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Premium disputes

If you disagree with the premium calculation there are ways to get the matter resolved.

SIRA is the regulator of the workers compensation system in NSW. Our job is to ensure the system:

  • provides support for workers if they get injured
  • is affordable for employers, and
  • is sustainable for the NSW economy.

One of the ways we do this is by providing information, support and advice for employers who are having a dispute over their premium calculation.

For policies up to 30 June 2016

This is for policies commencing before 4pm on 30 June 2016 (regardless of when the dispute happened).

Insured with icare through one of their insurance agents

In the first instance you should seek an internal review of the premium from icare.

If you still disagree and you believe your premium calculation does not comply with the applicable Insurance Premiums Order, you can make a request for SIRA to resolve the dispute.

We must receive the application within one month of you receiving notification of the premium calculation (we can sometimes extend this timeframe under special circumstances).

The application form must be completed correctly, so if you have any questions we suggest you call us and we can answer them before you submit the form.

You still have to pay the premium during this process. If your appeal results in a revised premium calculation then the premium will be adjusted accordingly.

To request an application form, please contact our Regulatory Reviews branch via email to regulatory.reviews@sira.nsw.gov.au.

Insured with a specialised insurer

Discuss the matter with your insurer.

If you believe the insurer has not appropriately dealt with the matter at a senior level, ask for the matter to be considered in line with their internal dispute procedures.

There is no formal right of appeal to SIRA regarding the decision of a specialised insurer.

For policies after 30 June 2016

This is advice for policies commencing on or after 4pm on 30 June 2016 (regardless of when the dispute happened).

Insured either with icare or insured with a specialised insurer

In the first instance you should seek an internal review of the premium from your insurer.

If you still disagree and you believe your premium calculation does not comply with the premium filing as per SIRA’s  Market Practice and Premiums Guidelines (MPPG) for a particular year (MPPG for 2017,  2018 revised and 2020 revised), you can refer the matter to SIRA.

An application for a SIRA Regulatory Review must be lodged within 28 days of the outcome of the internal review conducted by your insurer, together with a copy of your insurer’s internal review decision.

To request a Regulatory Review, please contact SIRA via email at: regulatory.reviews@sira.nsw.gov.au

Note: If your complaint is about your insurer’s claims management, conduct or an administrative issue please contact SIRA Assistance Service via email at contact@sira.nsw.gov.au or phone on 13 10 50 (as such matters are not within scope for a Regulatory Review).

Regulatory Review conducted by SIRA

A premium dispute may relate to, for example, the effect of the cost of claim from a previous period, the determination of the workers compensation industry classification (WIC), or wage calculation (including whether a person is a worker or a contractor for workers compensation premium purposes).

Once a review application for a premium dispute has been received by SIRA, SIRA’s Regulatory Reviews branch will determine whether the premium has been calculated in accordance with the approved formula in your insurer’s premium filing.

A SIRA Regulatory Review does not consider whether the premium principles of the relevant MPPG has been complied with when calculating an employer’s individual premiums. This has been considered when the insurer’s premium filing for the year was approved by SIRA.