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Motor accidents regulatory activity

The State Insurance Regulatory Authority’s (SIRA) compliance and enforcement activity delivers on its strategic goals of improving customer experience and results, maintaining scheme and policy affordability and building public trust.

Below you will find Information about the key compliance and enforcement activity on the NSW Motor Accident schemes.

Quarterly reports

Motor accidents regulatory update for 1 July - 30 September 2021

Latest motor accidents regulatory update

An overview of SIRA’s regulatory actions in the CTP scheme is now available for the third quarter of 2021.

Insurers

SIRA regulates six licenced insurers in the NSW CTP Scheme: Allianz, NRMA, Suncorp (brands: AAMI and GIO), QBE and Youi. Youi is a recent entrant to the CTP scheme with their licence being granted in December 2020.

Regulatory activity – 1 July 2021 to 30 September 2021

  • SIRA issued 12 regulatory notices in the quarter, bringing the calendar year to date total to 28
  • Eight remediation plans from CTP insurers were ongoing as at the end of this quarter
  • Insurers completed 8 remediation plans in this quarter (including plans started prior to 1 July 2021)
ItemALLIANZAAMIGIONRMAQBEYOUI

Regulatory notice issued in the period

1

2

1

1

7

0

Remediation plans open in the period

2

1

1

2

2

0

Remediation plans closed in the period

1

1

1

2

3

0

  • SIRA has issued 28 regulatory notices and requested 16 remediation plans from CTP insurers as at 2021
  • Insurers completed 22 remediation plans in 2021, as at 30 September.

Detailed summary of current insurer regulatory activity

*Please note that some matters relate to issues identified that have ongoing remediation and/or investigations from the previous calendar year.

Insurer detailed information

Allianz

Allianz were issued one regulatory notice between 1 July 2021 and 30 September 2021. Allianz had two ongoing remediation plans, and one remediation plan was completed. Details are outlined in the table below.

Matter
Regulatory notice
Notice issued
Regulatory activity

Communication of entitlements (MAIA)

Communicating a potential entitlement to claim damages

03/08/2021

Remediation and investigation ongoing

Incorrect premiums (MAIA)

Premiums not charged in accordance with approved filings

17/06/2021

Remediation and investigation ongoing

Internal review assurance activity (MAIA)

Non-compliance with internal review requirements

5/04/2021

Remediation completed

AAMI

AAMI received two regulatory notices between 1 July 2021 and 30 September 2021, one of which required remediation. One remediation plan was completed and one is ongoing. Details are outlined in the table below.

Matter
Regulatory notice
Notice issued
Regulatory activity

CTP Greenslip refund timeframes (MAIA)

Delay in issuing a refund for an unused CTP policy

15/09/2021

No further action required

Communication of entitlements (MAIA)

Communicating a potential entitlement to claim damages

3/08/2021

Remediation and investigation ongoing

Internal review assurance activity (MAIA)

Non-compliance with internal review requirements

5/04/2021

Remediation completed

GIO

GIO received one regulatory notice between 1 July 2021 and 30 September 2021 and completed one previous remediation plan. Details are outlined in the table below.

Matter
Regulatory notice
Notice
issued
Regulatory activity

Communication of entitlements (MAIA)

Communicating a potential entitlement to claim damages

3/08/2021

Remediation and investigation ongoing

Internal review assurance activity (MAIA)

Non-compliance with internal review requirements

05/04/2021

Remediation completed

NRMA

NRMA received one regulatory notice between 1 July 2021 and 30 September 2021. Two remediation plans were completed, and two remediation plans were ongoing. Details are outlined in the table below.

Matter
Regulatory notice
Notice issued
Regulatory activity

Communication of entitlements (MAIA)

Communicating a potential Award of Damages entitlement

3/08/2021

Remediation and investigation ongoing

Internal review assurance activity (MAIA)

Non-compliance with internal review requirements

5/04/2021

Remediation completed; investigation ongoing

Data Integrity

UCD Fault Determination

25/11/2020

Remediation completed

Incorrect weekly benefits payments (MAIA)

System error resulting in miscalculation of weekly benefits

30/10/2020

Remediation and investigation ongoing

QBE

QBE received seven regulatory notices between 1 July 2021 and 30 September 2021. Six remediation plans are ongoing and three have been completed. Details are outlined in the table below.

Matter
Regulatory notice
Notice issued
Regulatory activity

Injury coding timeframes (MAIA)

Failure to meet injury coding timeframe requirements

24/08/2021

Remediation ongoing

Timeliness of decisions (MAIA)

Delay in providing treatment decisions

28/09/2021

Remediation and investigation ongoing

Incorrect premiums (MAIA)

Premiums not calculated in accordance with approved filings

17/09/2021

Remediation and investigation ongoing

Timeliness of decisions (MAIA)

Delay in providing a liability decision

17/09/2021

Remediation and investigation ongoing

Communication of entitlements (MAIA)

Communicating a potential Award of Damages entitlement

3/08/2021

Remediation and investigation ongoing

Incorrect weekly benefits payments (MAIA)

Incorrect application of indexation to weekly benefits

13/07/2021

Remediation completed; investigation ongoing

E-Greenslip timeframes (MAIA)

Failure to transmit CTP policies to Transport for NSW within timeframes

30/07/2021

No further action required

Internal review assurance activity (MAIA)

Non-compliance with internal review requirements

5/04/2021

Remediation completed; investigation ongoing

Communication of entitlements (MAIA)

Communicating a potential Award of Damages entitlement

3/08/2021

Remediation and investigation ongoing

Timeliness of decisions (MAIA)

Delay in providing a decision in relation to a treatment request and delay in providing a liability decision

25/03/2021

Remediation completed and investigation ongoing

Youi

No issues identified.

Significant matters notified to SIRA from Independent Review Office (IRO)

IRO notified 27 significant matters to SIRA between 1 July to 30 September 2021. Significant matters are defined in the Memorandum of Understanding.

Authorised Health Practitioner activity – summary of recent activity

A total of 435 practitioners were published as active as of 30 September 2021. During the quarter two practitioners ceased in the role, and SIRA received14 applications and approved 8 practitioners.

Item1 July to 30 September 20211 January 2021 to 30 September 2021

Applications received

14

53

Approved

8

37

Applications pending

2

2

Unsuccessful

212

Authorisation ceased

2

3

Total of number of active practitioners at end of period

435

435

Previous activity

Motor accidents regulatory update for 1 April - 4 August 2021

Latest motor accidents regulatory update

Detail on regulatory actions taken are now available for the second quarter of 2021 (financial year quarter 1 April 2021 to 30 June 2021). This update includes additional year to date data and information.

SIRA regulates six licenced insurers in the NSW CTP Scheme: Allianz, NRMA, Suncorp (brands: AAMI and GIO) and QBE. Youi was granted a licence and commenced in the scheme on 1 December 2020.

Regulatory activity - 1 April 2021 to 4 August 2021*

Overview of insurer regulatory activity from 1 April 2021 to 4 August 2021. Including a collective summary of total figures for the year to date given the additional reporting outside of the usual reporting quarter.

Item

ALLIANZ

AAMI

GIO

NRMA

QBE

YOUI

Regulatory notice issued in the period

4

3

3

4

4

0

Remediation plans open in the period

2

1

1

1

2

0

Remediation plans closed in the period

0

3

4

0

0

0

  • SIRA issued a total of 18 regulatory notices in the quarter, bringing the year to date total to 23 (Jan-4 Aug 2021)
  • Seven remediation plans were opened during this period, bringing the year to date total to 9
  • In the same period, seven existing remediation plans closed in the same period, bringing the year to date total to 14

Detailed summary of current insurer regulatory activity

*Please note that some matters relate to issues identified that have ongoing remediation and/or investigations from the previous calendar year.

Insurer detailed information

Allianz

Allianz received 4 regulatory notices in the period up to 4 August 2021. Details are outlined in the table below.

MatterRegulatory noticeNotice issuedRemediation plan and investigation outcome

Communication of Insurer Internal Review decisions to injured people (MAIA)

Non-compliance with requirements

1/04/2021

Remediation plan is ongoing

Not considered for further regulatory action

Incorrect calculation of premiums (MAIA)

Premiums not charged in accordance with approved filing

17/06/2021

Remediation plan and investigation ongoing

Renewal notice delays (MAIA)

Failure to comply with renewal notice requirements

24/06/2021

Not required

Communication of entitlements** (MAIA)

Communicating a potential Award of Damages entitlement

03/08/2021

TBC

AAMI

AAMI had 8 regulatory notices issued in the period to 4 August 2021. Details are outlined in the table below.

MatterRegulatory noticeNotice issuedRemediation plan and investigation outcome

Interstate at fault vehicle damages claims* (MAIA)

Interpretation of Guidelines

22/07/2020

Closed. Investigation ongoing

CARS 2R replies* (MACA)

Failure to comply with CARS 2R Reply timeframes

05/08/2020

Closed. Investigation ongoing

Internal review timeframes* (MAIA)

Non-compliance with internal review acknowledgement and decision timeframes

10/09/2020

Closed. Investigation ongoing

Incorrect Green Slip premiums* (MAIA)

System error resulted in customers being charged incorrect premiums

06/11/2020

Closed. Not considered for further regulatory action

Green Slip price discrepancy (MAIA)

Discount not applied to renewals

25/03/2021

Closed. Not considered for further regulatory action

Communication of Insurer Internal Review decisions to injured people (MAIA)

Non-compliance with requirements

05/04/2021

Ongoing. Not considered for further regulatory action

Timeliness of treatment decisions (MAIA)

Non-compliance with timely determination of treatment and care requests

5/05/2021

Not required. Not considered for further regulatory action

Communication of entitlements** (MAIA)

Communicating a potential Award of Damages entitlement

03/08/2021

TBC. Investigation ongoing

GIO

GIO received 9 regulatory notices in the period to 4 August 2021. Details are outlined in the table below.

Matter

Regulatory notice

Notice issued

Remediation plan and investigation outcome

Permanent impairment* (MAIA)

Delay in request for insurer to concede permanent impairment

21/07/2020

Closed. Not considered for further regulatory action

Interstate at fault vehicle damages claims* (MAIA)

Interpretation of Guidelines

22/07/2020

Closed. Investigation ongoing

CARS 2R replies* (MACA)

Failure to comply with CARS 2R Reply timeframes

5/08/2020

Closed. Investigation ongoing

Internal review timeframes* (MAIA)

Non-compliance with internal review acknowledgement and decision timeframes

10/09/2020

Closed. Investigation ongoing

Incorrect Green Slip premiums* (MAIA)

System error resulted in customers being charged incorrect premiums

6/11/2020

Closed. Not considered for further regulatory action

Green Slip Price Discrepancy (MAIA)

Discount not applied to renewals

25/03/2021

Closed. Not considered for further regulatory action

Communication of Insurer Internal Review decisions to injured people (MAIA)

Non-compliance with requirements

1/04/2021

Ongoing. Not considered for further regulatory action

Timeliness of treatment decisions and payments (MAIA)

Non-compliance with timely determination of treatment and care requests

5/05/2021

Not required. Not considered for further regulatory action

Communication of entitlements** (MAIA)

Communicating a potential Award of Damages entitlement

03/08/2021

TBC. Investigation ongoing

NRMA

NRMA received 8 regulatory notices to 4 August 2021. Details are outlined in the table below.

MatterRegulatory noticeNotice issuedRemediation plan and investigation outcome

Internal review timeframes* (MAIA)

Non-compliance with internal review decision timeframes

16/10/2020

Closed. Investigation ongoing

Incorrect weekly benefits payment* (MAIA)

System issue resulting in miscalculation of weekly benefits

30/10/2020

Ongoing. Investigation ongoing

Claims without a fault determination* (MAIA)

Failure to provide fault determination

25/11/2020

Ongoing. Not considered for further regulatory action

Timeframe of liability decisions (MAIA)

Failure to comply with liability decision timeframes

25/03/2021

Not required. Not considered for further regulatory action

Communication of Insurer Internal Review decisions to injured people (MAIA)

Non-compliance with requirements

5/04/2021

Ongoing. Not considered for further regulatory action

Privacy - notifiable data breach (MAIA)

Failure to report within timeframes per licence conditions

16/05/2021

Not required. Not considered for further regulatory action

Liability notice requirements (MAIA)

Failure to comply with liability notice requirements

17/05/2021

Not required. Not considered for further regulatory action

Communication of entitlements** (MAIA)

Communicating a potential Award of Damages entitlement

03/08/2021

TBC. Investigation ongoing

QBE

QBE received 8 regulatory notices issued in the period to 4 August 2021. Details are outlined in the table below.

MatterRegulatory noticeNotice issuedRemediation plan and investigation outcome

Non-compliance with injury coding* (MAIA)

Ongoing non-compliance with MAIA 2017 injury coding timeframes

09/09/2020

Closed, investigation ongoing

Non- compliance with injury coding* (MACA)

Ongoing non-compliance with MACA 2017 injury coding timeframes

09/09/2020

Closed, investigation ongoing

Incorrect decision – notice period (MAIA)

Failure to provide prescribed period of notice before ceasing weekly benefits

01/02/2021

Not required

Timeframe of liability and treatment decisions (MAIA)

Delay in providing a decision in relation to a treatment request

25/03/2021

Ongoing, investigation ongoing

Communication of Insurer Internal Review decisions to injured people (MAIA)

Non-compliance with requirements

5/04/2021

Ongoing, not considered for further regulatory action

Incorrect application of indexation to weekly benefits (MAIA)

Failure to apply indexation to weekly benefits after the second entitlement period

13/07/2021

Ongoing, investigation ongoing

Timeframes for electronically transmitting e-green slips (MAIA)

Timeframes for insurers to electronically transmitting an e-green slip

30/07/2021

Not required

Communication of entitlements** (MAIA)

Communicating a potential Award of Damages entitlement

03/08/2021

TBC, investigation ongoing

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* Remediation plan carried over from previous calendar year
** Regulatory notice issued in August 2021 are listed as ongoing in the above table

MACA - Motor Accidents Compensation Act 1999
MAIA - Motor Accident Injuries Act 2017

Escalation of significant matters from Independent Review Office (IRO) to SIRA – from commencement 1 March 2021

In the period 1 March 2021 (commencement of the IRO) to 30 June 2021, IRO received 317 complaints. A total of 418 complaints were received as of 31 July 2021, none of which were escalated to SIRA for regulatory action.

Authorised Health Practitioner activity – summary of recent activity

A total of 431 practitioners were published as active as at 30 June 2021. During the quarter SIRA received notification of one practitioner retiring and 13 applications from health practitioners, of these 10 were approved.

Item 

1 April 2021  to  

30 June 2021 

1 January 2021 to 

30 June 2021 

Application received

13

39

Approved

10

29

Applications pending

1

1

Unsuccessful

4

10

Authorisation ceased

1

1

Total of number of active practitioners at end of period

431

431


CTP Claims and Injury Management Assurance Program
- update

  • SIRA is progressing a review into insurer conduct relating to the management and settlement of claims for the award of damages (2017 Scheme). This includes examining claims resolution and insurer duty to resolve claims justly and expeditiously.
  • A review into how insurers are assisting injured people with returning to work and usual activities has commenced. It will consider how insurers engage with the injured person's treatment providers, employer (if applicable), and rehabilitation service providers to support recovery.

Previous activity

Motor Accidents Regulatory Bulletin – issue one