Specialised Insurers Work Health and Safety Loss Management Program: assessment criteria

1. Introduction

Specialised insurers are licensed by the State Insurance Regulatory Authority (SIRA) to underwrite workers compensation risks for employers of an approved defined industry within the NSW workers compensation system.

The Work Health and Safety Loss Management Program (LMP) is the management by a specialised insurer of its work health and safety risks specific to its defined industry. The LMP provides the appropriate assistance to employers of the defined industry to ensure their work health and safety obligations are met and their workers are not exposed to health and safety risks.

2. Background

Risk management is the identification, assessment and prioritisation of risks to direct resources to resolve or mitigate and control the impact of those risks occurring.

Specialised insurers are required under their licence to provide an LMP acceptable to SIRA, which:

outlines how work health and safety risks of the defined industry are identified and monitored
assesses the work health and safety risks and documents strategies for mitigating or controlling the risks
states the assistance provided to employers to meet their work health and safety obligations
reports on the effectiveness of the LMP strategies to reduce injuries.

3. Work Health and Safety Loss Management Program assessment criteria

a. Framework

Specialised insurers must establish the context of their work health and safety LMP. The framework of the program should consist of the following four phases (as a minimum):

Planning phase
Risk management phase
Measurement & evaluation phase
Review phase

i. Planning phase

The planning phase profiles the defined industry, identifies key risks and establishes how performance will be measured in order to reduce injuries:

Develop a work health and safety risk management strategy for the defined industry
Identify key elements within the strategy that includes:
- industry-specific hazards
- high-risk activities
- injury data and emerging trends
- relevant work health and safety legislative requirements (industry-specific)
Establish measurable objectives and targets aimed at reducing injuries.

ii. Risk management phase

The risk management phase is designed to focus on implementing strategies to address and manage the identified areas of high risk.

Strategies should include the specialised insurer identifying the resources or level of support required to:

address industry-specific emerging issues
promote work health and safety initiatives and
assist insured employers to develop, implement and maintain a health and safety management system

An employer’s health and safety management system should consist of the following (but not limited to):

work health and safety policy
work health and safety responsibility and accountability
consultation and communication
work health and safety risk management process
work health and safety training
incident Investigation and reporting requirements
work health and safety records and documentation
review of health and safety management system requirements

Specialised insurers should develop a process to assist insured employers in monitoring their work health and safety performance such as the provision of a work health and safety self-audit program (audit tool). This audit tool could contain guidance materials pertaining to work health and safety legislative requirements, relevant Codes of Practice and national industry standards that would assist insured employers to comply with their work health and safety obligations.

iii. Measurement and evaluation phase

Specialised insurers should measure and evaluate the performance of their LMP. This should include:

reporting the effectiveness of each strategy in eliminating or mitigating and managing high risk activities
planning verification activity to assist insured employers in maintaining their health and safety management system

Specialised insurers could establish work health and safety control measures or intervention strategies to assist insured employers that are deemed not to be performing at the acceptable level of work health and safety performance.

iv. Review phase

The review phase is designed for specialised insurers to evaluate and review the effectiveness of their LMP against the established objectives and targets as set out in the planning section.

b. Records

Specialised Insurers should establish procedures to address record-keeping provisions such as (but not limited to) identification, collection, storage, maintenance, retrieval and disposal of LMP records, including management of confidential records.

4. SIRA compliance verification activity

SIRA will undertake compliance verification activity at least once during a standard licence term or as deemed necessary by SIRA.

Compliance verification activity may involve verification activities undertaken on the premises of insured employers.

5. Work Health and Safety Loss Management Program performance level

The overall performance level of the specialised insurer’s LMP would be deemed satisfactory by meeting the following compliance requirements:

The work health and safety risks of a defined industry have been identified, assessed and appropriately controlled
There are current objectives and targets established to measure and improve work health and safety performance of insured employers
Strategies have been developed to manage high risk activities including demonstration of the assistance provided to insured employers in meeting their work health and safety obligations
There is a proprietary or in-house verification program (to conduct monitoring activities) in order to assist insured employers in maintaining their health and safety management system requirements
The effectiveness of the LMP is evaluated against the established objectives and targets and is reported to senior management/Board.
There are processes in place to ensure the LMP is periodically reviewed, updated (as required) and approved.