Comparing workers' compensation scheme performance

Australia has 11 main workers’ compensation systems: three Commonwealth and one in each of the eight states and territories.

Due to differences in the types of scheme as well as legislation governing scheme performance and benefit, standardisation measures are used to allow comparisons between jurisdictions. 

• The Comparative Performance Monitoring report and its supplementary material are published annually. It monitors the comparative performance of jurisdictions over time to allow benchmarking across jurisdictions and identify best practice to support policy making.
• The report includes data are sourced from workers’ compensation and WHS authorities in Australia and New Zealand; the National Dataset for Compensation-based Statistics; the Traumatic Injury Fatalities Dataset; the National Return to Work survey and the Australian Bureau of Statistics.

Standardisation of premium rates and funding ratios

Factors affecting how premium rates and funding ratios can be compared across the schemes include differences in:

• benefits and coverage, in particular coverage of journey to and from work
• claim management arrangements
• variations in funding arrangements for WHS services
• the definition of wages for premium setting purposes including whether superannuation contribution is part of wages
• levels of self-insurance
• the definition of funding ratio of net outstanding claim liabilities
• centrally managed and privately underwritten schemes.

Because of these differences, adjustments are made to:

• include superannuation as part of wages
• for employer excess as applied in each jurisdiction and for journey coverage
• allow for medical expenses
• use a standard definition of assets and liabilities
• use standard definition of net outstanding claim liabilities.

Duration of absence (continuance rate)

The duration of absence associated with claims indicates the severity of injuries happening in Australia.

The table below shows the variation across jurisdictions in the percentage of claims involving a selected period of compensation. These data were based on claims lodged in 2012–13—the most recent year reliable data were available for this indicator. 

The table shows 52% of serious claims in Australia resulted in less than six weeks of compensation, while 10% of ongoing claims passed 52 weeks of compensation.

Jurisdiction	less than 6 weeks	6 weeks or more	12 weeks or more	26 weeks or more	52 weeks or more
New South Wales	58	42	27	15	8
Victoria	38	62	45	29	19
Queensland	56	44	26	12	5
South Australia	52	48	32	20	13
Western Australia	50	50	35	21	13
Tasmania	56	44	25	14	8
Northern Territory	46	54	36	20	10
Australian Capital Territory	47	53	38	23	12
Australian Government	43	57	40	24	14
Seacare	27	73	50	27	6
Australian Average	52	48	32	18	10
New Zealand	69	31	18	8	4

* Includes all accepted workers’ compensation claims for an incapacity that results in a total absence from work of one working week or more.

Serious injury and disease claims by mechanism of incident

The mechanism of incident identifies the overall action, exposure or event that best describes the circumstances that resulted in the most serious injury or disease.

Of the 107,400 serious injury and disease claims in 2014–15, body stressing accounted for 41%, falls trips and slips 23%, and being hit by moving object 15%.

Workers’ compensation premiums and entitlements

Premium rates by jurisdiction

In 2014–15, the standardised Australian average premium rate was 1.39% of payroll, a 9% decrease from the previous financial year. The Queensland scheme recorded the lowest premium rate among all Australian jurisdictions at 1.19% of payroll, while South Australia recorded the highest with 2.42% of payroll. 

Premium rates by industry 

Premium rates data by industry are shown using the 1993 version of the Industry Classification System as most jurisdictions are unable to supply premium data based on the 2006 Industry Classification System. 

Indicator 23 shows average premium rates by industry in Australia for the years 2010–11 to 2014–15. These data show that the agriculture, forestry and fishing industry recorded the highest average premium rate at 3.4% of payroll. The lowest premium rate was recorded by the finance and insurance industry at 0.3% of payroll.

Entitlements under workers’ compensation

Premium rates are set at a level to ensure sufficient funds are available to cover entitlements payable under workers’ compensation in case an employee is injured or develops a work-related disease. Different entitlement levels across the jurisdictions explain some of the differences in premium rates. Entitlements within each jurisdiction will also vary based on the characteristics of the employee, (for example earnings, work status, number of dependents) and the severity of the level of impairment.  The Comparative Performance Monitoring report provides a comparison of entitlements across jurisdiction for a number of different scenarios. 

Workers’ compensation scheme performance

There are differences in the funding arrangements for the various schemes around Australia. The centrally funded schemes have their WHS and workers’ compensation functions, staffing and operational budgets funded by premiums. 

For those jurisdictions with privately underwritten schemes, funding for non-workers’ compensation functions comes directly from government appropriation.

Assets to liabilities ratio (funding ratio)

This indicator measures the adequacy of the scheme to meet future claim payments. Ratios above 100% indicate the scheme has more than sufficient assets to meet its predicted future liabilities

Centrally funded schemes

Indicator 15 shows the average funding ratio for centrally funded schemes was 138% in 2014–15, 13 percentage points more than the previous year. 

All centrally funded schemes recorded an increase in funding ratios compared to the previous year. Comcare was the only centrally funded scheme with a funding ratio below 100%, indicating assets may not be sufficient to meet future liabilities in this jurisdiction.

Privately underwritten schemes

Indicator 16 shows that in 2014–15, the average funding ratio for privately underwritten schemes was 123%, an increase of nine percentage points from the previous year. This was due to increases in the funding ratios observed in all three privately underwritten schemes.

Scheme expenditure

Indicator 18 shows that in 2014–15, most Australian schemes paid out more as weekly benefits than lump sum benefits. Western Australia, Tasmania and Queensland recorded similar proportions between weekly and lump sum benefits. 

Queensland and Tasmanian schemes are the only jurisdictions that paid out more in lump sum payments than in weekly benefits.

Current return to work

Indicator 19 shows the current return to work rates for the latest three surveys by country and by Australian states and territories. 

Data for this indicator were sourced from information published in the National Return to Work Summary Report for the years 2012, 2014 and 2016. The 2016 Current Return to Work data shows that 83% of Australian and 74% of New Zealand injured workers from premium paying and self-insured organisations had returned to work and were working in a paid job at the time of the interview.

Disputation rate

Indicator 20 shows the Australian disputation rate has increased by 26% since 2010–11. In 2014–15 the disputation rate was 6.5% of active claims; up 12% compared on the previous year. All jurisdictions recorded increases in disputation rates during the five year period.