Special licence conditions imposed on NRMA Insurance and QBE
11 October 2022
SIRA has imposed special licence conditions on Insurance Australia Limited (trading as NRMA Insurance) and QBE Insurance (Australia) following an audit of claims management, specifically in relation to treatment and care.
The audit commenced in June 2022 as the scheduled first quarter activity in the Insurer Conduct and Claims Assurance Program (ICCAP).
SIRA identified issues with both NRMA Insurance and QBE’s claims management in relation to delivering on their treatment and care decision obligations.
These issues were apparent despite SIRA initiating improvement plans for NRMA Insurance and QBE after poor compliance scores in relation to treatment and care measures in their annual self-assessments.
In addition, NRMA Insurance and QBE had previously been directed to remediate following non-compliance with treatment and care obligations.
This is the first time that special licence conditions have been imposed on insurers in the NSW motor accidents scheme.
SIRA will manage the remediation of each insurer through the following special licence conditions:
- The licensee must develop and provide to SIRA for approval an updated remediation plan by 30 September 2022.
- The remediation plan must respond to the compliance findings identified in the licensee treatment and care ICCAP report to ensure systematic compliance is embedded across all areas where substantial compliance was not demonstrated.
- The remediation plan and associated reporting requirements must be prepared in line with SIRA’s remediation plan expectations.
- The licensee must implement the remediation plan as approved by SIRA in accordance with the timescales in that plan and provide SIRA with a monthly update on the implementation of that plan by the 15th day of each month.
SIRA will increase oversight of both NRMA Insurance and QBE to ensure that appropriate remediation steps are taken to improve injured person’s access to entitlements through timely and transparent insurer decision making related to treatment and care.