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OnBase and Guidewire™: Driving Better Outcomes for Workers' Compensation
Ruth Fisk - Global Director, Insurance
12M I L L I O N
WO R K E R S5%
I N C R E A S E D C L A I M S
989,700M O R E
P E O P L E B Y 2 0 2 0
531,800O N T H E J O B
A C C I D E N T S
AUD $61.8
B I L L I O N
The Impact
GDP
Employers
Government Insurers
Injured Worker
Workers’ CompensationCenturies Old Protection Model
Otto von Bismarck
governs Prussia
1800Prussia
Employers' Liability Law
1871Prussia
Employment Liability Act
1880Britain
Adopts the Employment Liability Act
1882~Australia
Workers' Accident Insurance
1884Prussia
Modern Day Insurer
2017Australia
Controlling High Cost and
Improving Outcomes
The Future of Workers’ CompensationOnBase and Guidewire™
Injured WorkerAn injured worker faces the stressful situation of dealing with a medical situation and worrying about the impact it will have on their ability to support their family and to return to work.
Claim processes need to be simplified anddecisions expedited to remove stress for claimants to get better outcomes.
If an injured worker has the right support from their employer and insurer, not only can they return to work faster, but they can be assured their income stability will not be jeopardized.
EmployersAn employer should have the ability to report a claim easily and securely. They should be able to actively participate, not only in reporting the claim, but in the worker’s rehabilitation and eventual return to work plan.
Employers need tools they can leverage so they can actively participate in and contribute to successful return to work plans.
Regulatory compliance can be expensive when employers lack the solutions to ensure their process is being adhered to. Ease of communication within the system is necessary for success.
Medical Providers
The medical provider is the critical participant in recommending what rehabilitation must take place for the worker to return to work.
Medical Providers must be given access to more efficiently and securely share information to help to expedite claim resolution.
Evidence Based Medicine is a the cornerstone of information flow that will allow all parties of the process to accelerate the process of resolving a claim.
Case Managers
Case Managers are key in streamlining the process. Having access to the right information, at the right time can greatly impact the process and the experience for both the worker and the employer.
Seamless communication between all sources of information to the Case Managers will result in faster claims resolution and happier customers.
Reducing the process by one day can save millions of dollars for the insurer.
First Notice of Injury
Employer registers
Claim
Physician delivers
Treatment Plan
Evidence Based
Medicine
Return to work date
Injured Worker visits
Physician
Creates Self determination
plan
Attend Support Group
Return to Work
Assign Case
Manager
Submit Medical Records, X-Ray, Dicom Images
Review and Approve Payment
Mobile Reminders
Applied Data Analytics
The use of predictive analytics allows claims managers to identify potential complicating factors about an individual’s condition up-front, enabling them to take these risks into account and create a more proactive approach to their ongoing treatment plans.
Predictive analytics provides proven treatment plans and preventative measures
Insights from predictive analytics also identify “routine” claims that have the potential to become complex, as well as patterns in types of injuries
Return to Work
Customer Success Story | Insurance
Accident Fund GroupProcess automation keeps insurer with 58,000 customers nimble and responsive.
“OnBase and Guidewire provide the foundation for us to compile data-driven analysis and models which enables us to provide better care to the claimant, allowing them to recover and return to work faster.”
To learn more:
Visit the OnBase team at
Table 10!
Thank youRuth Fisk – Global Director, Insurance
www.OnBase.com/en-AU/Insurance