Insurer resources

The Claims Managers Capability Framework sets out the practices, skills and behaviours expected of claims managers in the Western Australia workers compensation scheme.

The Capability Framework translates the Insurer and Self-insurer Principles and Standards of Practice into observable practices and behaviours which claims managers should demonstrate when delivering scheme services.

Claims Managers Capability Framework

The Clinical Framework for the Delivery of Health Services (Clinical Framework) is an evidence-based guide designed to support healthcare practitioners delivering services to people with compensable injuries. Developed by the Transport Accident Commission (TAC) and the Victorian WorkCover Authority, this framework reflects contemporary research and has been widely endorsed by Australian workers compensation jurisdictions, as well as peak health associations.

WorkCover WA endorses the use of the Clinical Framework by medical and allied health practitioners delivering services to injured workers in Western Australia.

The Clinical Framework outlines five principles shown to deliver optimal recovery and return to work outcomes for injured workers.

1. Measure and demonstrate the effectiveness of treatment.
2. Adopt a biopsychosocial approach.
3. Empower the injured person to manage their injury.
4. Implement goals focused on optimising function, participation and return to work.
5. Base treatment on best available research evidence.

We encourage you to use and share the framework with your colleagues, patients (injured workers), employers and workplace rehabilitation providers in working towards optimal outcomes in recovery and return to work.

WorkCover WA collects data periodically to monitor scheme performance and to set recommended premium rates. Premium rates data is collected through:

• Form WC12 – Statement of policies, premium, wages and claims
• Form WC20 Mid Financial Year – Summary of cost of claims from July to December
• Form WC20 Full Financial Year – Summary of cost of claims from July to June
• Form WC30 – Statement of premiums and expenses associated with the writing of workers compensation business

All Forms are to be submitted via WorkCover WA Online.

Guidelines

The Premium rates data – Guidelines describes data required by WorkCover WA of insurers and self-insurers to set recommended premium rates and monitor scheme performance. Licensed insurers and self-insurers are required to provide data as specified in this document.

Templates

Templates for reporting premium rates data are as follows:

• Form WC12 TEMPLATE
  Template for reporting Form WC12 – Statement of policies, premium, wages and claims.
• Form WC20 Mid Financial Year TEMPLATE
  Template for reporting Form WC20 Mid Financial Year – Summary of cost of claims from July to December.
• Form WC20 Full Financial Year TEMPLATE
  Template for reporting form WC20 Full Financial Year – Summary of cost of claims from July to June.
• Form WC30 TEMPLATE
  Template for reporting Form WC30 – Statement of premiums and expenses associated with the writing of workers compensation business.

Sample data

Sample data to show how to complete the templates are as follows:

• Form WC12 SAMPLE
  Sample data to show how to complete Form WC12 – Statement of policies, premium, wages and claims.
• Form WC20 Mid Financial Year SAMPLE
  Sample data to show how to complete Form WC20 Mid Financial Year – Summary of cost of claims from July to December.
• Form WC20 Full Financial Year SAMPLE
  Sample data to show how to complete Form WC20 Full Financial Year – Summary of cost of claims from July to June.
• Form WC30 SAMPLE
  Sample data to show how to complete Form WC30 – Statement of premiums and expenses associated with the writing of workers compensation business.

WorkCover WA collects data periodically to monitor scheme performance and to set recommended premium rates. Premium rates data is collected through:

• Form WC20 Mid Financial Year – Summary of cost of claims from July to December
• Form WC20 Full Financial Year – Summary of cost of claims from July to June
• Form WC31 – Statement of expenses associated with the writing of workers compensation claims.

All Forms are to be submitted via WorkCover WA Online.

Guidelines

The Premium rates data – Guidelines describes data required by WorkCover WA of insurers and self-insurers to set recommended premium rates and monitor scheme performance. Licensed insurers and self-insurers are required to provide data as specified in this document.

Templates

Templates for reporting premium rates data are as follows:

• Form WC20 Mid Financial Year TEMPLATE
  Template for reporting Form WC20 Mid Financial Year – Summary of cost of claims from July to December.
• Form WC20 Full Financial Year TEMPLATE
  Template for reporting Form WC20 Full Financial Year – Summary of cost of claims from July to June.
• Form WC31 TEMPLATE
  Template for reporting Form WC31 – Statement of expenses associated with the writing of workers compensation claims.

Sample data

Sample data for reporting premium rates data are as follows:

• Form WC20 Mid Financial Year SAMPLE
  Sample data to show how to complete Form WC20 Mid Financial Year – Summary of cost of claims from July to December.
• Form WC20 Full Financial Year SAMPLE
  Sample data to show how to complete Form WC20 Full Financial Year – Summary of cost of claims from July to June.
• Form WC31 SAMPLE
  Sample data to show how to complete Form WC31 – Statement of expenses associated with the writing of workers compensation claims.