Rehabilitation Service

Transcription

1 Rehabilitation Service Injury management C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 1 17/11/ :11

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3 Contents 4 Rehabilitation is a key tool in managing injury claims 6 How much money can you save using Zurich Municipal Rehabilitation 8 How does the rehabilitation service work? 9 Process for a typical rehabilitation case 10 An experienced and qualified team 11 Rehabilitation Referral form C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 3 17/11/ :11

4 Rehabilitation is a key tool in managing injury claims Zurich Municipal has a fully integrated team of health professionals who as Rehabilitation Case Managers (RCMs) can intervene in injury claims in a number of ways. The Medical Management Team provides both pre and post claim solutions to meet the needs of our customers and claims handlers. For the majority of claims where there is a liability we seek to offer rehabilitation to claimants where this is likely to result in quicker recovery. This in turn leads to a reduction in claims costs and can result in a speedier resolution to the claim. The integration of our Medical Management Team within the claims function supports the claims handlers with detailed medical knowledge to spot anomalies and inaccuracies within medico legal reports. We offer treatment that includes physiotherapy, diagnostic and surgical solutions. For our largest customers with significant volumes of accidents we can offer our rehabilitation service. This innovative approach to injury management brings together risk management, injury management and traditional insurance to help customers. Accidents at Work We understand that accidents are the biggest cause of absence from work. Whether they cause short term, unscheduled absence or long term illness they all have a serious impact on your business. Accidents at work happen and it s the employers who have to bear the cost: Accidents in the workplace currently cost Britain s employers 13.8 billion every year Injuries in the workplace can cost the employer 8 to 36 times the amount of any insurance payments An estimated 638,000 people suffer a workplace injury annually An estimated 27 million working days are lost due to workplace injury and work related ill health Source: Health and Safety Executive (HSE) Zurich Municipal s rehabilitation service is suitable for most injuries arising from workplace accidents and offers immediate access to professional medical expertise. This early intervention can help to reduce the cost of accidents to the business. Reducing costs with our rehabilitation service Many businesses seriously underestimate the costs of day to day accidents and injuries. In addition to increased insurance premiums and compensation, there are hidden costs such as loss of production, retraining, overtime or recruiting temporary staff. Cost ( ) Cost to employer Cost of claim Duration of injury 4 C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 4 17/11/ :11

5 What does the Zurich Municipal Rehabilitation service offer? Our rehabilitation service can help you reduce the cost of injuries and accidents at work by ensuring employees access appropriate and timely treatment, and in turn return to work sooner. It is an innovative approach to injury management, which brings together traditional insurance, risk management and injury management to help your employees return to work sooner. It s all about working with you to help manage the cost of risk to your organisation. Our service is suitable for most injuries arising from workplace accidents and offers immediate access to professional medical expertise. As well as demonstrating a commitment to the wellbeing of your employees, this early intervention can help reduce the cost of accidents to your organisation. For example, loss of earnings can form a large part of a claim. By reducing the length of time an employee is absent from work, Zurich Municipal Rehabilitation can have a positive effect on the final costs. Zurich Municipal Rehabilitation allows you to demonstrate a commitment to the wellbeing of your employees, and provides wider benefits to your business. We provide: Early intervention Access to medical expertise Employee involvement Reduction in absence levels Reduction in average number of days lost Support for employees to return to work quicker or in some cases to remain at work and still receive treatment Reduction in insurance claims 5 C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 5 17/11/ :11

6 How much money can you save using Zurich Municipal Rehabilitation The total cost savings will vary from organisation to organisation. We believe that the additional medical costs in most cases are less than the claims savings, therefore reducing the overall claims cost. This should reduce premiums. Estimated cost of work related injuries Estimated costs ( millions) central lower* upper* Sick pay (inc NI) 1,205m 1,129m 1,281m Insurance premiums 1,419m n/a n/a Production disturbance 128m 113m 143m Administrative and legal costs 86m 85m 88m Total costs 2,838m 2,750m 2,927m *95% confidence intervals totals may not sum due to rounding. Confidence intervals are not additive so do not sum to the total. Confidence intervals reflect the underlying sampling variability in the injury and illness incidence estimates. Source: Health and Safety Executive (HSE) At Zurich Municipal we believe in proactively treating injuries to prevent chronicity and long term absence. The average cost of providing treatment is 418, and for every pound spent on the initiative the benefits outweigh the costs. According to the Health and Safety Executive (HSE), the overall rate of new cases of work-related ill-health was roughly 1,300 cases per 100,000 workers with musculoskeletal disorders regarded as the most common type of work related illness. Industry sectors with ill health rates significantly higher than the average include education, health and social care and public administration and defence. Types of injuries most likely to benefit from Zurich Municipal s rehabilitation service: Muscular injuries Injuries to joints Hernias Fractured bones Back injuries Moderate to severe wounds Crush injuries Falls from heights Injuries from machinery 6 C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 6 17/11/ :11

7 Identifying if the work-related injury is suitable for the rehabilitation service The injury assessment table below is designed to help you identify if the work-related injury is likely to be suitable for our rehabilitation service: Category Description Timeframe Examples Too minor Injuries that do not require medical attention Injuries resulting in less than 3 days absence Rationale These injuries tend to resolve of their own accord and do not require any active intervention. If the condition does not improve, they can be referred to Zurich Municipal for injury management Injuries that result in an absence of less than three days Minor cuts Bruises Minor sprains/ strains Older injuries Hernias Appropriate referral Accidents reportable to the HSE (form F2508) Injuries involving an absence of three days to three months. A specific incident that occurs during the course of employment Rationale These cases will be managed by the Medical Management Centre Injuries that result in an absence of three days to three months Fractured bones Back injuries Moderate/ severe lacerations Crushing injuries Falls from heights Injuries from machinery Further discussion necessary Injuries where there is a delay between occurrence and reporting Injuries/illness that affect a pre-existing condition Rationale This type of injury requires careful consideration before acceptance into injury management. We will only accept the case if we believe we can provide a positive impact Injuries up to six months old Older injuries from the Appropriate referral list Psychological injury following a specific incident Any injury over six months old Out of scope Most cases where the workplace has caused injury without a specific incident Injuries where there is a long delay between occurrence and reporting Some cases where the workplace has caused injury without a specific incident Any injury more than six months old Occupational asthma Asbestosis Stress Mesothelioma Industrial deafness To obtain the best results it is vital the injury is reported immediately. Any delay in providing treatment can have a significant impact on the recovery process. 7 C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 7 17/11/ :11

8 How does the rehabilitation service work? Following a RIDDOR (Reporting of injuries, diseases and dangerous occurrences regulation) reportable incident, you can immediately contact one of our Rehabilitation Case Managers (RCMs). The RCM will notify our claims department of all new cases referred to us. This allows us to manage any potential claim (for instance by investigating the accident), before a formal claim is made. Rehabilitation commences with a detailed assessment of the case with the injured party to establish a personalised rehabilitation plan. Our team will liaise with the injured party, claims handler, solicitor, GP and treatment providers to assess the injury and arrange for the most appropriate medical consultation and treatment. In most cases, we can arrange for treatment to start within a few days of your call to us. This helps ensure the best possible outcome for your employee so that they can return to work sooner. Our RCM will establish a rehabilitation programme that is appropriate and realistic that meets the medical, social, domestic and psychological needs of the individual. This is referred to as the bio-psychosocial model and looks at that individual and the impact of the injury on all elements of their life rather than addressing an area in isolation. Our close engagement with the individual is aimed at enhancing their short term recovery and long term independence. Our RCM will also be in regular contact with the injured party via telephone. This is very much a two way process where the injured party is expected to take an active part. There is an expectation on the injured party to engage with treatment and the rehabilitation plan. Sometimes an injured party may not fully engage in the programme and where they do not the RCM may deem it appropriate to withdraw treatment. This may be used as a failure to mitigate argument where a rehabilitation case later becomes a claim. Once treatment has been provided and the injured party has made progress in their recovery, we will look for them to return to their employment in a safe and appropriate manner. We will always consult with you about the return to work and look to create a partnership between the employer and employee to ensure the return to work is sustainable. The rehabilitation service gives us the opportunity to work closer with you to manage accidents at work. Our focus is on getting the injured party back to work in their pre-accident role following an accident. In such cases the RCM will work with the employer to look at lighter duties, alternative roles and/or a graduated return to work programme. Occasionally the injured party may not be able to return to work with their pre-accident employer and in these cases the RCM may arrange vocational rehabilitation services to look at alternative types of work and training within the capabilities of the injured party. At Zurich Municipal we don t charge for the service of our medical management team unless you pay separately for our claims handling service. However, we do record treatment costs and they form part of your on-going claims experience. 8 C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 8 17/11/ :11

9 Process for a typical rehabilitation case Incident occurs on site Accident involves an absence of three days or more Incident occurred on site Injury is of a type likely to benefit from injury management Zurich s RCM notified Customer notifies Rehabilitation Case Manager (RCM) of the incident via mmc@uk.zurich.com The RCM will liaise with all parties to establish full information surrounding the injury If case is not suitable for injury management the RCM will advise insured site co-ordinator and the claims handler If injury case is suitable for injury management the RCM will agree a treatment plan with the injury party and advise insured site co-ordinator If treatment is already being provided (e.g. by the NHS) the RCM will monitor the case and consider intervention at a later date if necessary The RCM will liaise with all parties throughout to update on progress etc. If injury case is suitable for injury management the RCM will agree a treatment plan with the injured party and advise insured site co-ordinator 9 C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 9 17/11/ :11

10 An experienced and qualified team Based in our Medical Management Centre, all our qualified Rehabilitation Case Managers (RCMs) have industry experience, so they can talk to you knowledgeably and help to find the right answer for each individual case. Strong relationships enable everyone involved to get the best results from Zurich Municipal Rehabilitation, so we ll allocate a specific RCM to your business. This means you ll always know exactly who to contact and will get to know and trust your RCM. In return, your RCM will gain a clear understanding of your working environments and can better tailor your employee s return to work. Our aim is to make sure that everyone benefits from the rehabilitation process. This means getting treatment for your employee that will enable them to return to work as soon as possible, while controlling the potential claims costs. Find out more To learn more about how the rehabilitation service can help you, contact your Risk and Insurance Consultant, visit our website zurichmunicpal.co.uk or us at info@zurichmunicipal.com 10 C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 10 17/11/ :11

11 Rehabilitation Referral Form To be used in any case of an injury at work involving a permanent employee that has resulted /is expected to result in absence from work or impact on their ability to carry out their normal duties. (NB: This does not supersede the notification of injury/ accident requirements under Health & Safety reporting which should still be followed). Employee Confirmation The employee must be aware of the referral and understand the reasons for the referral. Please circle Yes to confirm Yes Referrer details Company:... Name:... Address:... Date:... Phone:... Fax: Injured Party / Employee Details Name:... Pre-injury employment / job description / role / Contracted hours:... Date of birth:... Home address:... Home landline:... Home mobile:... Work address:... Work mobile:... Details of Accident/Event: Date of Accident:... Time:... Brief description of the incident: Please attach a copy of the accident report or Riddor Brief Details of Injury/illness/condition: When Employee First Absent:... Expected Duration of Absence: (if known)... Send completed form to mmc@uk.zurich.com C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 11 17/11/ :11

12 Zurich Municipal is a trading name of Zurich Insurance plc, a public limited company incorporated in Ireland. Registration No Registered Office: Zurich House. Ballsbridge Park, Dublin 4, Ireland. UK Branch registered in England and Wales, Registration No. BR7985. UK Branch Head Office: The Zurich Centre, 3000 Parkway, Whiteley, Fareham, Hampshire PO15 7JZ. Authorised by the Central Bank of Ireland and subject to limited regulation by the Financial Conduct Authority. Details about the extent of our regulation by the Financial Conduct Authority are available from us on request. These details can be checked on the FCA s Financial Services Register via their website or by contacting them on Our FCA Firm Reference Number is Copyright Zurich Insurance plc All rights reserved. Reproduction, adaptation or translation without prior written permission is prohibited except as allowed under copyright laws For more information visit C54255_ZM_Rehabilitation_Brochure_A4_FOR PRINT_v2.indd 12 17/11/ :11