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Workers Compensation - Self Insurance

SBC's Self Insurance Management System ('SIMS') is a true enterprise web browser solution used for the management of Workers Compensation claims in all Australian jurisdictions. SBC SIMS reduces the complexity and effort required for the management of workers compensation claims through a unique user interface that minimises the number of keystrokes and screens required to manage a workers compensation claim and to ensure that costs for workers compensation claims are kept to a minimum.

SBC SIMS is a highly configurable workflow solution that can be implemented to meet the business practices of our customers and has full WorkCover compliance for all Australian jurisdictions.

Compensation Calculator – SBC SIMS includes workers compensation calculators for all Australian State jurisdictions and Comcare. The calculator can be set to automatically calculate an injured workers’ statutory entitlements whether they be on total or partial incapacity. SBC SIMS also includes options for top up or make up salary, salary excess, maximum benefits thresholds, indexation, automated multi week payment options, statutory and organisation set thresholds, abatement, automatic calculations of step downs, the ability to handle shift and irregular hour workers and employees with multi employment or job details. The SBC SIMS workers compensation calculator is a powerful user-friendly tool that can substantially reduce the timeframes required to manage a workers compensation claims portfolio.

Rules for income maintenance, lump sums and permanent impairment also exist within SBC SIMS.

Estimates – A full estimate worksheet exists within SBC SIMS. The estimate worksheet allows for the generation of estimates based on pre-determined criteria such as length of time on total or partial incapacity, medical and allied health costs, legislative prescribed amounts such as disabilities, pain and suffering etc, investigation and legal costs, shared claim contributions and makeup/top up salary amounts.

Jurisdictional based estimate categories are also included so that SBC SIMS will calculate unique state based estimate categories.

A full estimate history and audit trail is maintained.

Rehabilitation/Return to Work – SBC SIMS provides a full rehabilitation and return to work module that allows for injury management and return to work plans to be drafted, implemented and reviewed. Each plan can contain a variety of goals and actions that allow for a staged approach to suitable and alternate duties. SBC SIMS can also capture work restrictions, periods of partial incapacity and medical diagnosis.

Claims Management – SBC SIMS provides an efficient and effective claims management tool that allows a claims team to minimise the effort and costs associated with the task of claims management.

Key features of the SBC SIMS Claims Management include:

  • management of recoveries
  • permanent impairment
  • common law/lump sums
  • medical certificates
  • injury details including NDS/TOOCS requirements
  • incident details
  • litigation details

Workflow and Reminders – Workflow and Reminders – SBC SIMS includes a workflow, reminder and diary system that can automate the management of claims through the use of SBC statutory reminder alerts for each jurisdiction, including reviews, stepdowns and automated alerts.

Provider Payments – SBC SIMS includes a full vendor and medical payments module that allows pre-determined Medicare/AMA/MBS codes to be loaded minimising the effort required to process payments. Fraud verifications are included so as to ensure that payments are made within authorisation limits.

Reporting – SBC SIMS includes a comprehensive set of reports that can be used for the analysis of a claims management portfolio as well as day to day operational management. SBC SIMS also includes analytical reports that allow claims managers to undertake trend and actuarial analysis.

Integration of Organisation Structure – SBC SIMS includes functionality that allows the import of an organisation’s organisational structure down to site/location level. SBC SIMS tightly links all claims data to an organisational structure so as to allow for analysis, reporting and profiling of each site/location of an organisation.

Document Management – SBC SIMS Documents are easy to generate and load using the document management features of this software. Document types within SBC SIMS can be configured so as to generate automatically based on pre-determined system criteria and are based on the prescribed WorkCover templates in each jurisdiction.

Profiling – Within SBC SIMS exists the ability to profile injured workers, medical providers and sites. The use of profiles ensures that full history can be easily obtained for a worker, provider or for a site.

Jurisdiction Requirements – SBC SIMS is fully complaint with all relevant state based legislation including:

  • NSW – Workers Compensation Act
  • VIC - Workers Compensation Act
  • QLD - Workers' Compensation And Rehabilitation Act
  • SA - Workers Rehabilitation And Compensation Act
  • WA - Workers' Compensation And Injury Management Act
  • TAS - Workers Rehabilitation And Compensation Act
  • ACT - Workers Compensation Act
  • NT - Workers Rehabilitation And Compensation Act

In addition, SBC SIMS is also compliant to the corresponding state safety, OH&S and rehabilitation legislation.

SBC SIMS has been built with all legislative specific rules for each jurisdiction within our software system.

Where an organisation is a self insurer in multiple jurisdictions, SBC SIMS provides for a single multi jurisdictional solution so that users can easily move between claims that are in different jurisdictions.

Dashboards – SBC SIMS includes a set of visual dashboards that allow a user to review a summary of the status and trends for a claims portfolio.

Security – Workers Compensation, by nature, is subject to strict privacy and confidentiality requirements and SBC SIMS allows for organisation to implement their own security restrictions and protocols to ensure that workers compensation information is kept secure at all times.

SBC has over 15 years experience with the implementation of self insurance software for a variety of self insurers across a diverse range of industries. This experience combined with our Australian based project teams ensure that SBC SIMS is a true productivity solution for an organisation’s workers compensation claims management needs.

For further details of SBC's Self Insurance SIMS solution please contact SBC at info@sbcit.com.au or at your local SBC office Contacts Page.

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