Liz Hobday reported this story on Thursday, May 26, 2011
MARK COLVIN: A report by the Victorian ombudsman has uncovered a series of problems with the agencies that manage work cover payments for injured workers.
The ombudsman's investigation found the agencies had manipulated incentive schemes, delayed payments to workers and mismanaged files.
In one case it found that the insurance company CGU, which had the contract, had hidden 10,000 overdue accounts, in a locked cupboard.
For the more than 50,000 Victorian workers with active claims for workplace injuries, the report will make interesting reading.
It describes how six major insurance companies contracted to WorkSafe have mismanaged files, causing a litany of problems, including delayed payouts and privacy breaches.
Personal injury lawyer Shaun Marcus says the report comes as no surprise.
SHAUN MARCUS: I would say every client would have a story to tell about their WorkCover agent it would be that wide.
LIZ HOBDAY: He says delays in medical payments are a daily problem for his clients.
SHAUN MARCUS: Medical and life expenses often workers have to pay for them out of their own pocket and will send these receipts to the WorkCover insurer for payment and all too regularly they either go missing, are not processed, or are processed in part for no apparent reason other than poor record keeping.
LIZ HOBDAY: The ombudsman found problems at Allianz, CGU, Gallagher Bassett, GIO, QBE, and Xchanging, which between them were paid more than $200 million by WorkSafe last financial year.
In one of the worst examples, the report found staff at CGU had hidden 10,000 files in a locked cupboard and manipulated invoices to make the company to the tune of $2.5 million.
But WorkSafe chief executive, Greg Tweedly, says despite the findings, most claims are well managed.
GREG TWEEDLY: They've got to look at the percentage of cases where things go right and there's a large, large, large percentage where people are looked after and looked after well and these circumstances are small in number; they are regrettable and we're doing everything possible to minimise that in the future.
LIZ HOBDAY: The Minister responsible for WorkSafe, Gordon Rich-Phillips, says he's told WorkSafe he wants the problems fixed.
GORDON RICH-PHILLIPS: These concerns that are being raised by the ombudsman are significant and are of concern to the new government and we expect WorkCover to work diligently to address them.
LIZ HOBDAY: WorkSafe has just awarded tenders to its agents for the next five years but only one of the companies named in the report, GIO, hasn't signed another contract.
Lawyer Shaun Marcus says there's little injured workers can do, if they are struggling to deal with insurance companies.
SHAUN MARCUS: There is just nearly no accountability for the WorkCover agent or for an injuredworker to get that money out of the WorkCover agent more importantly and the appeal mechanisms or the resolution mechanisms are just timely and cumbersome.
LIZ HOBDAY: Most of the agencies contacted by the ABC did not return calls, while GIO declined to comment.
CGU has repaid $2.5 million to WorkSafe, plus a fine of $2.8 million. A spokesman told the ABC the company had improved file management and injured workers had not been affected.
MARK COLVIN: Liz Hobday
6 comments:
It is no surprise for me .They are also wasting Millions on Private investigator. Mind you when they see me , they take off .I id not enough time to take their number plates . This is how good they are.
John Pisac my weekly payments are being stopped because they have been payed for total of 104 weeks and I have current work capacity. Big problem there this is my second 104 weeks stopage I also am totaly unfit for work and its permament. I am also being blackmaild by CGU to as they told me we will give you hard time until you except what we offer you.I have been typing telepfone conversations with my case manager lets see what happens next
I have a serious and permanent back injury.While I was a "number" in the file of GIO, I applied for some home gardening help eg mowing edging. After several more assessments it was approved. However at the same time, my employer switched to CGU. It has now been two years since approval and I have had my lawns mowed five times, due to CGU misplacing invoices which resulted in my provider being reluctant to come to my house.I only ever correspond with the insurer by emails because I don't have any faith in their verbal approvals. Recently as I waited the required 28 days for a response from my case manager on a seperate issue, I discovered my case manager had changed but no word from her and no introduction from my new case manager.
I have 12 years of documentation on C.G.U. and what appears to be fraudulent activities, not to mention the government agencies that cover all of this up.
ive got nearly six years of cgu s stuff ups documented and ive even taped a few ..........im busting to get a judge to look at my case. im hoping my barrister and solicitor can make them look like the clowns that they are. the countdown is on and the timeframes now will have to be adhered to . i dont think they can take their time on this one now.......but ive been proved wrong in the past as cgu seems not to have to adhere to timeframes in the act ..like us injured workers do
ive had lots of problems with workcover,in 2008 i injured by back working as a concretor,10 yrs service didnt mean anything with old employer whom sent me home early 2009 ,stating no work, i had prolapsed discs in l4/ l5 s1,etc, work cover doctors said didnt need operation and that i should be able to find work in different field,problem was no one would take me on with a back injury, even with there wise program.130 weeks later, given a permenent disability of 5% then paid out small sum from xchanging,then they cut me off workcover, 2 weeks later old boss sacked me, i had no income for 3 months at all,was given a outcome certificate from concilation,to go to court about it,next problem was centrelink did not want to know me,3 months later given a pension of 65 dollers a week and a pension card,.but they want money back if i get compo,And cause wife had a job so meaning i have been getting only 250 dollers a month to try and survive since jan 2012, very frustrating, to me only way i have managed house repayments and bills ,is 2 sell everything i own . pull super out ,,it seams work cover really dont care,, now just had major surgary to remove 2 damage discs FUSION on back, because got a second opinion on back, and neurosurgon said should have been fixed yrs ago, fell now like a new man finally,,has anyone had same problems with workcover..even old boss seams to get away with what ever, i offen wonder if i will ever get compensaton for my injury,as it is putting lots of pressure on family being injured and can i claim anything for getting scammed by xchanging in them not fixing me to start with..im hoping now i can get on with my life.4 yrs of hell is not the way a injured person should be treated.NOT HAPPY WITH INSURANCE COMPANY i was followed for months as well,why? dumb founded , all it did was put more stress onto me and family..they are the lowest of all people,would not wish this on anyone..is there anyone with same thing happening out there
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