Regulatory Priorities 2025-26

Executive summary

Since 2015, SIRA’s purpose has been to protect and support the people of NSW as the independent regulator of the Workers Compensation, Compulsory Third Party (CTP), and Home Building Compensation Schemes. Each year, we will publish our regulatory priorities to highlight our key focus areas as the regulator of these schemes.

For 2025-26, our regulatory priorities support SIRA’s purpose of making sure that the NSW insurance schemes protect and support people who need them, now and in the future. These priorities will help us focus on what will deliver the most significant impact and achieve the goals and objectives outlined in our new SIRA 2028 strategy.

By publishing these priorities, regulated entities and service providers are alerted to our targeted and strategic regulatory approach. As a contemporary regulator, SIRA will also continue to monitor the regulatory environment for emerging risks and respond or adjust
its priorities where necessary.

Our strategy

Our SIRA 2028 strategy emphasises our ambition to be a customer-centred, intelligence-led, risk-based regulator. We strive to achieve improved outcomes for people in NSW to ensure people are protected by affordable, stable and accessible insurance schemes and can access the support they need. We do this by striving to achieve scheme outcomes to ensure schemes are trusted, financially sustainable, and that regulated entities comply with their obligations.

Our approach to regulation

SIRA’s regulatory framework sets out how we regulate and exercise our functions under the State Insurance and Care Governance Act 2015. The regulatory framework establishes a transparent and consistent approach to our regulatory activities, enabling SIRA to meet its objectives and guide where we will deploy our resources.

In line with this framework, we focus our regulatory activities to achieve the best outcomes for scheme users and apply proportionate compliance and enforcement actions as part of a risk-based approach.

SIRA's Regulatory Priorities 2025-26

Our regulatory priorities for 2025-2026 ensure that SIRA continues to meet its principal objectives and address identified risks, issues and challenges. Risks and issues were assessed at system, scheme, regulated entity and customer level using a range of intelligence sources.

The priorities span 3 overarching themes, underpinned by key focus areas aligned to our strategic goals and objectives and where we will focus proactive efforts in the coming year. Publication of our priorities also enables regulated entities to consider their respective performance and future planning against the priority areas.

1. Regulatory environment

We will strengthen the regulatory environment by improving scheme design, policy & performance.

1.1. Improve outcomes for people with a claim

Key objectives under the NSW Workers Compensation and Compulsory Third Party (CTP) Schemes include ensuring early and appropriate treatment to support recovery from injury and return to work and activity. A key objective of the Home Building Compensation (HBC) Scheme is to ensure claims are handled efficiently and in accordance with the law, offering critical consumer protection for homeowners in NSW.

2. Strategic collaboration

We will lead strategic level collaboration to improve scheme outcomes.

2.1. Improve insurer claims practices

Insurer claims practices are integral in enabling outcomes and a positive experience for people with a claim. Engaging people with a claim and the voice of lived experience is critical in guiding our work. The NSW Government has committed to consulting key stakeholders as part of a review of claims management in the Workers Compensation Scheme to ensure claims management meets the needs of people with an injury. A review of the Home Building Compensation Scheme is also underway as part of the NSW Government’s Plan for building reform to restore faith and confidence in the industry.

3. Regulatory action

We will take strong, intelligence-led, risk-based regulatory action in line with our Regulatory Framework.

3.1. Target under and non-insurance

SIRA has functions enabling it to investigate noncompliance by building businesses with their insurance obligations under the Home Building Act 1989. Current intelligence indicates widespread business failure to insure, or underinsurance of home building projects.

Similarly, findings from a review of under and non-insurance in the workers compensation scheme suggests a significant shortfall in the premium pool.

We will focus our efforts on:

• Enforcement activities targeting non-compliant employers in high-risk industries and underinsurance locations.
• Targeting building businesses and apartment building construction non-insurance and under-insurance in relation to HBC insurance and working jointly with the Building Commission of NSW.

3.2. Target systemic non-compliance by entities

SIRA will target activities under its Regulatory Framework to priorities that will have the most significant impact on outcomes. Tailored supervision strategies ensures SIRA responds to emerging issues at a regulated entity level with regulatory activities proportional to risk. This includes specific supervision strategies for entities with the greatest impact, including icare.

SIRA has powers under the State Insurance Care and Governance Act 2015 to regulate relevant service providers including (but not limited to) medical practitioners, allied health practitioners, workplace rehabilitation providers, and medico-legal providers.

We will focus our efforts on:

• Strengthened and consistent supervision of relevant service providers targeting systemic non-compliance and inappropriate servicing or billing.
• Strong, consistent and intelligent led supervision of regulated entities in line with SIRA’s regulatory framework and entity supervision strategies.

3.3. Fraud investigations and enforcement activities

Fraud investigations and enforcement activities maintain the integrity of the insurance schemes SIRA regulates.

SIRA has a comprehensive Fraud Framework that outlines its approach to deter, detect, and respond to fraud.

We will focus our efforts on:

• Collaborating with NSW Police and other regulators to improve joint investigations
• Leveraging data analytics and intelligence to support comprehensive and timely evidence gathering.
• Prosecuting fraudulent activities.

How we will measure and report against our progress

We have identified and prioritised a range of activities and projects aligned to the regulatory priorities and focus areas throughout 2025 to 2026.

These activities span the four regulatory pillars from our Regulatory Framework (design, licence, supervise and enforce) and rely on the spectrum of SIRAs regulatory toolkit.

Our progress will be monitored regularly with updates provided. We will publicly report against our progress with key information provided in our quarterly regulatory updates, our SIRA Bulletins or other publications, in addition to our annual reporting.