Having trouble with your Case Manager? Try this

insurer case manager


Having trouble with your Case Manager?

In this podcast, Director, Pania Watt discusses your best options if you are having difficulty with your insurer’s case manager.


Dan: In the context of workers’ compensation matters, your case manager plays an important role. In this podcast, I’m talking with Bourke legal director, Pania Watt, about that relationship and what you should do if the relationship deteriorates. Pania, tell me who a case manager is and why a person might have trouble with them.

Pania: Case managers are just people. They’ve often got very high caseloads. So lots and lots of injured workers just like you to manage, support, remember to pay and make lots of decisions about on a day by day or weekly basis. Now, I don’t know if it’s a consequence of this, but a lot of case managers are just not great at communicating with injured workers. If you feel like you’re being treated just like a number when you’re dealing with your case manager, that’s probably a pretty apt description.

Dan: I’m guessing that you hear that thing from a lot of your clients.

Pania: Yes, we do. Some case managers are better in their interactions than others. But too often our clients find that just when they get a case manager who is kind and who understands what they’re going through, they’re moved on to a different case manager. It’s not uncommon for injured workers to have four, five case managers in a year, sometimes more, and that’s really tough for our clients, because while the insurers keep notes, there is still going to be a need to explain everything that’s happened all over again, because the new case manager just may not understand. The last thing you want as an injured worker is having a person who makes all the decisions about your claim, not understanding what your claim is actually about or the kind of support that you really need. It’s a relationship which is, unfortunately, pretty one sided in terms of power and control.

Dan: Pania, what happens then if your client is finding it tough to deal with their case manager?

Pania: Your case manager also has a manager, and usually this person is their team leader. If your case manager is routinely not available when you call, doesn’t return your phone calls, doesn’t respond to emails that you send, or seems to always be on leave, these seem to be the main examples that my clients give me. The first thing that you should do is call the insurer and ask to speak to your case managers supervisor or team leader. I’ve often found that escalating the problem to the next level of management can get you a response much faster than just following your case manager up over and over.

Dan: Okay, but what happens if your client just can’t see eye to eye with their case manager?

Pania: Dan, unfortunately, this happens sometimes. The power imbalance in the relationship between an injured worker and a case manager can create a fair bit of frustration, and when you throw into the mix pain and disability from an injury, as well as financial worries due to being on workers’ compensation, things can get volatile. I’ve had clients so upset by interactions with their case manager that they just can’t bring themselves to take on having a conversation on the telephone with them. If you’re in a situation where you don’t feel that your relationship with your case manager is salvageable, you can make a complaint and give reasons to the insurer as to why you should be appointed a different case manager.

Dan: Sounds rough. Is there anything else that your client can do if they’re in this situation?

Pania: IRO’s Solutions Group can also play a role. Solutions have achieved excellent results in relation to general claims management issues that my clients have had previously. Any injured worker can call IRO on 139 IRO or go to their website at iro.nsw.gov.au and complete their online form. IRO will contact the insurer and liaise with them about the complaint and generally have a response back to you within five business days, if not before.

Dan: Pania, any final advice for injured workers’ struggling with their case manager?

Pania: Look, I appreciate if you’re listening to this, it’s hard to have a person that’s not you have that level of control over so many parts of your life. Hopefully, what we’ve talked about today is going to give you some more tools to put you on an even playing field with your case manager. But if you want to talk some more with a lawyer who is well-experienced in workers’ compensation, give us a call at Bourke Legal. We’d love to hear from you.

Thanks for listening. If you have any questions, please do not hesitate to contact Bourke Legal on 1300 026 875.