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

ruth.fisk@onbase.com

www.OnBase.com/en-AU/Insurance