A Bendigo lawyer says the unjust actions of insurance agents revealed by an Ombudsman investigation into the management of complex workers' compensation claims are not uncommon.
In a critical report released yesterday, Victorian Ombudsman Deborah Glass said the WorkCover scheme was failing to deliver fair outcomes for workers with long-term injuries.
"WorkSafe agents continue to make unreasonable decisions, the dispute process can be time consuming, stressful and costly, and WorkSafe is too often unwilling or unable to deal," Ms Glass said. These agents are five commercial bodies - Allianz, CGU, EML, Gallagher Bassett and Xchanging - that manage compensation claims on behalf of WorkSafe.
Ms Glass found evidence of agents selectively using evidence to terminate entitlements, conducting surveillance of workers with little or no evidence that the individuals had misrepresented their injury, and requiring workers to attend occupational rehabilitation when inappropriate.
Bendigo workers' compensation lawyer Jennifer Lay said this sort of behaviour was "all too familiar for the clients Slater and Gordon represents".
"Time and time again we see insurers using questionable practices to make key decisions that deny injured workers their entitlements," Ms Lay said.
"When someone is injured at work they are entitled to compensation and access to treatment to give them the best shot at recovery. Injured workers shouldn't have to fight every step of the way against insurers who seem more interested in their ever-growing profits than providing people with the support they deserve."
The Ombudsman's investigation followed a 2016 probe into the same issue.
"Many of the decisions and actions we saw were not only unjust and wrong. Some were downright immoral and unethical," Ms Glass said.
WorkSafe has accepted all 13 of the Omdbudsman's recommendations.
"WorkSafe is in the midst of a major transformation program that will improve the way claims are managed and the support services available to injured workers," chief executive Colin Radford said. "The Ombudsman's report reinforces the importance of this work."
The Victorian government has also accepted the recommendations that it commission an independent review of the agent model and introduce a new dispute resolution process.
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