ANAO releases audit of Comcare’s Workers Compensation Scheme

A new report by the Australian National Audit Office (ANAO) has deemed Comcare’s administration of claims made under the workers compensation scheme to be effective. However, the report also highlights that Comcare has not benchmarked the target for its efficiency measure, which means the efficiency of the claims management process is not clear. 

Comcare is the national authority for work health and safety and workers compensation, and provides workers compensation insurance and claims management to Australian Government entities. Effective administration of workers compensation claims is important for the optimal health and work outcomes for injured employees and the financial sustainability of the Comcare scheme. 

The audit assessed the effectiveness of Comcare’s administration of its workers compensation scheme claims. 

To form a conclusion against the objective, the following criteria were applied:  

• Does Comcare have business processes and systems in place that support the effective management of claims? 
• Do Comcare’s governance arrangements enable effective oversight and efficient management of claims? 

The report also found that Comcare has fit-for-purpose business processes and systems in place that support the effective management of claims. Comcare’s governance arrangements enable effective oversight and management of claims. Comcare has external effectiveness and efficiency performance measures, however the efficiency measure target is not based on benchmarking, making it difficult to clearly demonstrate efficiency in claims management. 

As per these findings, the Auditor-General made two recommendations related to reviewing the delegated claims management arrangements and improving Comcare’s corporate performance measures relating to claims management. 

Recommendations 

The two recommendations made by the Auditor-General are as below. 

Comcare periodically reviews the delegated claims management arrangements, including identification of areas of efficiency and any lessons learned that could apply to Comcare’s management of claims, or inform the application of the arrangements to other non-corporate Commonwealth entities. 

Comcare reviews its corporate performance measures to: 

(a) undertake benchmarking for the administrative cost ratio performance measure target; and 

(b) ensure more comprehensive coverage of its claims management function with a balance of efficiency and effectiveness measures. 

Comcare has agreed to both recommendations.  

You can read the full ANAO report on the ANAO website here.