Faults emerge in work insurance

By RICHARD BRADDELL

WELLINGTON - Private insurers appeared reluctant to approve claims and were often late in honouring invoices, according to a survey of the privatised workers' compensation market four months after it began in July last year.

Dated last month, the report to the Department of Labour, says that some physiotherapists had been made redundant as workloads slumped by up to 40 per cent in some areas. Many general practitioners had raised charges to cover the burden of providing some insurers with more information than thought reasonable.

But the report, based on surveys conducted by Blue Lotus Research, cautions that with the market still in its infancy, some problems may have been only short-term.

The inference of growing efficiency might be drawn from statistics released by the regulator. They show a sharp rise in claims towards the end of last year.

The privatised market ends next July when workers' compensation returns to ACC's monopoly.

The report says that medical practitioners were deluged with form-filling and difficulties in getting approvals from private sector insurers. And employers had at times refused to recognise that accidents had occurred at work.

"Most GPs had put their fees up to cover this extra time taken. Delays in claim acceptance and payment of claims (and non-payment of claims) continue to place demands on administrative staff time," says Blue Lotus.

"Time is spent locating patients' insurers, assisting patients in filling out forms, auditing accounts to find out if payments have been received, processing claims to be filed, bulk billing ACC and manually billing individual insurers."

Providers who treated patients ran the risk of having to absorb the treatment cost if claims were not accepted.

"This has led to some providers charging the full amount and leaving it to the patient to claim back from the insurer," it says.

While many providers believed the paperwork problems could be resolved, they remarked on the ramifications of the move from a state sponsored system and the incentive it gave insurers to cut costs by disputing claims. And, as in the case of physiotherapy, going for shorter treatment regimes.