New requirements for insurer claims administration and conduct

notice | 24/12/2018

SIRA has created new standards of practice and guidelines for insurers to improve outcomes in the workers compensation system.

The Standards of practice, Workers compensation guidelines and Workers compensation medical dispute assessment guidelines, were released today (21 December) and will take effect on 1 January 2019.

The standards of practice will support and encourage insurers to have effective claims management practices to help deliver positive experiences and outcomes for workers, employers and the people of NSW.

They are supported by streamlined and consolidated Workers compensation guidelines which have been published in the Government Gazette on the NSW Legislation website today.

The workers compensation guidelines replace the:

  • Guidelines for claiming workers compensation (1 August 2016)
  • Guidelines on injury management consultants (27 September 2012)
  • Guidelines on independent medical examinations and reports (13 March 2012).

Workers compensation medical dispute assessment guidelines have also been gazetted. They replace the WorkCover medical assessment guidelines 2006 and complement reforms to the dispute resolution process.

The WorkCover interim payment direction guidelines 2009 have been revoked. Instead, stakeholders should refer to the Workers Compensation Commission’s practice direction no. 10 Interim payment directions for weekly payment of compensation or medical expenses compensation (30 October 2018).

Visit SIRA’s claims handling requirements webpage for more information about the standards and guidelines. This page also has information about the online platform SIRA is building to improve access to information about workers compensation claims management.