Professional Documents
Culture Documents
Today
Some context
The challenge
The solution
Making it Happen
Research
Policy
Business Lead
Project Management
The Results
Some context
The size of it
4.4m
1.7m
CLAIMS
PER YR
1 EVERY
seconds
The Challenge
Employer
Insurance
Claims Management
ACC
The Solution
Current service
Levy focused account
management
Claims management
services for injured
worker
Current value
proposition
We provide claims
services for injured
workers
Customer Centric
value proposition
We will help you
manage costs and
increase productivity
Timeframes
March 2011:
June 2011:
Evaluation
June 2012:
September 2012:
Go live
Making it happen
The role of Policy:
Conceptualise
Challenge, challenge, challenge
Coordinate
Condense information
Communicate concisely
Making it happen
The role of Research:
A key, early partner
Willingness to be flexible and tailor approach
Adapted to business needs without compromising research best
practice
Delivered on measuring benefits
The Map
Best Practice RTW
CURRENT STATE
Employer
ACC
Employee
Treatment/
Rehabilitation
Provider
STRATEGIC/ HIGH-VALUE/PRIORITY
CUSTOMER
(+add-ons)
Temporary Earthquake
Employer Service
Consider upgrading
products and services to
meet market needs
IPS Customer
Project to
inform
segmentation
(Aug-Sep 11)
Lo
Medium employer who is capable and willing to support RTW and a key
influencer of other employers
Standard Customer
Access to standard/ core services
Access to add-ons
Large employer or Accredited employer who is capable and willing to
support RTW
Large employer who does not have capability to support RTW
High
High
STRATEGIC/ HIGH-VALUE/PRIORITY
CUSTOMER
(+add-ons)
Employer-Centric Case
Management Model
Proposed Employer-Centric Claims Management Model for Trial from October 2011
Key Risks
Risks for the Trial
The approach will not work if:
o ACC is unable to match employers to claims
o there is not a culture change in ACC to see the employer as the customer (from a claims
management perspective).
The approach will be less successful if:
o ACCs customers are mostly low injury volume employers
o the value proposition (financial value of these products) for employers is not understood or
articulated.
ACCIS will not be operational so there will not be a system to match products to employers.
There will be limited skills/capability/capacity of IPS staff to deliver IMC services and products
as a result of the restructure. It will also take time to develop staff in new roles due to the scale
of change under the restructure.
Short timeframes of the trial may limit ACCs ability to effectively test trial products and
services.
Risks for Future Development of Service
The service needs to fit with product development for expanded risk-sharing options for small/
medium employers and an expanded AEP (IPS).
There are a number of barriers for more radical options (eg legislation, systems, resourcing,
need for more research and direction). In addition, these options will need to be further
developed by IPS (ie flowing out of the IPS Customer Project & overarching blueprint).
If the definition for customer segments (eg high-value customer) is not fit-for-purpose across
both IPS and Claims Management there will be inconsistencies in service delivery, which may
impact on Scheme costs and ACCs ability to meet customer needs.
Employers may not want to pay for add-ons (but may be interested in levy discounts). Product
pricing must be right.
Potential limitations for ACC if the Work Account is opened up for choice of insurer (eg
statutory limits on products and services that can be offered).
ACC will trial standard and add-on products and services with pre-selected
medium to large employers (nationally), and standard products with small to
medium employers within 2 pre-selected industries (regionally).
Standard Customer
Strategic/ High-value/
Priority Customer
Work/non-work injury
claim is streamed to
dedicated Key
Employer Contact
within relevant
industry group
Claims
administrator/
coordinator
team
(centralised)
Relationship
Manager
Key Employer
Contacts
(grouped by
industry type)
Claims Coordinator/
Administrator
Claims and Administrative
support:
General claims
administration (eg manage
purchase orders, invoice
discrepancies, payment
information gathering etc)
Provide other assistance
as delegated by KEC
including management of
simple claims if required
Relationship Manager
Key business relationship
for high-value employers:
Will need to link in closely
with KEC to ensure
coordinated services/
communication with
employer
Making it happen
The role of Business Lead:
Courage and conviction
Communicator/translator
Connector/conduit
So far, so great
We have received the very best of service, the results have been amazing
and the close communication has been very much appreciated. We have
gone from a second class service from ACC to first class service which has
saved us time, money & most importantly produced very good RTW results
Trial employer
Really appreciate your proactive stance to our work related Injuriesthis
is a 1st for me, (re ACC action) in my 7.5 years here. You show all the signs
of being from a private & commercial background, as opposed to a
governmental one..
ECS employer