70% Of Workers’ Comp Billing Disputes End Badly For California Payers

A performance report on the first five years of California’s independent bill review program reveals that adjusters’ billing decisions rarely align with how the state workers’ comp system sees things. According to the latest report from the California Dept. of Industrial Relations’ Division of Workers’ Compensation (DWC)¸ more than 70 percent of workers’ comp bills submitted to the state for bill review adjudication are decided in favor of the medical provider disputing the amount remitted by payers. That means that in seven out of 10 cases¸ not only are payers on the hook for additional medical costs¸ they also have to pick up the tab for the review fee.
Source: The Claims Page – USA 70% Of Workers’ Comp Billing Disputes End Badly For California Payers

How Insurers Can Turn Their Salvage Into Social Purpose

If your client has filed a claim after experiencing a major event like a flood or fire¸ it’s likely that contractors have removed salvageable materials that are still usable. For example¸ in the event of a kitchen flood¸ contractors may place a large bin outside and start taking apart the flooring and cabinets that had been damaged. But in this case¸ the flood would have likely damaged flooring and lower cabinets¸ so why throw the upper cabinets in a bin destined for the landfill when they can be repurposed? One large Canadian insurer has taken a unique approach to divert such salvageable materials from landfills. Since 2014¸ The Co-operators has partnered with Habitat for Humanity Canada for the insurer’s ReClaim program¸ which provides Habitat for Humanity ReStores with good quality materials salvage from a home claim.
Source: The Page – USA How Insurers Can Turn Their Salvage Into Social Purpose

Real Or Fake? Finding Workers’ Comp Fraud

Security cameras in a company cafeteria recently captured a brazen attempt to fake a workers’ compensation injury. The video shows that the man dumped a cup of ice onto the floor¸ disposed of the cup and then lay down on the floor as though he slipped on the ice. Prosecutors have charged the man with fraud and theft by deception. In this case¸ the fraud was well-documented. But most employers do not have cameras in their lunch rooms or other areas of their work places. It can be very difficult to prove someone has faked an injury in the workplace without cameras catching the person in the act. But the consequences of undetected workers’ compensation fraud are enormous.
Source: The Page – USA Real Or Fake? Finding Workers’ Comp Fraud

Expertise “essential” to smooth claims process

Specialist firm says staff must know their stuff


Source: Business Online Expertise “essential” to smooth claims process

Innovation and diversity in the insurance industry are not mutually exclusive

Many companies still lack equal representation in the C-suite, and male leaders need to be part of the inclusion conversation


Source: Business Online Innovation and diversity in the insurance industry are not mutually exclusive

Judges revealed for Insurance Business Australia Awards

Panel announced for prestigious industry awards


Source: Business Online Judges revealed for Insurance Business Australia Awards

“Arrogant” driver lies to insurer after crash

The incident was caught by a dashcam and then posted online


Source: Business Online “Arrogant” driver lies to insurer after crash

POP Insurance Holdings in worldwide tech tie-up

The partnership seeks to deliver a better experience to brokers and insurers


Source: Insurance Business Online POP Insurance Holdings in worldwide tech tie-up

About 450 Vehicles Declared Total Losses After Acid Spill On Canadian Highway

British Columbia’s public auto insurer says about 450 vehicles have been written off since sulphuric acid spilled along a busy commuter route near Trail¸ B.C.¸ in two incidents last spring. The Corp. of B.C. says there have been more than 4¸450 received in the wake of the spills but the vast majority of those vehicles were not damaged. It says it is still in the early stages of a lawsuit but no trial date has been set. The spills happened on April 10 and May 23¸ 2018¸ when tanker trucks owned and operated by Westcan spilled sulphuric acid from Teck’s plant in Trail along a stretch of highway near the city. ICBC filed a notice of civil claim against Teck Metals¸ Teck Resources¸ International Raw Materials¸ Westcan¸ the Regional District of Kootenay Boundary¸ the City of Trail¸ two drivers and the provincial government in October. Most defendents have filed responses denying responsibility.
Source: The Claims Page – USA About 450 Vehicles Declared Total Losses After Acid Spill On Canadian Highway

Medical Malpractice Claims Down¸ Payouts Up: Study

The frequency of medical malpractice has dropped substantially¸ but average case management expenses and indemnity payments continue to rise¸ according to a report. The rate of medical professional liability declined 27% from 5.1 cases per 100 physicians to 3.7 cases from 2007 to 2016¸ according to a report issued on Tuesday by CRICO Strategies called Medical Malpractice in America: A 10-year Assessment with Insights that examines national trends in frequency¸ payment and root causes of preventable harm. The report analyzed events affecting 124¸000 patients. “For the roughly one million physicians across the country¸ this trend signals a dramatic change in their risk of being named in an MPL case¸” the report stated.
Source: The Claims Page – USA Medical Malpractice Claims Down¸ Payouts Up: Study

Insurer Reveals The Most Frequent Days For Crashes Due To Daydreaming

Erie has reviewed police data on car crashes¸ and found that Saturdays in September are the most frequent days for fatal car crashes involving daydreaming while driving. The insurer recently published an analysis on its findings¸ which also discovered that Tuesdays in February are the lowest days for crashes involving daydreaming. Erie’s previous analysis last year found that being “generally distracted” or “lost in thought” is the number one distraction identified in fatal crashes. Erie cited its crash data from the Fatality Analysis Reporting System (FARS) – a repository that includes information from police reports on the causes of fatal car crashes. The insurer also consulted with the Institute for Highway Safety to analyze the data.
Source: The Page – USA Insurer Reveals The Most Frequent Days For Crashes Due To Daydreaming

Workforce year-ender: the big issues 2018, and what lies ahead

Workforce surveyed key IR figures on what they saw as the big issues in 2018, and what they expected to be the major talking points for 2019. Here’s what they said:

Kelly O’Dwyer, federal minister for industrial relations and employment

What was the most important issue or event in industrial relations this year?

It has become clear that there have been delays which have undermined enterprise bargaining approvals. This clearly conflicts with the Fair Work Act’s objective of a simple, flexible and fair framework for enterprise level agreements that deliver productivity benefits for our nation.

What are you most/least looking forward to in 2019?

I am looking forward to reinvigorating collaboration in workplaces and showing that the ALP’s approach of re-empowering union-driven conflict is contrary to the interests of employees, business and the community.

Brendan O’Connor, Labor IR/employment spokesperson

What was the most important issue or event in industrial relations this year?

It was this government’s support of cutting penalty rates for up to 700,000 low paid Australian workers. At a time when wages growth has hit record lows and company profits are growing at a rate of nearly six times that of wages, this govt is so callous, they voted eight times against protecting penalty rates for low paid, hardworking Australians.

What are you most/least looking forward to in ‘19?

Continuing to push to protect penalty rates and ensuring workers share in the benefits of economic growth. Australians deserve a pay rise and we need to stem the tide of insecure work – this isn’t happening under Scott Morrison and his Liberals. While this govt is busy fighting itself, everything is going up except for people’s wages.

Sally McManus, Australian Council of Trade Unions (ACTU) secretary

What was the most important issue or event in industrial relations this year?

This year the union movement has been united in campaigning for wage growth and more secure work.

The need to change the rules for working people in order to achieve wage growth and job security is at the top of the national agenda but there is a huge amount of work left to do. We have won the biggest ever increase in the minimum wage and have led a series of demonstrations attended by hundreds of thousands of workers who have found a new voice and are determined to stand up and demand better treatment.

What are you most/least looking forward to in ‘19?

We look forward to another year of fighting to change the rules so working people have more secure jobs and their fair share of the wealth we have been part of creating. We are fighting to restore the fair go for working people by demanding rules that ensure we have the power and rights we need. This is the only way we will turn around record inequality and the unacceptable level of job insecurity in our country.

Sandra Parker, Fair Work Ombudsman (FWO)

What was the most important issue or event in industrial relations this year?

A major focus for the FWO this year was protecting workers in the Fast Food, Restaurant and Café sector. This sector is consistently overrepresented and accounts for 18% of our workplace disputes in 2017-18 and almost a third of our litigations, despite making up only 7% of the workforce. Our activities targeting popular food precincts have shone a light on poor workplace practices in these areas, and revealed a clear link between cheap eats and unpaid wages. This year, we reported on unannounced visits by Fair Work Inspectors to Victoria Street, Richmond; Glebe Street, Sydney; and Fortitude Valley in Brisbane, which led to recoveries of more than $470,000 for workers. Also in this sector, we filed our first court action using the Protecting Vulnerable Workers laws this year against a Crust Pizza outlet. We alleged the former operators provided false or misleading information or documents to the FWO, as well as significant underpayments of vulnerable workers. This is an important case to watch next year.

What are you most/least looking forward to in ‘19?

We are looking forward to working with industry leaders to change the culture of problematic sectors, particularly Horticulture and Fast Food, Restaurants and Cafes. Following the recent release of our Harvest Trail Inquiry report, we are looking forward to acting on the findings to improve workplace compliance throughout the Horticulture industry. We’re encouraged by the positive response we have received from stakeholders and will work closely with them to implement the recommendations of our Inquiry in the New Year. We will also continue to closely monitor any requests for assistance from Harvest Trail workers.

In the coming year, we have a number of cases tracking toward enforcement outcomes under the serious contraventions of the Protecting Vulnerable Workers laws. We hope these actions will send a strong message to employers who are underpaying workers, failing to keep proper records or coercing workers that we will protect vulnerable workers by seeking maximum penalties from the courts.

Professor Andrew Stewart, University of Adelaide law school IR academic

What was the most important issue or event in industrial relations this year?

It’s hard to go past the decision in Workpac v Skene as the single most important development in 2018, given that it potentially means that well over a million current or past Australian employees may have been misclassified as casuals – and in theory are owed billions of dollars in unpaid entitlements.

But I’m bound to say that the biggest ongoing issue is what Jim Stanford, Tess Hardy and I have termed the wages crisis in Australia. And I’m not just saying that because we’ve recently published a book of essays about it … [available for free download here].

What are you most/least looking forward to in 2019?

I’m most looking forward to the 2019 federal election, for a chance at a policy reset in relation to workplace relations, and the opportunity to explore much-needed reforms to the Fair Work legislation. In practice, that seems more likely to come from Labor, though I wouldn’t rule out a desperate Coalition suddenly rediscovering the policy agenda from their first term in office (remember that great big Productivity Commission report?). I’m least looking forward to the 2019 federal election, which on past experience will be an unedifying contest between Labor accusations of a return to Work Choices and Coalition accusations of union thuggery.

Tess Hardy, University of Melbourne law school IR academic

What was the most important issue or event in industrial relations this year?

It is difficult to identify just one! The Full Court decision in Workpac v Skene certainly has far-reaching implications for casual workers (and their employers). While the current govt is seeking to curtail the flow-on effects of this decision by enacting a regulation which seeks to offset annual leave entitlements against the casual loading that has already been paid, there is some doubt about whether this is politically and legally feasible.

If there is a change of government next year, it is highly likely that Labor will come under pressure to act on this issue.

What are you most/least looking forward to in 2019?

Given my abiding interest in all things enforcement, I am most looking forward to seeing key provisions of the Protecting Vulnerable Worker Act – including the provisions which relate to serious contraventions and franchisor liability – tested before the courts. These statutory provisions are relatively novel, and there remain many questions about their scope and application. I am very keen to see what a judge makes of them!

Stephen Smith, Australian Industry Group (Ai Group) workplace relations policy head

What was the most important issue or event in industrial relations this year?

The very problematic decision of the Federal Court in the WorkPac v Skene casual employment case. If Parliament does not address the decision, there could be widespread disruption to the labour market.

What are you most looking forward to in 2019?

The end, finally, of the 4 Yearly Review of Awards, after six years of hard work.

Giri Sivaraman, Maurice Blackburn lawyer

What was the most important issue or event in industrial relations this year?

Any illusion that wage theft is not rampant in Australia, particularly amongst migrant workers and international students, has been demolished by series of recent investigations and reports. Our country’s prosperity should not be built off the backs of exploited workers.  To my mind the most important issue of the year was wage theft, and the most important events were the Queensland govt’s parliamentary inquiry into wage theft and the announcement by the Victorian govt that it’s going to enact laws to crack down on the issue.

Another highly significant issue has been the series of legal challenges to the validity of the gig economy, ranging from the unfair dismissal case that found Foodora to be an employer not a contractor, to our class action against Uber. The gig economy is one of the greatest challenges to secure employment for Australian workers and to our current framework of industrial laws.

What are you most/least looking forward to in 2019?

I’m well and truly showing my political stripes here, but I most look forward to significant reform of federal industrial laws and the Fair Work Act under a new federal Labor govt.  I feel strongly that this will better serve the needs and rights of workers and unions. What I really dread is the almost daily revelations of sexual harassment in the workplace that we currently have, that shows how far we need to go to stop the ill treatment of women at work.

Elissa Speight, Ashurst senior associate

What was the most important issue or event in industrial relations this year?

There have been a number of developments around casual employees this year, with the most significant flowing from the Federal Court’s decision in Workpac v Skene. Depending on the outcome of a separate test case currently before the Federal Court, and absent legislative intervention, it is possible that casual employees with regular predictable hours may be entitled to the same statutory entitlements under the NES as permanent employees. This development is likely to fuel the emerging use of class actions as a mechanism for claiming various employment entitlements.

What are you most/least looking forward to in 2019?

The outcome of the upcoming Federal election has the potential to reshape the industrial landscape in a number of areas which are critical to our clients’ businesses.  If there is a change in govt, one area in which we can expect change is the regulation of collective bargaining, including the facilitation of multi-employer bargaining and a broadening of the Fair Work Commission’s powers to arbitrate disputes.

Linda White, Australian Services Union (ASU) assistant national secretary

What was the most important issue or event in industrial relations this year?

The turmoil in the federal govt means we are edging closer to a change of govt and then we can change the rules for working people so that we get a fairer system for all. For the ASU our continued campaigns for a better NDIS, paid domestic violence and the need to bridge the gender gap for women in Superannuation has been a key focus and we have had some significant gains but there is still work to do and we will not stop until we get results on these key campaigns

What are you most/least looking forward to in ‘19?

I am looking forward to a change in the Fed Govt in 2019 – Australians deserves better than what we have now.

Daniel Walton, Australian Workers’ Union (AWU) national secretary

What was the most important issue or event in industrial relations this year?

I think an important issue that has been overlooked somewhat is how unions have been campaigning to “change the rules”, while the Ai Group is actively and openly breaking them. In August the AWU won a landmark case in the Fair Work Commission against AstraZeneca, who had been given the wrong advice by Ai Group when it came to paying leave entitlements for shift workers. It meant shift workers at AstraZeneca, and potentially hundreds of thousands of others shift workers across the country, were entitled to increased pay and backpay. Instead of accepting the ruling, Ai Group is telling employers to ignore the FWC and continue to underpay shift workers. I think it’s telling that bosses can get away with openly ignoring the Commission, while unions cop incredible heat for simply flagging their intent to resist [see lead story on page 1].

What are you most/least looking forward to in 2019?

I’m looking forward to the prospect of the election of a former AWU national secretary as Prime Minister, because it will mean new legislation that will actually make a difference to our members. Industry policy has been a shambles under the Abbott/Turnbull/Morrison govt. We need strong new policies around dumping, on gas exports, on workplace protections. All of these are likely under a Shorten Labor govt. After over a year of ducking and hiding, I’m also very much looking forward to Michaelia Cash being forced to explain in open court exactly what discussions led to the disgraceful AFP raids on our offices in 2017.

Michael Kaine, Transport Workers’ Union (TWU) national secretary

What was the most important issue or event in industrial relations this year?

Putting the on-demand economy in the spotlight has been a major issue for our union this year. Two powerful surveys of on-demand workers showed the Australian public that the vast majority of delivery riders and rideshare drivers are paid well below minimum rates, have no superannuation and that their companies have not provided them with sick leave or wages when they are injured on the job.

Workers spoke out bravely about pay and conditions.

Josh Klooger paid the price of speaking out when Foodora sacked him. His bravery and tenacity in taking Foodora to the Fair Work Commission was a defining moment: on-demand economy companies could no longer rely on the veil of secrecy or silence in their treatment of their workers. Josh’s win is an important victory for our push for safe rates, because transport workers can only be safe, and keep others on the road safe, when financial pressure on them is lifted and they are paid fair safe rates. But the case is also important for the broader industrial relations landscape in demonstrating how the economy has changed and how enterprise bargaining has truly passed its sell-by date. Companies are using new business models to get around paying fair wages. Our economy will continue to suffer from low wage growth unless we give all workers the right to collectivise and demand rights.

What are you most/least looking forward to in 2019?

For 2019 I am looking forward to a year of even more activism by transport workers. Expect more protests by on-demand and airport workers with a major convoy by truck drivers taking place in March. We intend to continue to give voice through these demonstrations to transport workers in the fight for better jobs, with fair rates, decent conditions and secure employment.

I am also looking forward to more being achieved in the area of sexual harassment in the workplace. Our survey of cabin crew revealed a shockingly high number of workers experiencing sexual harassment, with few reporting it and even fewer satisfied with the outcome when they did report it. With a national inquiry underway and growing union activity in this area, next year will provide a chance to make further progress on combating sexual harassment.

Nadine Flood, Community Public Sector Union (CPSU) national secretary

What was the most important issue or event in industrial relations this year?

The Change the Rules campaign has completely reshaped the IR and economic debate, with workers organising to win fundamental changes to our jobs and our lives through a powerful union voice.

For the CPSU, our key shift this year was driving an industry plan to secure more jobs across the Commonwealth public sector, to go much further than opposing cuts and privatisations. We’ve broken through in explaining why the destructive arbitrary cap on staff numbers in Commonwealth agencies must be abolished, outlining a real alternative to cut overpriced contractor and consultant spending while converting contractors and labour hire into secure, permanent public sector jobs. Labor has seen the benefits of our plan for public services and quality jobs, and the Coalition has seen Commonwealth agencies pointing out how much damage the forced outsourcing and shift to labour hire is doing to public services.

What are you most/least looking forward to in 2019?

Next year’s federal election is a critical turning point for workers, inequality and the future wellbeing of our entire community. Hugely important changes to ensure decent wages and working lives for ordinary Australians hinge on the defeat of the Abbott-Turnbull-Morrison Govt in the first half of next year. People working in the Commonwealth public sector need a reset after more than five years dealing with an aggressively anti-union, anti-public service hostile employer, as the Coalition have been far more concerned with pursuing their ideological agenda than with good govt.

Tara Diamond, Aust Mines Metals Association (AMMA) industry services director

What was the most important issue or event in industrial relations this year?

2018 has been a very busy year with a wide range of industrial relations issues. It’s too difficult to select just one as the most important. For industrial relations across all sectors, the most significant event was probably the Full Federal Court decision in WorkPac v Skene and the uncertainty this caused around the capacity for casual employees to ‘double dip’ by receiving a loading in lieu of permanent entitlements plus permanent entitlements. We look forward to a resolution providing much-needed clarity on this issue as soon as practicable.

At the industry level, the amalgamation of the highly militant CFMEU and MUA has been of significant concern to resources, energy and related construction employers. Concerns about the impacts of union militancy on critical supply chains to nationally significant projects have seen widespread support of AMMA’s pending challenge to this merger. The industry’s challenge is directed at holding these unions to account for their repeated and flagrant law breaking.

Finally, for AMMA personally our highlight was former Prime Minister John Howard’s address to our Centenary Gala Dinner, in which he called on the present govt to take action on the “unfinished business” of workplace reform. These words will prove even more important as we head into a federal election year.

What are you most/least looking forward to in 2019?

While there are a number of ongoing technical and industry issues that will certainly keep AMMA’s consulting team busy, 2019 will also see a pivotal debate about how Australia’s should approach work regulation in an increasingly competitive global economy. The next 12 months will see a great battle of ideas. While there are significant forces campaigning on fear and uncertainty about the future of work and people’s livelihoods, AMMA has just this week released our own vision for the future of work regulation, one far more optimistic about the opportunities available to all Australians if policymakers can rise above present-day politics to design a regulatory system fit for the future. We look forward to promoting our industry’s positive vision for the future and combatting dangerous politically-motivated campaigns seeking to divide, rather than unite Australians around the future of work.

Jim Stanford, economist and Centre for Future Work director

What was the most important issue or event in industrial relations this year?

I would choose the union movement’s “Change the Rules” campaign, which really gathered focus and momentum as the year went on. Of course, unions have been dissatisfied with the state of labour laws, and the erosion of labour rights, for years. But this year, together with other community advocates, they have built a very effective and focused advocacy campaign that I think will have a major impact on labour policy in Australia. Examples of its potential include the big rallies held in Melbourne and other cities in October; the important role that the union movement’s independent door-knocking and phone-banking campaign played in the expanded majority won by the Daniel Andrews govt in Victoria; and the generally high profile of news and debates around the issues of wages and workplace fairness in the media and public commentary. The current atmosphere is very reminiscent of the “Your Rights at Work” initiative that the ACTU and its affiliates organised in 2006-07 – and that ended up making a significant difference in the 2007 election (when John Howard lost his seat).

There is a qualitative difference in this incarnation of the union movement’s organising, however: while union activists obviously are hoping to influence the results of the next election, they are self-consciously and explicitly planning on a longer-run effort to shift public opinion regarding core issues of work and fairness. Their agenda of proposed reforms would take several years to implement: including lifting the minimum wage to a “living wage” level, modernising labour laws (so Uber drivers and other gig workers would be protected), changing the structure of enterprise bargaining to allow multi-firm and industry-wide bargaining, and more. And they are advancing that agenda as an independent campaign, not as an arm of the Labor party. That positions them well to continue to advance the debate after the election … whoever wins. By carefully focusing its energies, building a strong “boots on the ground” infrastructure in communities (including crucial marginal electorates), and building strong public support for the core values underpinning the campaign (tapping into continuing Australian faith in fairness), I think this movement will reshape both public opinion about work and wages, as well as Australia’s labour policy framework.

What are you most/least looking forward to in 2019?

There will be a Commonwealth election sometime during the first half of 2019 (perhaps sooner rather than later, if the current disarray in Canberra is any indication). I look forward to seeing labour issues – and in particular, the stagnation of wages in Australia, and the growing gap between Australia’s egalitarian tradition and the grim economic reality that most workers presently face – feature as one of the top three issues in the campaign. Most workers have had no increase in real wages over the past five years; millions have fallen behind (especially given escalating prices for housing and other essentials). The present govt knows that this festering economic frustration issue could be very damaging. There’s an opportunity in Australia right now to move the needle: imagine a modernised approach to labour policy: including labour standards that adapt to ongoing change in the economy (like gig jobs), a more ambitious crack-down on wage theft and other illegal practices, and a revitalisation of Australia’s commitment to a ‘fair go.’

I am not looking forward to the rolling out of some pretty tired warnings and threats about how modernising labour laws and addressing inequality will somehow threaten Australia’s economic viability. We can expect many dire threats about how the proposals for reform will drag Australia back to the “bad old 1970s” – a time, interestingly, when GDP growth, job-creation, productivity growth, and real wage growth were all significantly superior to the current era. This rhetoric ignores the growing consensus among economists that more equality actually strengthens economic performance – by supporting consumer spending and aggregate demand, avoiding the economic, fiscal and social costs of exclusion and inequality, and boosting govt revenues. The doomsday prophecies we can expect to hear from the usual suspects should be understood as the last gasps of a vision of trickle-down economic policy that has lost its credibility, in Australia and around the world.


Source: Workplace Relations Workforce year-ender: the big issues 2018, and what lies ahead

Business interruption still largely misunderstood

One senior figure says more needs to be done before organisations truly understand their level of risk


Source: Business Online Business interruption still largely misunderstood

Smashing the glass ceiling in insurance

In the case of getting more women into leadership positions, there are some already blazing the way in the industry


Source: Insurance Business Online Smashing the glass ceiling in insurance

Cover-More enhances travel insurance offering

The insurer rolls out new major benefits in their policies to reflect the evolving needs of travellers


Source: Business Online Cover-More enhances travel insurance offering

OnePath upgrades life insurance adviser portal

The enhancements will help advisers provide a “timely and appropriate outcome” for clients, says head


Source: Insurance Business Online OnePath upgrades life insurance adviser portal

Biggest threats to Australian SMEs revealed

But are SMEs protected against these risks?


Source: Business Online Biggest threats to Australian SMEs revealed

AUB Group names new CFO – again

After a failed attempt earlier this year, it seems the group has finally found its latest senior exec


Source: Business Online AUB Group names new CFO – again

CBA admits unfair credit insurance sales

It has admitted breaching obligations under the Corporations Act


Source: Business Online CBA admits unfair credit insurance sales

Are brokers doing enough to close the protection gap?

One senior industry figure says more needs to be done to educate consumers


Source: Business Online Are brokers doing enough to close the protection gap?