Post on 20-Aug-2015
transcript
TAC – Scheme and business overview
Established as part of Transport Accident Act 1986 – commenced on 1 January 1987
Government-owned enterprise
Independent Board and Executive Management
Approximately 750 staff
Majority based in Geelong Headquarters (small offices in Bendigo, Dandenong and Melbourne)
TAC – Scheme overview The Transport Accident Commission 2
TAC charge raised $1.38 billion in 2011-12 (net premium revenue)
$9.48 billion total assets vs. $10.89 billion total liabilities (2012)
$1 billion in benefits to 44,000 people in 2011-12
Investments managed by central Victorian Government investment corporation
TAC – Scheme and business overview
Entitlements overview
TAC – Scheme overview Transport Accident Act 1986 3
Common Law Damages (Pain & suffering/economic loss)
Medical Services
Hospital and Like Expenses
Rehabilitation
Loss of Earnings
Loss of Earning Capacity
Loss of Earning Capacity
Impairment Lump Sum
Date of Accident
3 months 18 months 3 years Retirement
age Lifetime
Disability Services
Except medical excess
Except the first five working
days
If 50% or more impaired
If ‘at fault’ party identified and >30% impaired or
‘seriously injured’
Application window
TAC2015
TAC – Scheme and business overview
Our three Corporate Goals in balance
Client Experience:
Provide a high quality service
that is in line with customer’s
expectations of a modern
public service
Scheme Viability:
Use our funds fairly and
responsibly to ensure we can
provide support for Victorians,
now and in the future
Client Outcomes:
Assist our clients to get their
lives back on track and return to
health and independence as
effectively as possible
TAC – Scheme overview The Transport Accident Commission 4
TAC – Scheme and business overview
TAC receives approximately 16,500 no-fault claims the each year:
Minor Injury Moderate Injury Major Injury
3%
Spinal injuries
Brain injuries
Fatal claims 16%
Other
Hospitalised Claims
81%
Casualty visit
Outpatient Rx
GP treatment
(Independence)
(Recovery)
TAC – Scheme overview Claims Management – portfolio breakdown 5
TAC – Scheme and business overview
Spread of liabilities is a very different picture:
0.1% 9%
Moderate
Injury
Major
Injury
64%
Minor
Injury
27%
Common
Law
TAC – Scheme overview Claims Management – portfolio breakdown 6
Managing Social insurance in a changing world
• The Statutory challenge – the limits of law
• The historical challenge – the product of failure
• The balance sheet challenge – viability is vital
• The cultural challenge – TAC knows best
TAC The Social insurance challenge 7
Individualised funding – A toe in the water!
• Individualised funding agreements – 2004
• Low take up – get the infrastructure right
• Overcome cultural barriers first
• Flexibility is the attraction – Create options
• It’s not for everyone
TAC The Social insurance challenge 8
TAC – Scheme and business overview
Independence Model (Severe Injury)
The model aims to ensure a seamless transition for clients with a long-term disability to independent living
It was developed based on international best practice and the Victorian Disability Plan
Places the clients needs at the centre ( medical, rehabilitation, social, work and leisure)
Claims management model.
Independence Plan – Clients goals direct service provisioning. The client is an active participant through the life of the plan.
Collaboration is the key to the model’s success – TAC leading the coordination and collaboration of providers and client support needs to maximise client outcomes and independence
The Provider Advisory Group provides further expertise where needed
TAC – Scheme overview Claims Management 9
TAC The Social insurance challenge 10
Client outcomes at the centre
• Independence outcomes = Viability
• Independence outcomes = Client satisfaction