SIRA workers compensation regulatory activity update 4 - 2019-20

This is the fourth workers compensation regulatory activity update for 2019/20.

Regulatory activity over the last few months has been affected by the need to respond to issues arising from the COVID-19 pandemic.

SIRA has adapted the way it engages with insurers, providers and stakeholders in the scheme in order to comply with the COVID-19 restrictions established by Government. This has enabled us to continue our compliance and enforcement program, which is key to us delivering on our strategic goals of improving customer experience and results, maintaining scheme and policy affordability and building public trust.

Our regulatory activities continue to focus on areas of highest risk to injured people, policy holders and the workers compensation scheme. We take firm and fair enforcement action as needed, based on the severity of harm or potential harm, the degree of negligence, and/or the need for deterrence.

Key compliance and enforcement activity from 1 February to 1 May 2020 is summarised below by stakeholder group.

Compliance and enforcement activity for employers

  • For this reporting period, 2,767 businesses purchased a workers compensation policy after SIRA commenced non-insurance investigations. This reflects $2.58 million in additional premium raised and 5,537 more employees now being covered by a workers compensation policy. This financial year, SIRA has generated $11.84 million in policy premiums and covered an additional 25,887 NSW workers by targeting uninsured businesses
  • During this reporting period, $84,750 in penalty notices issued to businesses who were not insured
  • During this reporting period, $62,320 was collected from businesses as a further penalty for failing to purchase a workers compensation policy
  • 7 referrals were made to Revenue NSW to commence recovery action for $210,330 of avoided premiums under section 156 of the Workers Compensation Act 1987 (1987 Act)
  • 13 notices were issued to employers who had failed to establish a return to work program, failed to appoint a return to work coordinator, or not provided suitable work pursuant to the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act)
  • 231 visits were made by inspectors to employers with injured workers at risk of not returning to work (as identified through predictive modelling)
  • 35 complaints regarding employers not providing suitable work were referred for investigation
  • In response to complaints about not providing suitable work, five businesses were issued notices to provide information.

Compliance and enforcement activity for insurers

  • A quarterly conduct and compliance audit of the Nominal Insurer (icare) was undertaken under section 202A of the 1987 Act pursuant to implementation of the 21-point action plan. The action plan is SIRA’s response to the Compliance and performance review of the Nominal Insurer (managed by icare)
  • SIRA requested information/data from the Nominal Insurer under section 40C of the 1998 Act in order to review PIAWE risk
  • A self and specialised insurer self-assessment for weekly payments of compensation has been undertaken. The self-assessment reviewed actions taken by 10 insurers in response to a claim for weekly payment to ensure the appropriateness of actions taken to gather timely information to determine PIAWE, accuracy, timeliness and governance. SIRA is currently reviewing the results.

Compliance and enforcement activity for providers

  • Four allied health practitioners had approval to operate in the NSW workers compensation system revoked (as at 18 June 2020)
  • SIRA made a referral to the Legal services commissioner regarding business practices of a legal firm in relation to industrial deafness claims
  • SIRA made two referrals to the Health Professional Councils Authority regarding conduct of health practitioners.