SIRA Logo

Terms of reference

Context

In June 2016, following extensive public consultation, the Minister for Innovation and Better Regulation announced the Government’s intention to reform the NSW CTP Scheme. The proposed reform will see the introduction of a hybrid scheme, delivering no-fault defined benefits for all injured road users, while retaining the right to claim common law damages for the more seriously injured.

This model was chosen as it was the most preferred option suggested by stakeholders that made submissions during the consultation process and best delivers against the Government’s stated objectives for CTP reform:

  • increase the proportion of benefits provided to the most seriously injured road users
  • reduce the time it takes to resolve a claim
  • reduce opportunities for claims fraud and exaggeration, and reduce the cost of Green Slip premiums.

One of two key themes which consistently emerged during consultation for the new CTP scheme related to insurer claims handling culture and that as insurers operate with a profit motive the regulator must play a role in ensuring they balance this with fairly determining and delivering a claimant’s entitlement to benefits.

The Government has commissioned the SIRA Board to conduct further consultation on how best to establish a cultural shift from a focus on lump sum negotiation towards a defined benefits scheme that provides benefits quickly to returns the road user to maximum health, work, and quality of life.

To facilitate this consultation the discussion paper Insurer claims handling and dispute resolution in Compulsory Third Party (CTP) motor accident insurance has been released by the Government.

Role and function of the SIRA Board in the consultation process

The function of the SIRA Board in facilitating stakeholder forums is to:

  • lead consultation with stakeholders to obtain their views on measures that would assist to deliver the cultural shift required by insurers and other service providers in a defined benefits scheme
  • lead consultation on options provided in the Discussion Paper in relation to dispute resolution in a defined benefits scheme
  • capture feedback on other ideas or views that would improve claims management and the resolution of disputes in the scheme
  • provide a report to the Minister documenting feedback and the merit of any alternative options for delivering the documented approaches.

In providing advice and recommendations, the SIRA Board shall be guided by the Government’s stated objectives of scheme reform, the need to ensure fairness across the scheme and the focus of a defined benefits scheme on promoting the recovery of injured road users, balanced against the need for certainty and affordability.

Exclusions

The role of the SIRA Board consultation is not to review or provide advice on the merits of a hybrid scheme or the scheme design details of the defined benefit structure and eligibility for common law as proposed by the Government in June 2016. It is only to address the details and processes and related issues as outlined in the Insurer claims handling and dispute resolution in Compulsory Third Party (CTP) motor accident insurance discussion paper.

Timeframe

The public consultation period will close on 25 November 2016. The Board will report to the Minister after this.

Membership/Chair

The consultation process will be led by the State Insurance Regulatory Authority Board members, Dr Abby Bloom and Mr Graeme Innes.

Secretariat function

Support for the SIRA Board Chair will be provided by SIRA. This will include:

  • organising meetings and inviting participants
  • issuing calls for papers and finalising agendas in liaison with SIRA Board Chair
  • record and distribute actions or outcomes for or from meetings as required
  • coordinate research as required by the SIRA Board Chair.

Meetings

The SIRA Board representative will meet with stakeholders as required and agreed.