We have commissioned an independent reviewer to undertake an integrated compliance and performance review of the NSW workers compensation Nominal Insurer. The review includes the work undertaken on icare’s behalf by its agents Allianz, EML and GIO.
The Nominal Insurer – which is managed by Insurance and Care NSW (icare) – is the largest insurer in the NSW workers compensation system and accounts for approximately 65% of total active claims. It provides workers compensation cover for more than 320,000 employers, collects $2.3 billion in premiums, and pays out approximately $1.97 billion in claim-related costs per year.
The review includes:
- independent reviewer stakeholder meetings with key employer, worker and other stakeholder groups
- an audit of compliance with legislation and relevant guidelines including the Market Practice and Premiums Guidelines (MPPGs) led by the independent actuaries
- a performance review in relation to claims management, return to work outcomes and other objectives and requirements under the legislation by the independent actuaries, and
- public consultation.
Read the discussion paper.
Terms of reference for the review
The review is led by Independent Reviewer, Ms Janet Dore, and supported by independent actuaries Ernst and Young and authorised officers of SIRA.
The review will:
- assess Nominal Insurer compliance with SIRA’s Market Practice and Premium Guidelines (MPPGs) and identify any unintended consequences, risks and priorities for improvement in SIRA regulation of the premiums of the Nominal Insurer
- identify the benefits and risks to the performance of the NSW workers compensation system arising from icare’s implementation of changes to the Nominal Insurer operating model and supporting digital platforms
- assess the Nominal Insurer’s performance in relation to return to work outcomes, claims management (including guidance, support and services for workers, employers and health service providers), customer experience and data quality and reporting.
The review will consult with interested parties to obtain information and feedback. This includes:
- public consultation through the call for public submissions or written feedback closes on 14 June 2019
- meetings with key stakeholder groups - March to June 2019
A draft report is expected to be provided in June 2019, with a final report delivered to us by August 2019. The final report and any findings and recommendations are expected to be published by the end of the year.
We will receive regular progress reports and may take immediate action on any significant compliance issues identified by the review in advance of the final report being delivered.
In commissioning the review, SIRA is exercising authority and undertaking responsibilities under:
- State Insurance and Care Governance Act 2015
- Workplace Injury Management and Workers Compensation Act 1998, and
- Workers Compensation Act 1987.
Independent Reviewer - Ms Janet Dore
Ms Dore is an accomplished senior leader who has modelled trust and integrity in her varied roles across government and not-for-profit sectors.
She is a public advocate for safety and wellbeing and for economic development to benefit communities, with a strong background in implementing operational models for achieving outcomes in personal injury schemes.
Ms Dore was the chief executive officer of the Transport Accident Commission in Victoria from 2008 to 2015 and has previously held senior executive roles in local government as chief executive officer of the Cities of Ballarat and Newcastle NSW.
Ms Dore has been Chair of the Committee for Ballarat since October 2015 and is currently Deputy Chair of the Central Highlands Water Board, Victorian Taxi Services Commissioner, Municipal Monitor at the Rural City of Ararat, and Director of the Municipal Association of Victoria (MVA) WorkCare. Her previous Board experience has included nib Health Funds, Newcastle Airport, and the Institute for Safety Compensation and Recovery Research (ISCRR).
Ms Dore is an independent member of the State Insurance Regulatory Authority’s (SIRA) CTP Premium Committee, a subcommittee of the SIRA Board, and is familiar with SIRA’s premium regulation methodologies.
Ms Dore holds a Master of Business Administration from Deakin University and is a Fellow of the Australian Institute of Company Directors.