PAUL GREGORY DIRECTOR ILARS BALLINA, 14 OCTOBER 2016 · 2018-05-29 · BALLINA, 14 OCTOBER 2016 ....
Transcript of PAUL GREGORY DIRECTOR ILARS BALLINA, 14 OCTOBER 2016 · 2018-05-29 · BALLINA, 14 OCTOBER 2016 ....
STATISTICAL ANALYSIS
PAUL GREGORY
DIRECTOR ILARS
BALLINA, 14 OCTOBER 2016
ILARS OUTCOMES FOR 2015/16
Workers Compensation Independent Review Office
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Desired Outcome not Achieved -38 % of matters; Average cost $3619
Desired Outcome Achieved 62% of Matters; Average cost $6311
ILARS Funding Withdrawn -1160; 10%; $3390 • Cram Fluid -678 • No Response to ILARS Follow-up -397 • Other - 85
Resolved prior to WCC – 2808; 25%; $3535 • Insurer accepts claim- 1169 • By complying agreement after claim made -1635
Instructions withdrawn -1082; 10%; $2331
Resolved after referral to WIRO Complaints - 30; 0%; $1320
Resolved after intervention of ILARS Director - 27; 0%; $2995
Not proceeding with preliminary grant -1189; 11%; $2791 • Worker does not reach WPI threshold -778 • Medical evidence not supported -337
Death Benefits - 35; 0%; $7005
Commutation – 30; 0%; $2494
Workers Compensation Independent Review Office 2
ILARS OUTCOMES FOR 2015/16 (CON’T)
Workers Compensation Independent Review Office
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Outcome Desired Outcome Not Achieved Desired Outcome Achieved
WCC 458; 4%; $6530 3816; 34%; $8316
• Resolved following MAC 385 1174
• Resolved Teleconference 0 925
• Resolved at Conciliation 0 1077
• Resolved at Arbitration 72 607
• Resolved WIM dispute 1 30
Appeals 131; 1%; $8281 185; 2%; $9708
• After Medical Appeal Panel 118 162
• To the President 11 21
• To the Supreme Court 2 1
Workers Compensation Independent Review Office 3
FEES PAID FOR COMMON OUTCOMES
Workers Compensation Independent Review Office
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Average Disbursements
Average Professional Fees
Average Total Fees
For Top 20 law firms All Back Injury Matters
Resolved in the WCC
Maximum $4,091 $6,572 $11,320
Minimum $817 $4,989 $6,306
Median $2,025 $5,682 $8,272
Average $2,084 $5,726 $8,383
For top 10 law firms All Hearing Loss Matters
Resolved prior to the WCC
Maximum $1,396 $3,866 $5,198
Minimum $0 $700 $770
Median $877 $1,839 $2,939
Average $842 $1,913 $2,946
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FEES PAID FOR COMMON OUTCOMES (CON’T)
Workers Compensation Independent Review Office
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Average Disbursements
Average
Professional Fees Average Total
Fees
For top 10 law firms All Psychological Injury Matters
Resolved in the WCC
Maximum $3,223 $6,984 $10,226
Minimum $1,243 $4,771 $7,215
Median $2,506 $6,031 $9,033
Average $2,387 $6,007 $8,995
For top 20 law firms All non-Hearing Loss
Matters Resolved in the WCC
Maximum $2,629 $6,328 $9,342
Minimum $1,249 $5,183 $7,326
Median $1,967 $5,668 $8,135
Average $1,971 $5,675 $8,213
Workers Compensation Independent Review Office 5
INSURERS - ALL MATTERS
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Insurer
Ap
pe
als
Dis
con
tin
ue
d
fro
m W
CC
- N
o
resu
lt
ILA
RS
Fun
din
g W
ith
dra
wn
Inst
ruct
ion
s w
ith
dra
wn
No
t p
roce
ed
ing
afte
r p
relim
inar
y gr
ant
Re
solv
ed
in
WC
C
Re
solv
ed
pri
or
to W
CC
Gra
nd
To
tal
Tota
l Mat
ters
De
sire
d
ou
tco
me
% a
chie
ved
Scheme Agent 3% 1% 11% 9% 10% 37% 25% 100% 8797 5522 63% Allianz Australia Workers Compensation (NSW) Ltd 3% 1% 11% 8% 8% 38% 27% 100% 2285 1496 65%
CGU Workers Compensation 3% 1% 10% 7% 9% 40% 27% 100% 1193 776 65%
Employers Mutual NSW 2% 1% 9% 9% 10% 37% 29% 100% 943 634 67% GIO General Limited 2% 0% 11% 8% 9% 41% 24% 100% 1306 859 66%
QBE Workers Compensation 3% 1% 11% 9% 10% 35% 27% 100% 2179 1375 63%
Self-Insured 4% 1% 8% 9% 11% 39% 25% 100% 1055 675 64%
Bluescope Steel Ltd 1% 0% 9% 9% 7% 25% 47% 100% 81 51 63%
Coles Group Ltd 4% 2% 8% 10% 12% 50% 10% 100% 154 101 66%
Qantas Airways Limited 2% 2% 8% 12% 12% 29% 32% 100% 85 51 60%
Rail Corporation NSW 4% 0% 15% 12% 10% 33% 22% 100% 78 46 59%
Woolworths Limited 8% 3% 10% 12% 12% 35% 15% 100% 120 70 58%
Specialised Insurer 3% 1% 8% 6% 11% 50% 18% 100% 388 254 65% Catholic Church Insurance Limited 3% 0% 7% 8% 12% 59% 6% 100% 98 65 66%
StateCover Mutual Ltd 2% 1% 10% 6% 11% 42% 26% 100% 168 106 63%
TMF 3% 1% 9% 11% 12% 40% 21% 100% 947 588 62%
Allianz TMF 4% 0% 7% 10% 10% 48% 19% 100% 338 220 65%
Employers Mutual NSW 2% 1% 13% 11% 14% 32% 21% 100% 315 173 55%
QBE TMF 2% 1% 9% 10% 10% 40% 23% 100% 294 195 66%
Grand Total 3% 1% 10% 10% 10% 38% 25% 100% 11362 7123 63%
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INSURERS – DENIAL OF LIABILITY
Insurer Ap
pe
als
Dis
con
tin
ue
d
f
rom
WC
C -
No
r
esu
lt
ILA
RS
Fun
din
g
Wit
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n
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s
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ing
a
fte
r
pre
limin
ary
g
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t
Re
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WC
C
Re
solv
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pri
or
t
o W
CC
Gra
nd
To
tal
To
tal M
atte
rs
De
sire
d
ou
tco
me
% a
chie
ved
Scheme Agent 2% 2% 6% 10% 6% 65% 7% 100% 2090 1514 72%
Allianz Australia Workers Compensation (NSW) Ltd 2% 2% 7% 10% 6% 61% 10% 100% 582 409 70%
CGU Workers Compensation (NSW) Ltd 1% 2% 8% 6% 6% 69% 6% 100% 248 181 73%
Employers Mutual NSW Limited 1% 1% 2% 11% 5% 71% 7% 100% 211 164 78%
GIO General Limited 1% 0% 5% 10% 8% 67% 6% 100% 403 296 73%
QBE Workers Compensation 2% 2% 5% 12% 7% 64% 5% 100% 501 362 72%
Self-Insured 2% 1% 4% 15% 9% 61% 6% 100% 281 193 69%
Coles Group Ltd 4% 1% 5% 12% 9% 63% 4% 100% 82 58 71%
Specialised Insurer 1% 1% 4% 7% 4% 74% 6% 100% 139 112 81%
Catholic Church Insurance Limited 0% 0% 2% 13% 4% 73% 6% 100% 52 41 79%
TMF 2% 1% 7% 13% 10% 59% 7% 100% 324 218 67%
Allianz TMF 2% 0% 5% 12% 5% 65% 9% 100% 130 97 75%
Employers Mutual NSW Ltd - TMF 0% 1% 12% 17% 14% 46% 6% 100% 100 53 53%
QBE TMF 2% 1% 3% 11% 12% 63% 5% 100% 94 68 72%
Grand Total 2% 1% 6% 11% 7% 64% 7% 100% 2851 2045 72%
Workers Compensation Independent Review Office 7
INSURERS - WPI
Insurer Ap
pe
als
Dis
con
tin
ue
d
fro
m W
CC
- N
o
re
sult
ILA
RS
Fun
din
g
Wit
hd
raw
n
Inst
ruct
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s
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raw
n
No
t p
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ing
a
fte
r p
relim
inar
y
gra
nt
Re
solv
ed
in W
CC
Re
solv
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or
to
WC
C
Gra
nd
To
tal
To
tal M
atte
rs
De
sire
d o
utc
om
e
% a
chie
ved
Scheme Agent 4% 1% 18% 8% 14% 32% 20% 100% 4005 2084 52%
Allianz Australia Workers Compensation (NSW) Ltd 4% 1% 19% 8% 12% 32% 20% 100% 1014 549 54%
CGU Workers Compensation (NSW) Ltd 4% 1% 16% 7% 14% 35% 19% 100% 588 311 53%
Employers Mutual NSW Limited 4% 0% 15% 9% 16% 30% 22% 100% 461 246 53%
GIO General Limited 5% 0% 22% 8% 14% 34% 15% 100% 493 255 52%
QBE Workers Compensation 4% 1% 17% 7% 16% 28% 23% 100% 1072 551 51%
Self-Insured 6% 2% 14% 9% 15% 30% 18% 100% 430 234 54%
Coles Group Ltd 5% 2% 13% 7% 20% 27% 20% 100% 55 32 58%
Woolworths Limited 12% 4% 12% 9% 13% 29% 18% 100% 78 45 58%
Specialised insurer 5% 1% 13% 5% 20% 33% 18% 100% 148 76 51%
StateCover Mutual Ltd 6% 0% 22% 6% 20% 22% 20% 100% 51 21 41%
TMF 3% 1% 15% 9% 17% 32% 18% 100% 409 206 50%
Allianz TMF 4% 1% 11% 9% 18% 39% 15% 100% 137 72 53%
Employers Mutual NSW Ltd - TMF 3% 2% 17% 8% 19% 27% 18% 100% 162 76 47%
QBE TMF 3% 1% 18% 10% 13% 30% 20% 100% 110 58 53%
Grand Total 4% 1% 18% 8% 15% 31% 19% 100% 5056 2622 52%
Workers Compensation Independent Review Office 8
LAW FIRM PERFORMANCE REPORTS • Over the last 18 months Paul and his team has visited 44 law firms to discuss their relative
performance in applying for grants and completing matters. • Our performance report compares a law firm to the market average. • The report includes the following
– An analysis of the number of matters opened and closed for the firm and their ALSP’s – A table showing the number of emails exchanged per matter, the percentage of matters where ILARS asks
for further information and the percentage of matters where there is an invoice error. – A look at their market share in the regions they have offices. – A comparison of what the issues for the matters are, which insurers are on the other side and what type of
injuries do your client’s have. – A analysis of the type of outcomes your firm’s matters have and the relative costs of those matters.
• If your firm has applied for more than 100 matters with WIRO we are happy to prepare a report for you and discuss the results. We are also preparing a similar report for insurers.
Workers Compensation Independent Review Office 9
Lawyers ILARS Matters comparison data As at 30-Jun-16
Financial Information
All Matters Open Matters Closed Matters Total number of grants approved
Number of Grants
Total amount of grants
Amount of invoices processed Number
Amount of invoices processed
Rank in total approved
grants
Rank in total amount invoiced
% of total grants ($)
invoiced % closed
(No)
Rank of grants
invoiced %
Rank of Grants
closed %
Lawyers Pty Ltd 1,276 568 $2,885,567 $59,482 708 $3,888,414 6 7 55% 55% 74 88
All law firms 40,942 14,098 $70,520,967 $2,278,876 26,844 $121,833,397 60% 66%
Number of matters per lawyer
Lawyer 1 438 189 $ 949,628 $ 14,628 249 $ 1,567,278 61% 57%
Lawyer 2 84 67 $ 327,024 $ 2,024 17 $ 85,377 21% 20%
Lawyer 3 1 0 $ - $ - 1 $ 8,869 0% 0%
Lawyer 4 3 0 $ - $ - 3 $ 11,181 0% 0%
Lawyer 5 265 152 $ 804,128 $ 30,096 113 $ 547,295 42% 43%
Lawyer 6 2 1 $ 5,000 $ - 1 $ - 0% 0%
Lawyer 7 3 0 $ - $ - 3 $ 13,746 0% 0%
Lawyer 8 17 2 $ 10,000 $ - 15 $ 47,037 0% 0%
Lawyer 9 14 1 $ 5,000 $ - 13 $ 67,912 0% 0%
Lawyer 10 44 38 $ 190,000 $ - 6 $ 16,956 0% 0%
Lawyer 11 7 4 $ 20,000 $ - 3 $ 13,603 0% 0%
Lawyer 12 394 110 $ 554,787 $ 12,733 284 $ 1,509,160 67% 72%
Lawyer 13 1 1 $ 5,000 $ - 0 $ - 0% 0%
Lawyer 14 3 3 $ 15,000 $ - 0 $ - 0% 0%
Workers Compensation Independent Review Office 10
REQUEST FOR FURTHER INFORMATION ON GRANT APPLICATIONS
ALSP Name Matters Accepted or Pending
Matters Declined
Total Matters
% Accepted or Pending
% Declined
Number of matters where requisition raised
% of matters with requisitions
All ALSPs 41,894 2,925 44,819 93% 7% 7,966 18%
Lawyers Pty Ltd 1,310 113 1,423 92% 8% 296 21%
Individual lawyer 448 30 478 94% 6% 86 18%
Individual lawyer 86 10 96 90% 10% 18 19%
Individual lawyer 1 - 1 100% 0% - 0%
Individual lawyer 3 2 5 60% 40% 2 40%
Individual lawyer 272 18 290 94% 6% 67 23%
Individual lawyer 2 - 2 100% 0% 1 50%
Individual lawyer 3 2 5 60% 40% - 0%
Individual lawyer 21 2 23 91% 9% 8 35%
Individual lawyer 14 1 15 93% 7% 1 7%
Individual lawyer 48 3 51 94% 6% 8 16%
Individual lawyer 7 - 7 100% 0% - 0%
Individual lawyer 398 45 443 90% 10% 104 23%
Workers Compensation Independent Review Office 11
INVOICE ERRORS
Number of invoices where invoice is returned to law firm for correction
Number of invoices with no errors Once Twice 3 times 4 times 5 times
Total Invoices
Error percentage
All firms
8,360 1,679
204
47
16
4 10,310 19%
Average errors across lawyers >10 invoices 19% Median 18%
Lawyers Pty Ltd
248
60
9 2 - - 319 22%
Individual lawyer 106 25 1 1 133 20%
Individual lawyer 80 21 3 1 105 24%
Individual lawyer 35 8 3 46 24%
Individual lawyer
11 5 16 31%
Individual lawyer 5 1 6 17%
Individual lawyer 3 1 1 5 40%
Individual lawyer 3 3 0%
Individual lawyer 3 3 0%
Individual lawyer 2 2 0%
Workers Compensation Independent Review Office 12
HOW LONG DO MATTERS STAY OPEN
Workers Compensation Independent Review Office 13
MARKET SHARE IN THE AREA YOUR OFFICES ARE LOCATED
Area Suburb or Area Law Firm ALSP's Total Value of Grants
Number of Grants
Total Value of Approved Invoices
Number of Invoices
Rank in terms of the number of grants
Number of Firms in area
Hunter Hunter Lawyers pty Limited Individual lawyer $1,388,735 265 $577,391 121
Hunter Total $23,850,066 5120 $14,170,673 3249 6 34
Sydney Liverpool/Fairfield Lawyers pty Limited Individual lawyer $2,611,059 438 $1,581,906 233
Sydney Liverpool/Fairfield Lawyers pty Limited Individual lawyer $8,869 1 $8,869 1
Sydney Liverpool/Fairfield Lawyers pty Limited Individual lawyer $13,746 3 $13,746 3
Sydney Liverpool/Fairfield Lawyers pty Limited Individual lawyer $15,000 3
Liverpool/Fairfield Total $17,474,824 3248 $9,565,633 1691 3 31
Sydney South West Suburbs Lawyers pty Limited Individual lawyer $11,181 3 $11,181 3
South West Suburbs Total Lawyers pty Limited $56,922 11 $31,922 6 2 2
Sydney Sydney City Lawyers pty Limited Individual lawyer $417,401 84 $87,401 18
Sydney Sydney City Lawyers pty Limited Individual lawyer $82,037 17 $47,037 10
Sydney Sydney City Lawyers pty Limited Individual lawyer $82,912 14 $67,912 11 Sydney Sydney City Lawyers pty Limited Individual lawyer $206,956 44 $16,956 6
Sydney Sydney City Lawyers pty Limited Individual lawyer $33,603 7 $13,603 3
Sydney Sydney City Lawyers pty Limited Individual lawyer $2,249,724 393 $1,521,893 250
Sydney Sydney City Lawyers pty Limited Individual lawyer $5,000 1
Sydney City Total $60,551,624 11509 $37,171,557 6962 8 109
Workers Compensation Independent Review Office 14
OUTCOMES COMPARED TO AVERAGE Overall 38% 62% 37% 63%
Lawyers Pty Limited All Law firms Desired Outcome not
achieved Grant achieved desired
outcome Desired Outcome not achieved
Grant achieved desired outcome
Outcomes Percentage
Number of cases Percentage
Number of cases Percentage Percentage
Appeals 2% 2 6% 13 3% 3%
Discontinued from WCC - No result 2% 2 0% 3% 0% ILARS Funding Withdrawn 26% 34 0% 27% 0%
Cram Fluid Applies 12% 16 0% 16% 0%
No Response to ILARS Follow Up 11% 14 0% 9% 0% Instructions withdrawn 29% 39 0% 26% 0%
Not proceeding after preliminary grant 32% 43 0% 28% 0%
Medical evidence not supportive 7% 9 0% 8% 0%
Worker does not reach WPI threshold 24% 32 0% 18% 0% Resolved in WCC 8% 10 67% 146 11% 54%
Resolved at Arbitration by Arbitrator - Employer 2% 3 0% 2% 0% Resolved at Arbitration by Arbitrator - Worker 0% 7% 15 0% 7%
Resolved at Conciliation - settled by consent 0% 26% 57 0% 15%
Resolved at settlement during Arbitration 0% 3% 7 0% 2%
Resolved following MAC 5% 7 23% 50 9% 16%
Resolved TC - settled by consent 0% 8% 17 0% 13%
Resolved prior to WCC 0% 22% 48 0% 39%
Resolved - Insurer Accepts Claim 0% 4% 9 0% 14% Resolved after application for review/insurer accepts Claim 0% 1% 2 0% 2%
Resolved by complying agreement after claim made 0% 17% 37 0% 23%
Grand Total 100% 133 100% 217 100% 100%
Workers Compensation Independent Review Office 15
wiro.nsw.gov.au
Phone 139476
CONTACT US
Workers Compensation Independent Review Office 16