SIRA workers compensation regulatory activity update 3 - 2019-20

This is the third workers compensation regulatory activity update for 2019/2020.

The State Insurance Regulatory Authority (SIRA) compliance and enforcement activity continues to deliver on its strategic goals of improving customer experience and results, maintaining scheme and policy affordability, and building public trust.

Our regulatory activities focus on areas of highest risk to injured people, policy holders and the workers compensation scheme. We take firm and fair enforcement action as needed, based on the severity of harm or potential harm, the degree of negligence, and/or the need for deterrence.

Key compliance and enforcement activity from 22 November 2019 to 31 January 2020 is summarised by stakeholder group below.

Compliance and enforcement activity for employers

• 1,205 businesses purchased a workers compensation policy after SIRA commenced investigations for being uninsured. This reflects $1.6M in additional premium raised and 4,475 more employees now covered by a workers compensation policy. To date, SIRA has generated $9.39 million in policy premiums and covered an additional 20,350 NSW workers by targeting uninsured businesses
• $19,500 in penalty notices issued to businesses who were not insured
• $146,607 collected from businesses as a further penalty for failing to purchase a workers compensation policy
• 16 notices were issued to employers who had failed to establish a return to work program, failed to appoint a return to work coordinator, or not provided suitable work
• SIRA inspectors visited 149 businesses checking workers compensation insurance coverage as per section 238 of the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act)
• 13 complaints regarding employers not providing suitable work were investigated by SafeWork NSW inspectors under delegations from SIRA.

Compliance and enforcement activity for providers

• One chiropractor and one psychologist had their approvals to operate in the NSW workers compensation system suspended for failing to meet SIRA requirements under the Workers Compensation Act 1987 (1987 Act)
• Warning letters were issued to three medical practitioners and specialists regarding non-compliance with Fees Orders
• Insurers were advised how to reduce the potential for fraudulent medical provider behaviour.

Compliance and enforcement activity for insurers

• SIRA granted the Coles Group Pty Ltd a one-year licence renewal term and requires data quality issues to be remedied
• SIRA imposed a special licencing condition on Catholic Church Insurance to ensure a corrective action plan is implemented to improve case management practices
• A report from the independent review into Compliance and Performance of the Nominal Insurer (managed by icare) was released in December 2019. As a result of the review SIRA published a 21-point action plan.
• Penalties totalling $82,500 were imposed on the Nominal Insurer (managed by icare) for failure to comply with the Workers compensation market practice and premiums guidelines capping requirements
• The Nominal Insurer (managed by icare) was issued with a letter of censure for non-compliance with a direction issued by SIRA in relation to data accuracy requirements in accordance with the 1987 Act.
• Six directions for security deposit increases were made to self-insurers under section 213 of the 1987 Act.