Complex & stuck claims
Claims that have stalled, blown out or simply won't close
When a workers' compensation claim stops progressing, there is almost always a specific reason. We find it, reset the plan, and get the claim moving again.
Long tail and stuck claims are our core work, across every Australian state scheme.
Not sure whether a claim is stuck? Ten questions, two minutes, no email asked for.
Take the Stuck Claim CheckThe problem we solve
A stuck claim is a signal, not a dead end
If you are reading this, a claim has probably run longer than it should and you want a straight answer about why. Here is the honest one. A claim that has passed six months, keeps getting more expensive, or simply isn't moving is rarely stuck for the reason everyone assumes.
This is complex psychological injury case management and long tail claims work: the files that need a fresh set of eyes and someone to genuinely own them. We take on stalled and blown out claims, work out plainly why they have stopped progressing, and put a practical plan in place to get them moving.
Have you had someone read the whole file recently, end to end, and name the one thing holding it up? If not, that is where we start.
Talk to us about a claim
How to spot it
The signs a claim is stuck
If one or more of these is true, the claim is unlikely to resolve on its own. It is worth a fresh set of eyes.
It has run past six months
Time on its own is a warning sign. A claim still open well beyond the expected recovery window usually has an unresolved reason behind it.
Costs keep climbing
Reserves are being revised up, weekly payments continue, and the estimate at renewal keeps getting worse rather than better.
Nothing is actually progressing
Reviews happen and notes get added, but the injured worker is no closer to recovery or a durable return to work than months ago.
What's really going on
Why claims stall
Different claims stop for different reasons, but the causes are surprisingly consistent. A good review names the one that applies to yours.
Capacity was never made clear
Capacity means what the worker can safely do right now. Without a current, agreed view of it, everyone waits, and the claim drifts while decisions stay on hold.
A psychological overlay is missed
A physical injury that isn't recovering often carries a psychological or psychosocial factor that no one has named or addressed.
The return to work plan never landed
A plan exists on paper, but suitable duties were never real, the supervisor was never briefed, or the plan simply stopped being followed.
No one genuinely owns the file
Responsibility is split across the insurer, employer and treating team, so gaps fall between them and momentum quietly stops.
Our approach
From review to resolution
A clear, sequential path for a claim that has stopped moving: starting with an honest diagnosis, ending with a claim back under control.
Diagnose
We read the whole claim: history, medical, correspondence and payments. We tell you plainly why it has stalled, not just where it sits.
Reset the plan
We rebuild a practical injury management and return to work plan around current capacity, with clear actions, owners and timeframes.
Take ownership
We coordinate the treating team, employer and scheme, chase the actions that were falling through the gaps, and keep the file moving week to week.
Drive to resolution
We push toward a durable outcome: a sustainable return to work, or a clean, defensible close out. Then we hand back a claim that is under control.
The difference
What changes when we take over the file
The first thing that changes is ownership. One team reads the whole claim, names why it stalled, and takes responsibility for the actions that were falling through the gaps between the insurer, employer and treating team.
From there, the plan is rebuilt around current capacity and actually followed: suitable duties that are real, a supervisor who is briefed, and a return to work path everyone can see and track.
In the weeks after we step in, you should expect a clear diagnosis first, then a reset plan, then regular plain English reporting on movement. We will not promise a fixed saving or a guaranteed close date, because a claim that has already stalled deserves an honest read, not a sales figure.
Related services
Where this connects
Stuck claims rarely sit on their own. These services sit alongside a complex claims review.
Frequently asked questions
What makes a claim complex or stuck?
Usually a combination: the claim has run well past the expected recovery window, costs keep rising, and there is no clear progress toward recovery or return to work. A missed psychosocial factor, a psychological overlay, or a return to work plan that never landed are common threads. There is almost always a specific, identifiable reason.
Can you take over a claim that is already stalled?
Yes. Taking on long tail, stalled and blown out claims is our core work. We start with a full claims review to understand where the claim is and why it has stopped, then build a plan to get it progressing. You do not need to have done anything differently to hand a claim to us.
How does a complex claims review work?
We look at the entire file: claim history, medical reports, correspondence, capacity and payments. We give you a plain English read on why the claim has stalled. From there we reset the injury management and return to work plan, take ownership of the day to day coordination, and drive the claim toward a durable outcome.
Do you handle claims with a psychological component?
Yes. Many stuck claims carry a psychological or psychosocial overlay that has never been named, and these are among the hardest claims to manage well. Our complex psychological injury case management sits alongside this service, so a claim that started as a physical injury is handled with the right expertise once that factor is identified.
Which schemes and states do you cover?
We work nationally, across every Australian state and territory workers' compensation scheme. One team can review and manage a stuck claim wherever it sits.
Have a claim that won't move?
Tell us where it's stuck. We'll review it and tell you plainly whether we can help and what happens next, with no obligation. Or call 1300 477 662.