Why one claim follows you for three years
If your average performance premium (APP) is over $30,000, icare classes you as an experience-rated employer, and your claims history directly changes what you pay. Employers under that threshold are small employers, and their premium is not directly affected by claims costs.
At each renewal, icare divides your premium-impacting claims costs for the previous three years by your APP for the same three years. That figure, your Claims Performance Measure, is then compared with a scheme-wide benchmark to decide whether your premium gets a loading or a discount.
Note: Because the calculation draws on three years of history, a claim lodged this year can influence your premium at each of your next three renewals, not just the next one.
Source: icare, Premium calculation for experience-rated employers; SIRA, Premium calculation.
What a loading looks like on a renewal
icare's own sample renewal pack shows how quickly claims costs add up. The sample employer's premium-impacting claims costs over three years came to 10% of its APP, against a scheme benchmark of 4.3%. That put its Claims Performance Rate at 232.56%, and its premium was adjusted by a factor of 1.605, around 60% above its average performance premium.
icare's worked example of an employer with no claims experience shows the opposite effect, with a 7.5% discount taking a $99,200 APP down to $91,760.
Chart: Premium adjustment by claims performance, icare examples
- No claims experience: 7.5% below APP
- Claims costs 2.3 times the scheme benchmark: around 60% above APP
Source: icare, Renewal premium information pack; icare, Premium calculation for experience-rated employers. The 60% figure is Actevate's calculation from icare's adjustment factor.
Info: Not every dollar spent on a claim counts towards your premium. Costs that do count include weekly compensation, permanent impairment and commutation payments.
Note: icare caps how far an experience-rated employer's premium rate can move in a single year, so a large loading can be spread across more than one renewal.
Why a psychological injury claim weighs so much more
- 34.8 weeks median time off work for a mental health claim, compared with 7.0 weeks for other serious claims
- $68,600 median compensation paid, compared with $16,100 for other serious claims
- 17,900 serious mental health claims in 2024-25, or 12.2% of all serious claims
- 169% increase in these claims since 2014-15
Source: Safe Work Australia, Key Work Health and Safety Statistics Australia 2026. Time lost and compensation are for 2023-24, the most recent finalised year.
Weekly compensation is one of the costs that feeds the premium calculation, so a claim with almost five times the time off carries far more weight in your Claims Performance Measure. At the national medians, a single mental health claim attracts more compensation than four other serious claims combined.
For an experience-rated employer with a clean record, that single claim can be the difference between a discount and a loading for three renewals in a row.
Tip: Ask icare for your cost of claims report and check which open claims are still paying weekly compensation. Those are the claims that will shape your next three renewals, and the ones where return to work support has the most value.
The hazard that rarely gets attention: organisational justice
Safe Work Australia defines poor organisational justice as a lack of procedural justice, such as fair decision-making processes, or of informational fairness, such as keeping everyone up to date and in the loop. It becomes a hazard when it is severe, prolonged or frequent, and it sits in the Managing Psychosocial Hazards at Work Code of Practice alongside better-known hazards like job demands and low job control.
The research linking fairness at work to absence is strong. A prospective study of 3,773 hospital employees in Finland found that low justice in decision-making procedures was associated with a 41% higher risk of sickness absence in men, and found no evidence that the link ran the other way, from poor health to perceptions of unfairness. A 2022 narrative review of 103 studies found the evidence that perceptions of workplace justice predict mental health and lower sickness absence to be relatively compelling.
Source: Safe Work Australia, Poor organisational justice; Kivimäki et al., Organisational justice and health of employees: prospective cohort study, Occupational and Environmental Medicine; Narrative review of organisational justice and health, 2022.
Where it shows up in claims
Harassment or workplace bullying caused 31.6% of serious mental stress claims in 2024-25, and work pressure caused 26.5%. In our experience, how fairly a bullying complaint is investigated and how workloads are shared out are often what decides whether a conflict stays a workplace issue or becomes a claim.
Safe Work Australia also notes that hazards combine. Poor organisational justice can create a higher risk in workplaces with low role clarity, where it isn't clear who should be making decisions.
Tip: Look for the early signs Safe Work Australia lists, such as gossip about decisions, unresolved issues or divisions among workers. Then check whether rosters and complaint outcomes are decided consistently, and whether workers are told how those decisions are made.
Protecting your premium starts before a claim
The three-year window works in both directions. Every renewal without a premium-impacting claim moves an older claim out of the calculation, and every claim kept short limits how much it adds.
- Check which past claims drop out of the calculation at your next renewal, so you can forecast your premium rather than be surprised by it.
- Act in the first weeks of a claim, because fewer than half of claimants are back at work within four weeks and another 22.7% return between week 4 and week 13. Early contact and suitable duties in that window keep a claim from becoming a long one.
- Put organisational justice on your risk register with a control and a review date, the same as any other psychosocial hazard, rather than leaving it as an HR matter.
Source: Safe Work Australia, Key Work Health and Safety Statistics Australia 2026, return to work insights from workers compensation data.
Note: This article explains the NSW scheme run by icare. Victoria, Queensland and the other states use their own premium formulas, though most also factor in claims history for larger employers.
How Actevate can help
Actevate supports employers across the whole employee lifecycle. Our pre-employment health assessments match workers to the demands of their role, our return to work services help injured workers recover and return sooner, and our mental health training and Employee Assistance Program help you manage psychosocial risk before it becomes a claim. To talk through your claims history and what it means for your premium, call 1300 663 155 or get in touch.
Sources
- icare, Premium calculation for experience-rated employers
- icare, Renewal premium information pack
- SIRA, Premium calculation
- GIO, How do claim costs impact my premium?
- Safe Work Australia, Key Work Health and Safety Statistics Australia 2026
- Safe Work Australia, Poor organisational justice
- Kivimäki et al., Organisational justice and health of employees: prospective cohort study, Occupational and Environmental Medicine
- Narrative review of organisational justice and health, 2022
Disclaimer
This article is general information only and does not constitute legal, insurance or health and safety advice. Premium calculations depend on your policy, industry classification and claims history, so speak to your insurer about your own premium. icare examples are illustrative and may not reflect current rates. Figures marked as calculated are Actevate's own analysis. icare and Safe Work Australia have not reviewed or endorsed this article.





