Published: 20 April 2016
Author: Stringer Clark

WorkSafe claims agents under investigation in Victoria

Insurance firm Gallagher Bassett, along with several other workers’ compensation claims agents, is under investigation by the Ombudsman’s office over allegations of unfair and unscrupulous treatment of injured workers in Victoria, according to a report in yesterday’s The Age.

According to the report, “the State Ombudsman is investigating if the payment of financial bonuses by WorkSafe Victoria to its agents has contributed to an increase in the number of claims being rejected”. 

Other insurance companies who work for WorkSafe include Allianz, CGU and QBE.

According to the Victorian Ombudsman, the investigation is a response to the high number of complaints about WorkSafe agents. The office received 370 complaints in just one year, 2014-15.

Rejected claims causing difficulties

It will be interesting to see the findings of this investigation. Many of our personal injury clients continue to report to us that they are frustrated by the way in which their claims are handled by WorkCover agents. In particular, the rejection of the claim initially causes both emotional and financial stress to claimants already suffering from work related injuries.

Clients complain that the case managers dealing with their claim change constantly and they are dissatisfied with the way in which the insurer treats them. Our impressions are backed up by recent statistics which reveal a jump of almost 10 per cent over the past two years in the number of requests for conciliation, also reported on the story.

Hopefully these complaints and the Ombudsman’s investigation will lead to a fairer and more respectful treatment for Victoria’s injured workers when dealing with WorkCover insurers.

It is important that the WorkCover agents are held responsible for their decisions.

Injured and dissatisfied by your treatment?

If you have been injured at work and you are dissatisfied with your treatment at the hands of an agent, your first step is to try and have the issue resolved by the Accident Compensation Conciliation Service. 

If the matter cannot be resolved at conciliation then you have the option of referring the dispute to a panel of doctors or issuing court proceedings and having a magistrate resolve the dispute.

External link

Victorian Ombudsman’s investigation into handling of workers compensation claims