The State Insurance Regulatory Authority (SIRA) has recovered over $10 million in workers’ compensation premiums from New South Wales employers found to be underinsured, primarily due to wage under-reporting.
The recovery stems from investigations involving 81 employers identified through data analytics and direct engagement.
Seven cases were handled by SIRA’s inspectorate, while 74 were referred to its employer enforcement team for further regulatory action.
These efforts resulted in the declaration of nearly $450 million in additional wages.
Penalty infringement notices were issued to multiple employers, including a broker, for failing to submit accurate wage declarations on time, contravening workers’ compensation requirements.
SIRA uses predictive modelling to identify discrepancies by examining claims and policy data. This data-driven approach helps the regulator detect potential underinsurance cases, which can then be prioritised for further investigation.
SIRA emphasised that underinsurance practices create added financial strain on the workers’ compensation system, undermining its integrity.
The recovery of over $10 million in workers’ compensation premiums is one of the topics covered in SIRA’s regulatory activity update for the quarter ending Sept. 30.
The report outlines actions taken across the workers’ compensation, compulsory third party (CTP), and home building compensation schemes.
SIRA contacted 1,500 employers suspected of lacking valid insurance, leading to 988 new policies and $4 million in additional premiums. An extra 5,841 employees were covered as a result.
Regulators imposed 73 penalty infringement notices and referred $1.3 million in double-avoided premium penalties to Revenue NSW for collection.
Two audits were conducted on the Nominal Insurer managed by icare, assessing indexation remediation effectiveness and hearing aid claim management.
Six new remediation plans were initiated for licensed CTP insurers, addressing claims management non-compliance. In total, SIRA monitored 16 ongoing remediation plans.
Ten new fraud investigations were initiated, with one matter resolved in court, resulting in a 12-month Intensive Correctional Order.
SIRA continued its state-wide audit of building businesses to ensure insurance obligations were met. Twelve businesses received caution notices for non-compliance.
Of five applications submitted, three were approved while two were deemed withdrawn due to subsequent insurance coverage.
SIRA continued its oversight of healthcare providers operating within its regulated schemes.
Areas of focus included identifying inappropriate billing practices, such as incorrect use of case conferencing codes and improper claims under surgeon fee orders.
SIRA has issued compliance notices and engaged with stakeholders to address these issues.
SIRA’s enforcement and compliance measures aim to protect the sustainability of the schemes it oversees while ensuring fairness for employers, policyholders, and injured workers.
These activities, supported by education and outreach initiatives, are integral to maintaining system-wide accountability.
