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Increasing transparency and accountability in the workers compensation scheme

notice | 10/09/2019

The Hayne Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry, and the more recent APRA Capability Review, made a series of recommendations regarding transparency of regulatory action.

We have closely considered those findings and taken a decision to be more proactive in publishing details of scheme and insurer performance and compliance and enforcement activity from 2019/2020.

While there will always be some limits to what can or should be published, we are committed to meeting community expectations and believe that more transparency is in the best interest of SIRA’s customers and will ultimately help to deliver on our strategic goals of improving customer experience and results, maintaining scheme and policy affordability and building public trust.

Easier access to scheme data

We have released a new open data tool. It’s a self-service visual analytics tool that will make it easier to view scheme performance data over time. The portal is another way that SIRA is improving transparency and accountability in the Workers Compensation scheme.

It has been built with the input and support of WIRO, the Workers Compensation Commission and a range of other stakeholders and commentators. SIRA would like to thank them for their assistance.

The open data application is an example of the NSW Government’s Open Data Policy improving community access to information.

Publishing SIRA's enforcement and compliance activity

This is the first Workers Compensation enforcement and compliance update. It is a summary of compliance and enforcement activity from 1 July 2019. We will continue to build on and improve the information over time. Key activity for the period is outlined below.

Employers

  • 155 penalty notices approved for the amount of $750 each, issued pursuant to s155 of the Workers Compensation Act 1987, for employers failing to take out compulsory workers compensation insurance.
  • $3.4M in additional premium raised, from employers detected by SIRA as not having workers compensation insurance.
  • 4,556 additional employees now covered by workers compensation insurance (noting that icare does provide cover in the event of a business failing to have a workers compensation insurance policy).

Providers

  • 49 caution letters sent to medical practitioners/providers regarding compliance obligations.
  • Seven education letters sent to insurers to leverage practitioner/provider compliance.
  • One medical practitioner and one allied health practitioner subjected to SIRA site visits using powers under s238AA of the Workplace Injury Management and Workers Compensation Act 1998 to obtain information.
  • Two providers subjected to SIRA’s investigative powers pursuant to s238AA of the Workplace Injury Management and Workers Compensation Act 1998, due to suspected duplicate invoicing, overcharging and over-servicing.
  • Investigations commenced against one provider for failure to comply with SIRA inspectors under s238 of the Workplace Injury Management and Workers Compensation Act 1998. Potential maximum penalty of $11,000.

Insurers

  • 86 notices issued under section 40B of the Workplace Injury Management and Workers Compensation Act 1998 (data gathering power) to obtain information for suspected legislative breaches.
  • Two insurers, Catholic Church Insurance Limited and Veolia Environmental Services (Australia) Pty Ltd, notified of SIRA’s intention to impose new licence conditions.
  • Catholic Church Insurance Limited was issued three penalty notices with respect to non-compliance with claims management practices within their portfolio.
  • Civil penalties imposed on the Nominal Insurer in relation to 24 breaches of s267 of the Workplace Injury Management and Workers Compensation Act 1998 (duty to commence weekly payments following initial notification of injury).
  • Direction notice issued to the Nominal Insurer under s194 of the Workers Compensation Act 1987 (directions to insurers with respect to claims procedures) requiring compliance with Return to Work data items from 1 August 2019.
  • Nine formal warnings issued for breach of licence conditions pursuant to section 181 of the Workplace Injury Management and Workers Compensation Act 1998, in respect of the failure to provide timely and/or accurate claims data to SIRA:
    • Coles Group Limited
    • Racing NSW
    • Inghams Enterprises Pty Ltd
    • Statecover Mutual Limited
    • Toll Holdings Limited
    • Central Coast Council
    • NSW Trains
    • Boral Limited
    • Bluescope Steel Limited.
  • Five notices issued under s238AA of the Workplace Injury Management and Workers Compensation Act 1998 (notice served by an inspector, with the power to obtain information) in relation to claims information.