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. 2019 Jul 10;19(1):927.
doi: 10.1186/s12889-019-7251-x.

Injured worker experiences of insurance claim processes and return to work: a national, cross-sectional study

Alex Collie  1 , Luke Sheehan  2 , Tyler J Lane  2 , Shannon Gray  2 , Genevieve Grant  3
Affiliations

Injured worker experiences of insurance claim processes and return to work: a national, cross-sectional study

Alex Collie et al. BMC Public Health. .

Abstract

Background: Insurance claims management practices may have a significant impact on the health and experiences of injured workers claiming in workers' compensation systems. There are few multi-jurisdictional studies of the way workers experience compensation processes, and limited data on the association between claims experience and return to work outcomes. This study sought to identify worker, claim and injury related factors associated with injured worker experiences of workers' compensation claims management processes, and to examine associations between claims experience and return to work.

Methods: A national, cross-sectional survey of injured workers involved in ten Australian workers' compensation schemes. A total of 10,946 workers completed a telephone survey at 6 to 24 months post claim acceptance. Predictors of positive or negative/neutral claims experience were examined using logistic regression. Associations between claims experience, return to work status and duration of time loss were examined using logistic regression.

Results: Nearly one-quarter (23.0%, n = 2515) of workers reported a negative or neutral claims experience. Injury type, jurisdiction of claim, and time to lodge claim were most strongly associated with claims experience. Having a positive claims experience was strongly associated with having returned to work after accounting for injury, worker, claim and employer factors.

Conclusions: There is a strong positive association between worker experiences of the insurance claims process and self-reported return to work status. Revision and reform of workers' compensation claims management practices to enhance worker experience and the fairness of procedures may contribute to improved return to work outcomes.

Keywords: Claims management; Experience; Injury; Insurance medicine; Return to work; Workers’ compensation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Overview of sample selection
See this image and copyright information in PMC

References

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