analysis of the data and the sharing of these insights means that WIRO can continue to reduce the cost of the dispute resolution system, improve its outcomes and accurately identify the cost of disputes that escalate to the Workers Compensation Commission.
“If we can help more injured workers resolve problems then it will save matters escalating to formal legal disputes in the Workers Compensation Commission, where it can take up to two years for a matter to be finally resolved.
Garling is modest about his success but not about his staff whom he says have helped many families in desperate need.
“We are different from most other agencies,’ he said. “Our team is highly-skilled in workers compensation and they have an admirable passion to help injured workers.”
The strategy has proved so successful that Minister for Customer Service, Victor Dominello, tasked with bringing the entire government into the digital age, has informed WIRO that they will take on the same role for those people injured on the roads, under the CTP scheme.
“My hope is that those people will benefit in the same way,” Garling said. “Anything we can do to ease the burden on people living in desperate circumstances is a bonus.