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Workers compensation regulation bulletin - Issue 79 (December 2019)

Issue 79 12/2019

SIRA regulatory activity

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

The State Insurance Regulatory Authority has intensified compliance and enforcement activity during 2019 in order to deliver on our strategic goals of improving customer experience and results, maintaining scheme and policy affordability and building public trust.

SIRA’s regulatory activities are focused on areas of risk to injured people, policy holders and the workers compensation scheme. We will take strong enforcement action when needed, based on the severity of harm or potential harm, the degree of negligence, or the need for deterrence.

Key compliance and enforcement activity since 11 September through to 22 November 2019 is summarised below.

Employers

  • 11,169 businesses contacted by SIRA for potentially operating without the required workers compensation policy.
  • $135,750 in penalty notices issued to employers failing to take out compulsory workers compensation insurance.
  • 2,685 new workers compensation policies taken out by employers following SIRA regulatory intervention. This has resulted in approximately
  • $3.9M in additional premium raised from employers detected by SIRA as not having workers compensation insurance, and 7,578 more employees being covered by a workers compensation policy.
  • 17 referrals made to Revenue NSW to commence recovery action for $246,584 of avoided premiums under s156 of the Workers Compensation Act 1987.
  • One penalty notice for $500 was issued to an employer for failure to comply with a s174 Order under the Workers Compensation Act 1987 which relates to keeping and supplying records of wages and contracts.
  • 15 complaints regarding employers not providing suitable work were responded to by SafeWork NSW under delegations from SIRA. Of these, one employer was issued with a notice under s49 of the Workplace Injury Management and Workers Compensation Act 1998 requiring them to provide suitable work.
  • 19 notices were issued to employers for either failing to establish a return to work program or failing to appoint a return to work coordinator.
  • Three employers were the subject of return to work disputes which required further information to be sought to assist inspectors to make a determination. SIRA-authorised inspectors used powers under s238AA of the Workplace Injury Management and Workers Compensation Act 1998 to obtain information in relation to these return to work matters.

Providers

  • SIRA revoked its approval of 90 Allied Health Providers (AHPs) who no longer comply with SIRA requirements. Reasons included the provider no longer registered on the AHPRA (Allied Health Practitioner Regulation Agency) website.
  • SIRA revoked its approval for one AHP after they were found guilty of professional misconduct by the NSW Civil and Administrative Tribunal, which led to cancellation of the provider's registration as a physiotherapist.
  • SIRA detected a chiropractor with allegedly non-compliant billing practices and used its powers to require the provision of information as part of its investigation. SIRA is now requiring this provider to show cause as to why SIRA should not suspend or revoke the chiropractor’s approval as a workers compensation allied health practitioner.
  • SIRA detected a provider overcharging for services and the intervention resulted in the recovery of $154,552.
    Insurers:
  • In February 2019, after having identified a deterioration in the performance of the Nominal Insurer, SIRA commissioned Ms Janet Dore as an independent reviewer to conduct a Compliance and Performance Review into the Nominal Insurer. That Review is presently in its final stages with the report of the independent reviewer due to be published by SIRA by the end of the year.
  • Three formal warnings were issued to insurers for breach of licence conditions pursuant to s181 of the Workers Compensation Act 1987. Those breaches involved failures to provide timely and/or accurate claims data to SIRA.
  • SIRA is currently reviewing the performance tier for self-insurer Woolworths in accordance with SIRA’s tiering guidelines.
  • SIRA conducted audits of icare and Toll Holding as per s202A of the Workers Compensation Act 1987.
  • Twelve directions for security deposit increases were made to self-insurers under s213 of the Workers Compensation Act 1987.
  • SIRA imposed a special licencing condition on Catholic Church Insurance as a result of a case management audit.

For general enquiries, please call 13 10 50.

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