Workers compensation system monthly report
September 2018 report - published June 2019
System overview
Key workers compensation system statistics for the 12 months ending September 2018
- $253 billion of reported wages are safeguarded by the workers compensation scheme
- $3.6 billion in premiums were collected, representing 1.4% of reported NSW wages1
- $2.9 billion was paid out as costs for workers claims
- 98,685 claims were reported to SIRA
- 77,671 workers received weekly benefit payments
1For the 2017/18 financial year
Effectiveness
System effectiveness in protecting workers and getting workers back to work and wellbeing
Reportable claims
- 8,525 were reported in September 2018
- 9,638 were reported in August 2018
- 7,467 were reported in September 2017
Return to work rates
- 4 weeks: 67.6%
- 13 weeks: 81.5%
- 26 weeks: 87.5%
Claim types
Of the 8,525 reportable claims in September 2018, 93.3% (7,957) were related to physical injuries and 6.7% (568) were related to psychological injuries.
Claims by body locations
- Head: 10.3%
- Neck: 1.9%
- Upper limbs: 34.3%
- Trunk: 17.9%
- Lower limbs: 19.9%
Also:
- Psychological: 6.7%
- Multiple locations: 5.6%
- To be confirmed: 2.8%
- Systemic locations: 0.7%
Efficiency & viability
Efficient system delivery, sustainability, and viability of the system for generations to come
Total claim payments made by insurers
In September 2018, the Nominal insurer made payments worth approximately $170 million, Government self-insurers (TMF) $49 million, specialised insurers $14 million and self-insurers $15 million.
Claim payment types
The breakdown of claim payment types in September 2018 is as follows:
- Weekly payments: 37.3%
- Medical payments: 27.9%
- Common law (WID): 16.0%
- Rehabilitation payments: 5.8%
- Lump sum (S66 & S67) payments: 4.9%
- Death payments: 1.4%
- Investigation payments: 2.2%
- Other payments: 2.0%
- Legal payments: 1.9%
- Commutations: 0.6%
Total claim payments made by insurers
- September 2018: $248 million dollars paid in claim payments
- August 2018: $299 million dollars paid in claim payments
- Claim payments: Down 17.0% based on data provided by insurers at the end of September 2018. Please note this may increase should late running reports of payments be supplied by insurers after the September data submission.
Benefits paid to and for workers as a percentage of total claims expenditure
Of the total expenditure across the system in 2017/18, 45% was made on payments to claimants and 24% was spent to make payments for the claimants. Insurer expenses across the system was 31% of the total expenditure.
Note: The benefits paid to and for workers is calculated annually. Details of definitions can be found in the methodology and data section. Data sourced from the information insurers provide to SIRA as at the financial year 2017/18.
Customer experience & equity
Customers’ experience with the system is positive and equitable
Enquiries and complaints
SIRA received 2,212 enquiries in September 2018. There were 244 complaints received in the same period.
Note: Complaint data (which may include the name of an insurer) is derived from verbatim reports from customers. While SIRA does some data cleansing, the reporting is verbatim from customers and might occasionally reference an incorrect insurer and/or insurer type.
Disputes lodged
In September 2018, the dispute rate was 0.6%, with 92,478 active claims and 576 disputes lodged.
Note: Including data from WIRO (Workers Compensation Independent Review Office) and the Workers Compensation Commission
Workers perceptions of equity across the workers compensation system
Jurisdiction | Distributive justice Average (mean) on a 5 point scale | Procedural justice Average (mean) on a 5 point scale | Informational justice Average (mean) on a 5 point scale | Interpersonal justice Average (mean) on a 5 point scale |
|---|---|---|---|---|
New South Wales | 3.9 | 3.8 | 3.7 | 4.3 |
Australian Total | 3.9 | 3.8 | 3.7 | 4.3 |
Definitions of dimensions used to measure customers perception of equity and perceived justice:
- Distributive justice relates to the fairness of their compensation.
- Informational justice is about receiving accurate and timely information about the rationale for decisions.
- Interpersonal justice relates to whether workers were treated with respect and sensitivity.
- Procedural justice is about the fairness of the procedures used to determine the outcomes.
Source: Safe Work Australia 2018 Return to Work Survey
Affordability
Insurance affordability
Affordability of insurance is 1.4%, as a percentage of reported NSW wages for 2017/18.
NSW workers compensation insurer scorecard
Information about the performance of insurers operating within the workers compensation system
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Nominal insurer | 74% | 67% | 69% | 67% | 98% | 0.2% | 65% | 80% | 87% |
Government self insurer (TMF) | 13% | 16% | 20% | 19% | 100% | 0.2% | 78% | 87% | 90% |
Specialised Insurers | 6% | 8% | 5% | 6% | 94% | 0.2% | 74% | 84% | 88% |
Self insurers | 7% | 9% | 6% | 8% | 97% | 0.4% | 72% | 83% | 88% |
Note: Insurers reported this data to SIRA. Data is as at September 2018.
While reasonable care has been taken in preparing this document, the State Insurance Regulatory Authority (SIRA) makes no warranties of any kind about its accuracy, currency or suitability for any particular purpose. SIRA disclaims liability for any kind of loss or damages arising from, or in connection with, the use of any information in this document.
SIRA identified data quality issues with the accuracy and completeness of return to work data submitted by the Nominal Insurer (NI). The data appears to indicate a significant deterioration in the NI’s RTW performance. SIRA instructed the NI to improve the quality of the data. To address the data quality and potential performance concerns with the NI, SIRA carried out a data quality audit in December 2018 and commenced a Compliance and Performance Review in February 2019.
Download the report (PDF, 1 MB) and the methodology and summary data tables (Excel worksheet, 224 KB) used to support this report. If you have trouble accessing content within these reports, please send an email to [email protected] or call us on 13 10 50.
Website www.sira.nsw.gov.au | Catalogue no. SIRA08971 | © State Insurance Regulatory Authority 0619