Workers compensation monthly report August 2020
August 2020 report
Accessible version
System overview
Key workers compensation system statistics for the 12 months ending August 2020
$271 billion of reported wages are safeguarded by the workers compensation scheme 1
$3.8 billion in premiums were collected, representing 1.4% of reported NSW wages1
$3.2 billion was paid out as costs for workers1
78,979 workers received weekly benefit payments1
93,930 claims were reported to SIRA
8,279 reportable claims
66% return to work rate in August at 4 weeks
1For the 2018/19 financial year
Effectiveness
System effectiveness in protecting workers and getting workers back to work and wellbeing
Claim types
Of the 8,279 reportable claims in August 2020, 92.3% (7,639 claims) were related to physical injuries and 7.7% (640) were related to psychological injuries.
SIRA is now reporting claim volumes for COVID-19. Use this link to access the most current information. Access the latest from our open data portal.
Working from home claims
As at 30/9/2020, there were 167 claims for workers working from home. These were being handled by the different insurer types as follows: nominal insurer (NI) (76), TMF (54), self insurers (30) and specialised insurers (7). The data does not indicate the reason for the injured worker to work from home. Of these 167 claims, 14 occurred in September 2020, 24 in August, 20 in July, 39 in June, 34 in May, 20 in April, 10 in March. The remainder occurred earlier than March 2020.
Reportable claims
8,279 were reported in August 2020
8,411 were reported in July 2020
8,836 were reported in August 2019
Monthly average over the last 12 months
10,380 reports submitted A^
7,828 reportable claims ^
4,392 lost time T^
A Records submitted includes all records received from insurers across NSW. This data excludes administration errors.
T Lost time is based on workers receiving weekly benefits.
^ Figure is based on a 12 month average.
Insurer Performance
Information about the performance of insurers operating within the workers compensation system
| % share of reported wages | % share of total claims | % share of total payments made in April 2020 | % share of total active claims | % of injury notifications actioned within 7 days | % of Level 1 complaints to active claims |
|---|---|---|---|---|---|---|
Nominal insurer | 74% | 67% | 69% | 66% | 99.22% | 0.04% |
Government self insurer (TMF) | 13% | 16% | 19% | 20% | 98.97% | 0.02% |
Specialised Insurers | 6% | 8% | 5% | 7% | 93.96% | 0.02% |
Self insurers | 7% | 9% | 7% | 8% | 99.45% | 0.10% |
Note: Insurers reported this data to SIRA. Data is as at August 2020
SIRA published the NI Compliance and Performance Review in December 2019 and a status report on the 21 point action plan is now available. Please use the link below to access the plan.
System return to work rates
RTW rate 4 weeks | RTW rate 13 weeks | RTW rate 26 weeks | RTW rate 52 weeks | RTW rate 104 weeks | |
|---|---|---|---|---|---|
Scheme | 66.2% | 78.2% | 83.2% | 85.3% | 88.6% |
Scheme compared with last month | down by 1 % | down by 1 % | up by 1 % | down by 1 % | down by 1 % |
Nominal insurer | 67% | 79% | 84% | 85% | 88% |
Government self insurer (TMF) | 70% | 83% | 87% | 90% | 91% |
Specialised Insurers | 72% | 81% | 85% | 87% | 89% |
Self insurers | 70% | 79% | 81% | 85% | 88% |
Note: Data based on a rolling 12 month cohort.
SIRA identified data quality issues with the accuracy and completeness of return to work data submitted by the Nominal Insurer (NI). The data appears to indicate a significant deterioration in the NI’s RTW performance. SIRA instructed the NI to improve the quality of the data. To address both the data quality and performance concerns with the NI, SIRA carried out a data quality audit in December 2018 and completed a Compliance and Performance Review in December 2019. In addition SIRA has a 21 point action plan for the NI.
Maintaining a significant period of work
Maintaining a significant RTW measures monitors the length of time workers were reported to be working in a 12-month period following their initial return to work.
Note - This analysis requires a 12-month data development period and data is as at August 2020.
4% maintained RTW for less than 3 months
3% maintained RTW for more than 3 months up to 5 months
4% maintained RTW for more than 5 months up to 8 months
10% maintained RTW for more than 8 months up to 11 months
79% maintained RTW for 12 months
Return to work rates
At 4, 13, 26, 52 and 104 weeks, both single month and rolling 12 months average return to work rates, for both by date of injury month and by date entered into system month, have similar trends from September 2017 to August 2020.
August RTW rates (12 months rolling average) | 4 weeks | 13 weeks | 26 weeks | 52 weeks | 104 weeks |
|---|---|---|---|---|---|
By date entered into system (12 months rolling average) | 66% | 78% | 83% | 85% | 89% |
By date of injury (12 months rolling average) | 66% | 78% | 83% | 85% | 88% |
May RTW rates (single month) (data as at August 2020) | |||||
By date entered into system (single month) | 63% | 78% | |||
By date of injury (single month) | 65% | 78% |
Note: August data was used to report on the RTW rate for the month May 2020, to allow for 3 months development period.
Efficiency & viability
Efficient system delivery, sustainability, and viability of the system for generations to come
Total claim payments made by insurers
In August 2020, the Nominal insurer made payments of about $228.6 million, Government self-insurers (TMF) payments were about $64.4 million, self-insurers had payments of about $16.8 million, and specialised insurers had payments of about $12.9 million.
Claim payment types
The breakdown of claim payment types in August 2020 is as follows:
- Weekly payments: 40.52%
- Medical payments: 23.90%
- Common law (WID): 17.90%
- Rehabilitation payments: 5.44%
- Lump sum (S66 & S67) payments: 4.68%
- Investigation payments: 2.50%
- Death payments: 1.76%
- Legal payments: 1.71%
- Other payments: 1.45%
- Commutations: 0.15%
Total claim payments made by insurers
In July 2020, $344 million were paid in claim payments.
In August 2020, $323 million was paid in claim payments.
There was a 6.10% decrease in claim payments.
Note – Insurers regularly update claims data based on the progression of a claim. This has been observed to result in changing payment details month on month.
Benefits paid to and for workers as a percentage of total claims expenditure
Of the total expenditure across the system in 2020 payment year, 48% was spent on payments direct to claimants and 24% was spent on payments for the claimants, 28% was spent on insurer expenses. Among all the insurers, the NI (31%) and specialised insurer (34%) spent a greater percentage on insurer expenses than SI (12%), TMF (16%) and scheme overall (28%). Percentage of payments made directly to the claimants are 42% for specialised insurer, 45% for nominal insurer, 57% for self insurers and 61% for TMF, scheme overall was 48%.
Note: The benefits paid to and for workers is calculated annually. Data is based on expenditure 2020 payment year, as at 30 September 2020.
Customer experience & equity
Customers’ experience with the system is positive and equitable
Enquiries and complaints
In August 2020, SIRA received 1,929 enquiries and 866 complaints.
Note: These are the complaints and enquiries numbers received by SIRA and WIRO. Complaint data (which may include the name of an insurer) is derived from verbatim reports from customers. While SIRA does some data cleansing, the reporting is verbatim from customers and might occasionally reference an incorrect insurer and/or insurer type.
Disputes lodged
In August 2020, the dispute rate was 0.7%, with 98,146 active claims and 710 disputes lodged.
Note: Including data from the Workers Compensation Commission.
Perceived justice of the compensation process
Insurer type | Procedural Justice Average (mean) on a 5-point scale | Informational Justice Average (mean) on a 5-point scale | Interpersonal Justice Average (mean) on a 5-point scale |
|---|---|---|---|
Nominal Insurer | 4.0 | 3.9 | 4.3 |
Self and Specialised | 3.9 | 3.9 | 4.3 |
Treasury Managed Fund | 4.0 | 3.7 | 4.4 |
Definitions of dimensions used to measure customers perception of equity and perceived justice:
- Procedural justice, about the fairness of the procedures used to determine the outcomes.
- Informational justice, is about receiving accurate and timely information about the rationale for decisions.
- Interpersonal justice, relates to whether workers were treated with respect and sensitivity.
Source: Abridged Return to Work Outcomes Survey: NSW Workers Compensation System (October 2019).
Affordability
Insurance affordability
This is the affordability of insurance is 1.4%, as a percentage of NSW wages for 2018/19.
Additional scheme performance measures
Information about the performance of insurers operating within the workers compensation system
Cost to the scheme for weekly benefits paid per month
In August 2020, the total amount of weekly benefit payments paid by insurer type was:
$91.1 million by the Nominal insurer
$29.2 million by the Government self-insurer (TMF)
$4.3 million by specialised insurers
$6.6 million by self-insurers
Note: to ensure consistency across the time series the data excludes Section 39 claimants that exited the system up to June 2018.
Number of workers receiving weekly benefits per month
In August 2020, the number of workers receiving weekly benefits by insurer type was:
24,826 for the Nominal insurer
7,784 for the Government self-insurer (TMF)
1,348 for specialised insurers
1,980 for self-insurers
Note: The data is a distinct number of workers receiving weekly benefits and to ensure consistency across the time series, the data excludes Section 39 claimants that exited the that exited the system up to June 2018.
RTW including medical only claimants rate
In August 2020, the 4-week RTW rate was:
75.3% for the Nominal insurer
77.5% for the Government self-insurer (TMF)
82.0% for specialised insurers
85.4% for self-insurers
77.1% for the system average
In August 2020, the 13-week RTW rate was:
83.7% for the Nominal insurer
86.7% for the Government self-insurer (TMF)
87.1% for specialised insurers
89.1% for self-insurers
84.9% for the system average
In August 2020, the 26-week RTW rate was:
87.5% for the Nominal insurer
90.0% for the Government self-insurer (TMF)
89.0% for specialised insurers
90.1% for self-insurers
88.2% for the system average
Average days duration of weekly benefits paid in the first 6 months
In December 2019, the average was:
29.4 days for the Nominal insurer
31.7 days for the Government self-insurer (TMF)
21.4 days for specialised insurers
19.0 days for self-insurers
28.6 days for overall scheme
Note: This measure uses work hours lost and injury quarter to calculate average days, it is reported to December 2019 to allow for claim data development.
Scheme reportable claims development
Total reportable claims by financial year at development month 2.
12,343 in 2015/16
12,257 in 2016/17
12,492 in 2017/18
13,622 in 2018/19
13,590 in 2019/20
12,904 in 2020/21
Scheme claim payments development
Total claim payments by financial year at development month 2.
$12.3 million in 2015/16
$13.4 million in 2016/17
$16.8 million in 2017/18
$17.5 million in 2018/19
$15.7 million in 2019/20
$18.9 million in 2020/21