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Workers compensation bulletin - Issue 92

SIRA Regulatory activity

This is the fourth Workers Compensation regulatory activity update for 2019/20.

Regulatory activity over the last few months has been affected by the need to respond to the issues arising from the COVID-19 pandemic. SIRA has adapted the way we engage with insurers, providers and stakeholders in the scheme in order to comply with the COVID-19 restrictions established by Government. This has enabled us to continue our compliance and enforcement program, which is key to us delivering on our strategic goals of improving customer experience and results, maintaining scheme and policy affordability and building public trust.

SIRA’s regulatory activities continue to be focused on areas of highest risk to injured people, policy holders and the workers compensation scheme. SIRA takes firm and fair enforcement action as needed, based on the severity of harm or potential harm, the degree of negligence, and/or the need for deterrence.

Key compliance and enforcement activity 1 February through to 1 May 2020 is summarised below:

Employers:

  • For this reporting period, 2,767 businesses purchased a workers compensation policy after SIRA commenced non-insurance investigations. This reflects $2.58 million in additional premium raised and 5,537 more employees now being covered by a workers compensation policy. This financial year, SIRA has generated $11.84 million in policy premiums and covered an additional 25,887 NSW workers by targeting uninsured businesses.
  • During this reporting period, $84,750 in penalty notices issued to businesses who were not insured.
  • During this reporting period, $62,320 was collected from businesses as a further penalty for failing to purchase a workers compensation policy.
  • 7 referrals were made to Revenue NSW to commence recovery action for $210,330 of avoided premiums under s156 of the Workers Compensation Act 1987.
  • 13 notices were issued to employers who had failed to establish a return to work program, failed to appoint a return to work coordinator, or not provided suitable work pursuant to the Workplace Injury Management and Workers Compensation Act 1998.
  • 231 visits were made by inspectors to employers with injured workers at risk of not returning to work (as identified through predictive modelling).
  • 35 complaints regarding employers not providing suitable work were referred for investigation.
  • In response to complaints about not providing suitable work, 5 businesses were issued notices to provide information.

Insurers:

  • A quarterly conduct and compliance audit of the Nominal Insurer (icare) was undertaken under s202A of the Workers Compensation Act 1987 pursuant to implementation of the 21-Point Action Plan. The action plan is SIRA’s response to the Compliance and Performance Review of the Nominal Insurer (managed by icare).
  • SIRA requested information/data from the Nominal Insurer under s40C of the Workplace Injury Management and Workers Compensation Act 1998 in order to review PIAWE risk.
  • A self and specialised insurer self-assessment for weekly payments of compensation has been undertaken. The self-assessment reviewed actions taken by 10 insurers in response to a claim for weekly payment to ensure the appropriateness of actions taken to gather timely information to determine PIAWE, accuracy, timeliness and governance. SIRA is currently reviewing the results.

Providers:

  • Four allied health practitioners had approval to operate in the NSW workers compensation system revoked (as at 18 June 2020).
  • One referral to the Legal services commissioner regarding business practices of a legal firm in relation to industrial deafness claims.
  • Two referrals to the Health Professional Councils Authority regarding conduct of health practitioners.

SIRA and SafeWork NSW collaborate to address non-insurance

Since September 2018 SIRA has identified and initiated contact with approximately 35,000 NSW businesses which were at risk of operating without a workers compensation policy. Where SIRA does not receive an appropriate response to initial letters, SIRA issues a notice to produce evidence of a workers compensation policy.

Results of this SIRA compliance program include 8,000 new policies being taken out by businesses, covering almost 26,000 workers in NSW and accounting for approximately $12 million worth of premium into the workers compensation system. This work aids in ensuring fairness and equity for all employers and their workers.

SIRA is escalating activity in relation to those businesses that have not responded appropriately to SIRA action. Once SIRA is satisfied that the businesses are currently operational and not likely to be significantly affected by the current COVID-19 situation, SIRA and SafeWork NSW will undertake joint site visits. Visits will be prioritised based on the amount paid in wages, number of employees and potential number of years without insurance.

The visits will be undertaken by a SafeWork NSW Inspector alongside an officer from the SIRA Enforcement and Prosecutions team. The purpose of the visit is to validate our information, understand why the business has not responded and, if appropriate, pursue enforcement action against the business. SafeWork NSW Inspectors will also undertake work health and safety checks during the visit.

The visits will also provide an important opportunity for the education and capability building of the business on workers compensation and health and safety issues.

Notice of Dust Diseases Contributions for 2020-2021

SIRA has published the Dust Diseases Contributions for 2020-2021, which sets out contribution requirements for each NSW workers compensation insurer. The 2020-21 contributions, which are payable under the Workers' Compensation (Dust Diseases) Act 1942, will affect policies commencing 30 June 2020.

21-Point Action Plan progress

The 21-Point Action Plan was published in December 2019 as SIRA’s response to the Compliance and Performance Review of the Nominal Insurer (managed by icare). The plan provides a foundation for fact-based steady improvement in the performance of the Nominal Insurer and the health of the workers compensation scheme more broadly.

Work on implementing the plan has been progressing and an update on progress against the plan is now available.

Stay updated

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