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.
| Matter | Regulatory notice | Notice issued | Remediation 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.
| Matter | Regulatory notice | Notice issued | Remediation 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.
| Matter | Regulatory notice | Notice issued | Remediation 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.
| Matter | Regulatory notice | Notice issued | Remediation 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 |
** 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.