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Self-insurer licensing requirements

Self-insurers are an integral part of the NSW workers compensation system.

SIRA expects self-insurers to:

  1. comply with legislation
  2. comply with their licence conditions by performing to SIRA's acceptable standards in the areas of:
    1. conduct (incorporating legislative compliance and regulatory reporting)
    2. claims management, and
    3. financial ability

Self-insurers must comply with the legislative framework including the conditions for licence continuity.

Conduct

Self-insurers must conduct themselves in accordance with legislation and demonstrate reporting of a standard acceptable to us.

As a self-insurer, you must:

  • undertake risk management practices to support your strategic direction and submit a business plan reporting such practices and direction
  • secure workplace safety by complying with the Work, Health and Safety Act 2011
  • provide accurate business intelligence reporting within our time frames and to our standards. This includes reporting claims data, changes to ownership and corporate structure, and notification of significant matters

Claims management

Self-insurers must perform claims management in accordance with legislation and demonstrate injury and claims management of a standard acceptable to us.

You must invest in the appropriate resources, develop expert capabilities, and manage claims to meet our claims management principles and standards.

Outsourcing claims management is permitted however it does not remove your responsibility to meet our expectations.

You are required to undertake a claims management self-audit using the Insurer audit manual, and lodge the report with us.

Financial ability

Self-insurers must demonstrate ongoing financial ability and strength to meet their workers compensation obligations for licence continuity.

They need to have sufficient resources to cover their financial obligations, and be of a sufficient size to provide the necessary security and reinsurance policy to mitigate the risk of insolvency.

Self-insurers must prepare and lodge a copy of their annual report (including audited financial statements) each financial year.

Supervision

We will regularly monitor and assess self-insurer performance against our standards for conduct, claims management and financial ability.

A tiered supervisory model is employed to formally acknowledge expected performance and define our risk-based regulatory oversight of insurers.

We will provide formal performance assessment and tier placement on an annual basis and as required.

Claims run-off

Should you no longer hold a self-insurer licence, you will still be held responsible for the management of the tail of claims incurred while licensed.

SIRA will continue to hold security until we're satisfied that all claims have been discharged or adequately provided for.

Renewals

SIRA grants licences up to a period of eight years.

New applicant licences are granted for a period up to three years .

After your licence expires you will need to reapply in accordance with the Self-insurer licensing requirements.

Further information

The resources below will help you comply with our self-insurance criteria.

  1. Self-insurance licensing policy
  2. Single self-insurer standard licence conditions
  3. Group self-insurer standard licence conditions
  4. Self-insurer information requirements
  5. Self-insurer s189 business information requirements
  6. Insurer audit manual