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icare criticised over return to work data accuracy

NSW insurer icare has been censured by the State Insurance Regulatory Authority (SIRA) over “data accuracy issues” in relation to return to work rates.

But icare, which runs the Nominal Insurer workers’ compensation scheme, told insuranceNEWS.com.au it has been supplying accurate data for more than a decade and that the problem relates to a “misalignment” between the two organisations.

SIRA told insuranceNEWS.com.au it has “engaged extensively with icare since 2018 on its return to work performance and data quality issues”.

It says it directed icare to collect data in a number of categories in June last year, including when injured people cease and return to work.

However, an audit carried out in September found “continued non-compliance” in all but one category.

“One of the key objectives of the Workplace Injury Management and Workers Compensation Act 1998 is timely and sustainable return to work,” SIRA said.

“Accurate data from insurers is central to SIRA’s ability to assess return to work performance.”

icare has been “issued with a letter of censure” and SIRA has not ruled out further action.

“SIRA will conduct quarterly audits of the [Nominal Insurer], with the first of these audits presently underway,” it said.

“These will include an audit of data requirements until SIRA is assured that the [Nominal Insurer] is providing accurate data. SIRA may also consider further regulatory action of the audits if necessary.”

SIRA also fined icare $82,500 last month for ten instances of non-compliance with premium rate capping requirements.

An icare spokeswoman told insuranceNEWS.com.au that its return to work metric, which is available on its website, “has delivered accurate data for over a decade”.

“The issue resulted due to a misalignment of data between SIRA and icare,” the spokeswoman said.

“We continue to work with SIRA to align data collection for SIRA’s new return to work metric and to clarify interpretation and consistency of SIRA’s technical definitions, which was introduced in 2018.”

The spokeswoman says the capping requirements breaches have already been resolved.

“Of the 326,000 premium notices issued annually by icare, SIRA identified five instances where NSW businesses with poor work health and safety performance were notified of their full premium increase, instead of their premium notice reflecting an increase capped at 30%.

“An internal review by icare identified and informed SIRA of a further five NSW businesses where the cap was not applied on their notice. icare rectified the issue and amended notices were then issued.”

Last year SIRA commissioned a review of the Nominal Insurer scheme, partly in response to growing concern about its operation.

Independent reviewer Janet Dore published her findings in December, making 13 recommendations for improvement.