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The Social Insurance Challenge – TAC Context: Alan Woodroffe 2013

TAC – Scheme and business overview

Established as part of Transport Accident Act 1986 – commenced on 1 January 1987

Government-owned enterprise

Independent Board and Executive Management

Approximately 750 staff

Majority based in Geelong Headquarters (small offices in Bendigo, Dandenong and Melbourne)

TAC – Scheme overview The Transport Accident Commission 2

TAC charge raised $1.38 billion in 2011-12 (net premium revenue)

$9.48 billion total assets vs. $10.89 billion total liabilities (2012)

$1 billion in benefits to 44,000 people in 2011-12

Investments managed by central Victorian Government investment corporation

TAC – Scheme and business overview

Entitlements overview

TAC – Scheme overview Transport Accident Act 1986 3

Common Law Damages (Pain & suffering/economic loss)

Medical Services

Hospital and Like Expenses

Rehabilitation

Loss of Earnings

Loss of Earning Capacity

Loss of Earning Capacity

Impairment Lump Sum

Date of Accident

3 months 18 months 3 years Retirement

age Lifetime

Disability Services

Except medical excess

Except the first five working

days

If 50% or more impaired

If ‘at fault’ party identified and >30% impaired or

‘seriously injured’

Application window

TAC2015

TAC – Scheme and business overview

Our three Corporate Goals in balance

Client Experience:

Provide a high quality service

that is in line with customer’s

expectations of a modern

public service

Scheme Viability:

Use our funds fairly and

responsibly to ensure we can

provide support for Victorians,

now and in the future

Client Outcomes:

Assist our clients to get their

lives back on track and return to

health and independence as

effectively as possible

TAC – Scheme overview The Transport Accident Commission 4

TAC – Scheme and business overview

TAC receives approximately 16,500 no-fault claims the each year:

Minor Injury Moderate Injury Major Injury

3%

Spinal injuries

Brain injuries

Fatal claims 16%

Other

Hospitalised Claims

81%

Casualty visit

Outpatient Rx

GP treatment

(Independence)

(Recovery)

TAC – Scheme overview Claims Management – portfolio breakdown 5

TAC – Scheme and business overview

Spread of liabilities is a very different picture:

0.1% 9%

Moderate

Injury

Major

Injury

64%

Minor

Injury

27%

Common

Law

TAC – Scheme overview Claims Management – portfolio breakdown 6

Managing Social insurance in a changing world

• The Statutory challenge – the limits of law

• The historical challenge – the product of failure

• The balance sheet challenge – viability is vital

• The cultural challenge – TAC knows best

TAC The Social insurance challenge 7

Individualised funding – A toe in the water!

• Individualised funding agreements – 2004

• Low take up – get the infrastructure right

• Overcome cultural barriers first

• Flexibility is the attraction – Create options

• It’s not for everyone

TAC The Social insurance challenge 8

TAC – Scheme and business overview

Independence Model (Severe Injury)

The model aims to ensure a seamless transition for clients with a long-term disability to independent living

It was developed based on international best practice and the Victorian Disability Plan

Places the clients needs at the centre ( medical, rehabilitation, social, work and leisure)

Claims management model.

Independence Plan – Clients goals direct service provisioning. The client is an active participant through the life of the plan.

Collaboration is the key to the model’s success – TAC leading the coordination and collaboration of providers and client support needs to maximise client outcomes and independence

The Provider Advisory Group provides further expertise where needed

TAC – Scheme overview Claims Management 9

TAC The Social insurance challenge 10

Client outcomes at the centre

• Independence outcomes = Viability

• Independence outcomes = Client satisfaction

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Our journey continues

TAC Scheme context – 2013

12 TAC – Scheme and business overview