Table 7.8: Other ongoing licence requirements

 

Compliance with legislation

Ongoing licence requirements

Other matters

New South Wales

Self-insurers must comply with all statutory requirements and conditions of licence for licence continuity. Failure to meet such requirements may constitute a basis for licence suspension, cancellation or non-renewal. Before taking such action SIRA will provide the self-insurer a reasonable opportunity to rectify any breach.

Self-insurers must comply with all statutory requirements and conditions of licence for licence continuity. SIRA undertakes ongoing monitoring and review of self-insurers. Self-insurers provide specified information four months after their financial year end to enable an annual review (refer to Table 6.9 Reporting Requirements).

Specialised insurers have a period of 3 months from financial year end to submit specified information. State government self-insurers must provide audited financial statements within 5 months of financial year end, once they are tabled in parliament.

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Victoria

 

  • WorkSafe Victoria will monitor the self-insurer’s compliance with the Workplace Injury Rehabilitation and Compensation Act 2013, Ministerial Orders, the regulations, any terms and conditions of approval and other legislation (e.g. the Occupational Health and Safety Act 2004) throughout the licence period.
  • An annual performance report is provided to each self-insurer with information on a range of indicators (where possible benchmarked against comparable employers /other self-insurers /or WorkSafe Victoria Agents).
  • The report includes, but is not limited to an assessment of performance in relation to: self-audits; regulatory audits; financial indicators; incidence of injury and cost of claims; injured worker survey; and administrative compliance.

 

 

  • Self-insurers must comply with the WIRC Act, Ministerial Orders, the regulations, any terms and conditions of approval and other legislation (e.g. Occupational Health and Safety Act 2004).
  • Self-insurers are also required to provide specified information at specified times to WorkSafe Victoria.
  • Refer to Tables 6.4, 6.5 and 6.9 for details.

 

A self-insurer must notify WorkSafe Victoria as soon as they become aware of any strategically significant matter.

Queensland

s83 — Workers’ Compensation and Rehabilitation Act 2003 — A licence may be subject to:

  1. the conditions prescribed under a regulation, and
  2. any conditions, not inconsistent with the Act, imposed by the Regulator:
    1. on the issue or renewal of a licence, or
    2. at any time during the period of the licence.

 

 

  • Ability to provide data in the format and at time intervals required by the Regulator.
  • A self-insurer must supply the Regulator summary information about claims processed on their system.

s93 — Workers’ Compensation and Rehabilitation Act 2003 — When requested, provide copies of:

  • documents relating to all claims made
  • documents that may assist in assessing the quality and timeliness of claims and rehabilitation management
  • documents that may assist in assessing the self-insurers financial situation, and
  • any other documents required to be kept under the licence.

 

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Western Australia

 

  • WorkCover WA monitors self-insurer activities and performance and conducts periodic checks to ascertain if self-insurers maintain an acceptable level of compliance against requirements set out by WorkCover WA and the Workers’ Compensation and Injury Management Act 1981.
  • If a satisfactory performance is not indicated, a nominated person of the self-insurer may be called before WorkCover WA to show just cause why the approval and exemption of the self-insurer should not be cancelled in accordance with s165 and s166 of the Act.

 

Self-insurers are required to meet their financial, reporting and claims management obligations as specified under the Workers’ Compensation and Injury Management Act 1981. Refer to tables 6.8a–e for further information.

Self-insurers must:

  • demonstrate expertise to determine claims within the State in time limits specified
  • effect weekly payments within frequency specified
  • carry out responsibility with respect to injury management
  • submit accurate and timely statistical returns/information
  • provide and maintain a copy of their organisational chart
  • demonstrate that an injury management programme is in place, and
  • confirm that information management systems utilised by the self-insurer are able to meet the compliance standards as defined in the Q1 specifications including the provision of data and returns.

 

South Australia

 

  • ReturnToWorkSA may revoke the registration of a self-insured employer or group of self-insured employers, or reduce the period of registration, if the employer, or a member of the group, (as the case requires) breaches or fails to comply with the Act or a term or condition of registration — s129(9) Return to Work Act 2014
  • Self-insurers must comply with all statutory requirements and conditions of registration for registration continuity. Failure to meet requirements may result in reduction, revocation or non-renewal of self-insured registration. Furthermore, any proven systemic abuse of a delegation under the Act may result in the delegation being removed — Code of Conduct for Self-insured Employers

 

Self-insurers must comply with all statutory requirements and conditions of registration for registration continuity.

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Tasmania

 

  • A permit is subject to such conditions as may be imposed by the Board. A self-insurer who fails to comply with, or contravenes, any condition to which the permit is subject is guilty of an offence and is liable on summary conviction to a fine not exceeding 100 penalty units. — s107 Workers Rehabilitation and Compensation Act 1988
  • The Board may at any time, in its absolute discretion, by notice in writing served on a licensed insurer or self-insurer, revoke or suspend a licence or permit if it is satisfied:
    • that the licensed insurer or self-insurer has failed to comply with any provision of this Act and the failure constitutes a substantial breach of the requirements of this Act, or
    • that the licensed insurer or self-insurer has been convicted of an offence against this Act — s111(1)(b) and (c).

 

s107 — Conditions of permits

  1. A permit is subject to such conditions as may be imposed by the Board:
    1. on the granting of the permit; or
    2. at any time during the currency of the permit.
  2. The Board may, by notice served on a self-insurer, impose conditions (or further conditions) to which the permit is to be subject or vary any conditions imposed on the permit by the Board and any such conditions or variation shall, subject to s112(3), take effect on such date as the Board specifies in the notice, being a date not less than 14 days after the service of the notice on the self-insurer.
  3. A condition to which a permit is subject has effect whether or not the condition is endorsed on the permit.
  4. A self-insurer who fails to comply with, or contravenes, any condition to which the permit is subject is guilty of an offence and is liable on summary conviction to a fine not exceeding 100 penalty units.

Permit Conditions

Find more information for self-insurers on the WorkSafe Tasmania website under Self Insurers.

Northern Territory

s124 Return to Work Act 1986 — The Authority may at any time, in its absolute discretion, by notice in writing to an approved insurer or self-insurer, revoke or suspend approval

 

  • Ongoing satisfactory demonstration of the employer’s ability to:
    • – provide statistical and other information required
    • – provide financial contributions as requested, and
    • – adequately provide for and manage the company’s Northern Territory workers’ compensation claims.

Adequate expertise to determine claims within the Territory in the time limits specified. Effect weekly payments within the frequency specified. Carry out responsibility with respect to injury management. Submit accurate and timely statistical returns/information — s119 and s122.

 

Australian Capital Territory

 

  • Continue to meet obligations under the Act and Regulations and any other protocol approved by the Minister that relate to self-insurers.
  • Ensure that workers’ compensation claim form, register of injuries and early injury notification form comply with Workers’ Compensation Insurer’s Form Specifications.
  • Comply with Workers’ Compensation Insurers data reporting requirements.

 

Self-insurers must comply with all statutory requirements and conditions of licence for licence continuity.

 

  • The self-insurer must agree to participate in, and pay the costs of, an audit to establish that the self-insurer has adequate resources to meet its current and expected liabilities under the Act.
  • The employer must agree to participate in, and pay the costs of, an audit to establish that the employer has complied with its obligations under the Regulatory Framework.

 

C’wealth Comcare

Licensee must comply with the requirements of:

  • the Safety, Rehabilitation and Compensation Act 1988, Safety Rehabilitation and Compensation Regulations, the SRC Directions and any other applicable guidelines issued by the Commission under s73A of the SRC Act in respect to rehabilitation and compensation
  • Commonwealth WHS Act (where this applies to the licensee) and any applicable laws of the states or territories with respect to safety and health of employees
  • any guidelines dealing with covert surveillance of employees, and
  • conditions of licence and performance standards.

 

 

  • Comply with any written directions given by the Commission. If claims are managed by a claims manager, provide a copy of the Commission’s directions to the claims manager. Advise and provide a copy of the initiating process to Comcare as soon as possible of any court proceedings in relation to a matter arising in respect of a claim.
  • The licensee must advise in writing as soon as practicable when it becomes aware:

a) licensee has not complied with, or not likely to comply with, a condition of the licence

b) of any event that may materially impact upon its sustainability to hold a licence, including its capacity to meet its liabilities under the SRC Act or of any material change in financial position

c) of any material change to its legal structure, ownership or control

d) of any significant change in its employee numbers or significant change in the risk profile of the work undertaken by its employees.

  • Provide upon request information relating to the licensee’s operations.
  • Ensure claims manager complies with the conditions of the licence.
  • Be accountable for all claims management policies issued by the claims manager.
  • Notify the Commission in writing as soon as possible after it becomes aware that the claims manager has done, or omitted to do, something which has the effect that the licensee is, or likely to be, in breach of a term or condition of the licence.
  • Must enter into and maintain a written contract with the claims manager and provide a copy of the contract to the Commission. Obligations imposed by the licence must be written into the contract between the licensee and the claims manager.
  • Meet the guarantee requirement annually.
  • Maintain an appropriate level of reinsurance.
  • Continue to meet the Commission’s standards for prevention, rehabilitation and claims management.

A Licensee Compliance and Performance Improvement report, outlining the licensee’s achievements for the past 12 months and objectives and targets for the coming year, must be provided annually.

Data quality audits may also be conducted including in years two and six of the eight year licence (if and as required) to assess the accuracy of claims and rehabilitation data submitted.

New Zealand

 

Licensee must comply with the requirements of:

  • the Accident Compensation Act 2001, Regulations and any other applicable guidelines issued by Accident Compensation Corporation
  • the Privacy Act 1993
  • Health Information Privacy Code 1994, and
  • the Code of ACC Claimants’ Rights.

 

 

  • Comply with any written directions given by ACC. Advise ACC of:
    • – any serious ongoing claim or claims with a duration < 12 months as soon as practicable
    • – any insolvency event
    • – any report from Occupational Health and Safety (Ministry of Business, Innovation and Employment)
    • – anything that could contribute to Accident Compensation Corporation reviewing the status of the employer, and
    • – provide a copy of the initiating process to Accident Compensation Corporation as soon as possible of any court proceedings in relation to a matter arising in respect of a claim.
  • Provide Accident Compensation Corporation upon request, information relating to the licensee’s operations. Ensure claims manager complies with the conditions of the licence. Retain overall responsibility for claim and case management. Notify Accident Compensation Corporation in writing as soon as possible after it becomes aware that the claims manager has done, or omitted to do, something which has the effect that the licensee is, or likely to be, in breach of a term or condition of the licence. Must enter into and maintain a written contract with the claims manager and provide a copy of the contract to the ACC.

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