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Complaints about insurers

You can tell us if you have a complaint about an insurer’s products, services or staff. We can assess, review and attempt to resolve the complaint. This process is different for each type of insurance scheme.

We provide a service to help resolve complaints that concern insurer ‘non-compliance’ (eg not complying with the law, licence conditions or proper administration of the guidelines). Complaints about insurers can extend to their scheme agents or their service providers.

A dispute is different to a complaint. Disputes occur where there is disagreement between a claimant and an insurer about an insurer’s decision.

Complaints about a CTP insurer

We will acknowledge a complaint about a CTP insurer within five working days of receipt. You will be given the name and telephone number of the person handling your complaint as well as information relating to the action we’re taking.

To be fair to both parties, we will ask for your consent to refer your complaint to the insurer and get their response. The review may involve interviewing the relevant insurer’s staff or inspecting the claim file at the insurer’s premises.

During the review process we determine whether the insurer has been non-compliant or has dealt with the matter inappropriately.

After the review is complete, we will advise you of the findings.

How to make a complaint

To make a complaint, first speak to the insurer and try and resolve it directly with them. If you are not satisfied with the outcome, contact our CTP complaints team:

If you have a dispute about the insurer’s decision relating to your claim, see motor accidents injury disputes.

Numbers to call if you have a speech or hearing impairment, or need an interpreter

  • voice calls or telephone typewriter (TTY) call 133 677 then ask for 13 10 50
  • speak and listen service call 1300 555 727 then ask for 13 10 50
  • SMS relay service on 0423 677 767 then type13 10 50
  • make an internet relay call then type 13 10 50

If you require an interpreter, contact the National Telephone Interpreter Service on 13 14 50.

Complaints about a workers compensation insurer

Once a complaint has been made about a workers compensation insurer, our advisory services will attempt to resolve the complaint by giving you information and working out what the issue is. If they can’t do this, if you agree, they will contact the insurer to advise them of your complaint. The insurer will have two working days to contact you to resolve the issue.

If your complaint is not resolved with your insurer or you remain dissatisfied, contact us again and your complaint will be escalated to our customer care team. They will review your complaint directly with your insurer and try to resolve the matter within a period of 20 days. You will be provided the name and contact details of the case manager managing your complaint.

After we have all information available to us, we will discuss the matter with both parties.

If we are unable to facilitate a satisfactory outcome you can take the complaint to the Workers Compensation Independent Review Office (WIRO). This option is available to you at any time before or during a complaint.

How to make a complaint

First speak to the insurer about the issue and try and resolve it directly with them. If you are not satisfied with the outcome, contact our advisory service:

Numbers to call if you have a speech or hearing impairment, or need an interpreter

  • voice calls or telephone typewriter (TTY) call 133 677 then ask for 13 10 50
  • speak and listen service call 1300 555 727 then ask for 13 10 50
  • SMS relay service on 0423 677 767 then type13 10 50
  • make an internet relay call then type 13 10 50

If you require an interpreter, contact the National Telephone Interpreter Service on 13 14 50.

If you have a dispute about the insurer’s decision relating to your claim, see workers compensation disputes.

Complaints about a home building insurer

We can only assist you with a complaint about a home building compensation insurer. If you have a complaint or dispute about a building or trades contractor, contact NSW Fair Trading.

Concerns about claims outcomes can generally be addressed directly with insurers or by escalation to a court or the NSW Civil and Administrative Tribunal. Concerns about eligibility decisions need to be raised through icare’s disputes process.

SIRA does not do merit reviews of claims or eligibility decisions. However, if you have concern than an insurer has breached its obligations under the Home Building Act 1989, including associated market practice and claims handling guidelines, you can report these matters to SIRA or via NSW Fair Trading.

How to make a complaint

First speak to the insurer about the issue and try and resolve it directly with them. If you are not satisfied with the outcome, contact our advisory service:

Numbers to call if you have a speech or hearing impairment, or need an interpreter

  • voice calls or telephone typewriter (TTY) call 133 677 then ask for 13 10 50
  • speak and listen service call 1300 555 727 then ask for 13 10 50
  • SMS relay service on 0423 677 767 then type13 10 50
  • make an internet relay call then type 13 10 50

If you require an interpreter, contact the National Telephone Interpreter Service on 13 14 50.

If you have a dispute about the insurer’s decision relating to your claim, see home building compensation disputes.