SIRA begins performance audits at icare – Daily – Insurance News


SIRA begins performance audits at icare

1 November 2022

NSW’s State Insurance Regulatory Authority (SIRA) has kicked off a series of audits to address concerns about the performance of the Nominal Insurer, which is managed by icare, and the time it is taking to implement case management improvement initiatives.

SIRA, which will publish the results of each quarterly audit once completed, had previously agreed to delay audits to allow time for icare to implement its Nominal Insurer Improvement Plan.

The first audit, underway this month, will assess management of claims and return to work activities within the first four weeks. The main focus will be application of Standards of Practice for managing injury, psychological injury and return to work – early intervention.

Up to 50 recent claims with a significant injury – of which 35 are physical injury claims and 15 psychological injury claims – will be reviewed. SIRA will also interview frontline case managers to determine their understanding and application of legislation, guidelines and Standards of Practice.

Future quarterly audits will look at various aspects of icare improvement plans, including progress delivery insights and the effectiveness of remedial efforts on case management practices.

Last month, SIRA issued a letter of censure to icare after it disclosed the personal and health information of injured workers through an email attachment sent to the wrong recipients.

It cited a lack of appropriate safeguards and said some aspects of the response were unsatisfactory.

The privacy breach was caused by the incorrect transcription of employer email addresses and policy numbers in a spreadsheet before the cost of claims reports were sent out via a distribution list.

Some employers received information about injured workers whose claims they had no involvement with. Claim reports referring to 192,000 injured workers were sent to about 570 incorrect recipients.

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