NSW's State Insurance Regulatory Authority (SIRA) has reprimanded QBE and IAG-owned NRMA Insurance over delays in attending to claims-related matters, breaching their obligations as compulsory third party (CTP) insurance providers.

The insurance regulator issued letters of censure to QBE yesterday and NRMA Insurance on Friday.

SIRA says its investigation into three QBE customer cases found there were delays in responding to surgery requests within the required timeframes. Last November SIRA had issued a show cause notice to the insurer for each claim, requesting a response to the investigation findings and QBE had responded confirming acceptance of the proposed findings.

“After considering the results of the investigation, QBE’s regulatory compliance history in relation to treatment and care obligations including the imposition of special licence conditions, SIRA decided the appropriate enforcement action in these cases was to issue a letter of censure,” the regulator said.

In the censure letter to QBE, SIRA said the insurer failed to determine and process the claimants’ request for treatment within 10 days of receiving the request.

The delays contravened the Motor Accident Injuries Act 2017 and QBE’s CTP insurer licence conditions.

NRMA’s breaches relate to delays in processing the weekly payments of statutory benefits in seven CTP claims.

The claims investigated were notified to SIRA through complaints to the Independent Review Office (IRO) commencing in March 2021, the regulator said.

SIRA had already issued a regulatory notice to NRMA Insurance in November 2021, requesting analysis into how the delays occurred, a remediation plan, and assurance how they will prevent similar breaches occurring.

“The remediation plan began in December 2021 and remains open,” SIRA said.

SIRA says details of the various contraventions were communicated to the insurer, which has confirmed acceptance of the findings.

“After considering the results of the investigation and the actions and submissions by NRMA Insurance, SIRA decided the appropriate enforcement action in these cases was to issue a letter of censure,” the regulator said.

SIRA is undertaking an independent verification of how insurers meet their weekly benefit obligations as part of their Insurer Claims and Conduct Assurance Program (ICCAP) and the results of this audit will be published.