Workers’ compensation insurance – your right to a review.

Icare continues to be in the news for all the wrong reasons with employers increasingly concerned about the way that claims are being handled by icare and the increasing cost of insurance premiums.

Premiums for workers’ compensation insurance policies have become a major cost for SMEs. It is increasingly common for business owners to find that a relatively minor insurance claim, or a change in industry classification, results in a significant increase in the premium in following years, well above the 30% cap set by icare.

So, what rights do you have to first ensure that a claim is handled correctly and then, to review the premium imposed by the insurer?

Reviewing a claim decision and the management of the claim

Icare engages several insurance companies to manage claims on its behalf.

They will carry out a comprehensive review of the claim and issue a review decision. If you are dissatisfied with the decision, or the way in which the claim was managed and the decision made, then after exhausting the icare review process, you have the right to request that these matters be examined and reviewed by the NSW State Insurance Regulatory Authority (SIRA). SIRA regulates CTP (Green Slip), workers compensation and home building insurances in NSW.

Reviewing a Premium Increase

SIRA provides a set of Guidelines that specify a set of premium principles that must be followed by insurers in the marketplace and in setting premiums. Savage increases in premiums often follow a relatively minor claim. If an insured employer is dissatisfied with the premium and the way in which it was determined, then the employer may seek a further review by SIRA. This must be lodged within 28 days of the insurer’s determination.

So, you do not have to sit back and watch your business suffer when insurance companies have poorly managed a claim and then, adding salt to the wound, have increased your premiums. You can do something about it – and you should!

Next Steps

Need help dealing with icare? Contact Northern Strength. We’re here to connect you with the expertise and support you need to succeed.