SIRA bulletin - Issue 18
Changes to handling of disputes and insurer complaints from 1 March
The new Personal Injury Commission and Independent Review Office will commence operations from 1 March 2021. This will change the way workers compensation and CTP claim disputes and complaints about insurers are managed.
Personal Injury Commission
From 1 March disputes regarding workers compensation and CTP insurance claims will be managed by the Personal Injury Commission, a single tribunal that replaces both the Workers Compensation Commission and SIRA’s Dispute Resolution Services.
Contact details effective from 1 March 2021 will be:
Website: www.pi.nsw.gov.au (going live on 1 March)
Telephone: 1800 742 679
Email Address: [email protected]
Independent Review Office (IRO)
From 1 March the IRO will receive complaints about CTP insurers in the claims process, from both injured road users who are claimants and their representatives. The IRO (previously known as the Workers Compensation Independent Review Office or WIRO) will continue to manage complaints from injured workers about workers compensation insurers.
SIRA will continue to undertake regulatory investigation and enforcement action in relation to complaints in both schemes.
Contact details effective from 1 March 2021 will be:
Website: www.iro.nsw.gov.au (going live on 1 March)
Telephone: 13 94 76
Email Address: [email protected]
Your new go-to-channel for the latest SIRA news
The new SIRA hub goes live today, your new channel for reading about the latest SIRA updates, activities, programs, consultations, research and more. The stories on the SIRA hub explain why we are doing what we are doing and what it means for our stakeholders.
Currently, the hub is populated with some new articles as well as stories from previously published bulletins (SIRA, Workers Compensation, and Motor Accidents Bulletins). You will be able to filter articles by date, scheme and publication type, search for keywords and discover related information.
The SIRA hub is part of an improvement project to enhance digital engagement with our stakeholders. You are encouraged to review the site and send feedback or suggestions via the online form or by emailing [email protected]
Learn more about the SIRA hub and start exploring this new resource now.
A new standard for the management of psychological injury claims will take effect from 1 March 2021
Following public consultation, SIRA has introduced a new standard for insurers managing psychological injury claims. The new standard (Standard 33) is included in the existing workers compensation Standards of practice: Expectations for insurer claims administration and conduct.
Standard 33 is based on the principle that psychological injury claims are to be managed with empathy and a strong focus on early treatment, tailored communication, and timely recovery and return to work. Learn more about the updated standard.
SIRA continues three support programs following increased uptake
SIRA recently approved the continuation of three workers compensation support programs for workers, employers, and small business owners. The move follows growing uptake of the programs over the past year.
Recover at Work Assist for small business provides eligible small businesses with payments of up to $400 a week for six weeks. These payments help small businesses provide suitable work to a worker, by helping offset the costs of covering the worker’s usual duties while they recover at work.
Connect2work was introduced in response to the COVID-19 pandemic. It pays host employers $200 a week to provide work placement of 15 hours or more per week to a worker recovering from a work-related injury or illness. The payments aim to offset the costs associated with providing supervision to a worker.
The JobCover6 program was also introduced in response to the COVID-19 pandemic. It has been modified slightly for continuation. The program provides financial incentives to employers who offer up to six months employment to a worker recovering from a work-related injury, where that worker is looking for new employment.
Learn more about these programs and any changes to eligibility.
Now available: CTP Insurer claims experience and customer feedback comparison report December 2020
The sixth issue of the CTP Insurer claims experience and customer feedback comparison report is now available on SIRA’s website:
The December 2020 report compares insurers in the NSW CTP scheme on a range of evidence-based indicators which measure insurer performance. Reports like these help facilitate informed discussions about insurer performance and help customers make meaningful comparisons between insurers.
Key findings in the report, which compares data from 2019 and 2020, show that
- over 98% of claims were accepted in both years
- the most common reasons for claim denial included late lodgement, insufficient information, and the claim not involving a motor vehicle accident
- 73% of injured people received ‘pre-claim support’ in 2020, with a further 22% accessing treatment and care services within the first month (consistent with 2019)
- all insurers increased the percentage of injured people that received income support within the first month, and the total increase was up from 50% in 2019 to 54% in 2020.
Customers can also access this information in the ‘Insurer comparison report’ on the Green Slip website.
The December 2020 data is available on the CTP Open Data Portal which includes additional new metrics on Insurer Internal Review timeframes. SIRA will continue to include these additional measures in subsequent reports.
Motor Accident guidelines updated
The Motor Accident Guidelines have been updated to reflect how claims are managed following commencement of the Personal Injury Commission Act 2020. From 1 March 2021, SIRA’s Dispute Resolution Service, Claims Assessment and Resolution Service and Medical Assessment Service will cease operation, and the Personal Injury Commission will be established.
The new Claims Assessment and Medical Assessment Guidelines for the 1999 Compulsory Third Party (CTP) Scheme have been published online.
The 1999 guidelines apply to pre-1 March 2021 matters not yet finalised under the Claims Assessment and Resolution Service (CARS) and Medical Assessment Service (MAS) system. For new matters after 1 March 2021, the procedures set out in the Personal Injury Commission Rules 2021 will apply.
Motor Accident Guidelines version 7 for the 2017 CTP scheme has been published and commences on 1 March 2021
The 2017 guidelines continue to apply to insurer internal reviews and some regulatory matters relating to disputes in the Personal Injury Commission.
Have your say: ‘CTP for taxis and hire vehicles in the point to point industry’
SIRA is seeking feedback from insurers, people, and organisations involved in providing passenger services, as well as other interested stakeholders on the proposed draft Compulsory Third Party (CTP) premium-setting solution for the point to point (P2P) industry.
The proposed draft solution could replace how P2P premiums are currently determined and paid, which is based on distance travelled, and which was introduced as part of the transitional requirements under the Motor Accident Injuries Act 2017 (the Act).
Have your say CTP for taxis and hire vehicles in the point to point industry now.
User experience testing - help improve our website
As SIRA works to improve communication and engagement with stakeholders, we are calling for interested parties who visit our website to participate in a 15-20-minute human centered design activity. Your participation will help us find ways to improve your experience of the SIRA website.
If you are interested, please email [email protected] by COB Thursday 4 March and help shape the online resource you want to see.
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