CTP Insurer Claims Experience and Customer Feedback Comparison - Sept 2022

SIRA is committed to making strong, consistent and evidence-based decisions on enforcement action.

SIRA engages with law enforcement agencies, particularly the NSW Police Force, to deter and investigate fraudulent activity in the CTP scheme. SIRA’s regulatory activities are focused on areas of highest risk. Firm and fair enforcement action is taken as needed, based on the severity of harm or potential harm, the degree of negligence, and/or the need for deterrence.

The regulatory activities outlined below are supported by SIRA’s education and support initiatives. Together, these ensure that the motor accidents scheme is fair, affordable, and effective, and achieves public outcomes.

SIRA receives information on matters for potential enforcement and prosecution action through a range of regulatory monitoring activities:

The following enforcement and prosecution options are available to SIRA:

• Education
• Notification of breach
• Letter of censure
• Penalty provisions
• Criminal prosecution and licencing withdrawal
• Publication of information on breaches or poor performance.

For more information about how SIRA approaches its compliance and enforcement activities, please refer to SIRA’s Compliance and Enforcement Policy.

From 1 October 2021 to 30 September 2022, SIRA had 41 active matters under investigation relating to alleged insurer breaches of their obligations under the Motor Accidents Compensation Act 1999 (1999 Scheme) and the Motor Accident Injuries Act 2017 (2017 Scheme) and guidelines. A total of 8 matters were finalised during this period, which includes matters received prior to October 2021. The remaining are under investigation.  Please note that investigations may involve complex systemic issues affecting multiple claims and/or customers and may result in more than one enforcement action.

Table: Completed Investigations

Table: Regulatory Action

In 2 occasions, the letter of compliance sent to Suncorp was addressing both AAMI and GIO. Those notices are counted separately in the above table.