Self-insurer licensing requirements
If you are a self insurer, we have licensing requirements to ensure you maintain the high standards expected throughout the licence term.
We do this to ensure you provide your workers with:
- better work health and safety conditions
- fair and equitable treatment
- improvement in rehabilitation and injury management
We continually monitor your licensing compliance by reviewing workers compensation information and information supplied throughout the licence term. Monitoring is also supported by an audit framework in case management and work, health and safety.
Workers compensation arrangements will change for NSW merged Councils.
Strong financial viability and strength
You must continue to:
- be adequately capitalised without any undue reliance on external borrowings
- have a strong and sound financial position based on net tangible assets
- have a sound profit history and cashflow
You must prepare and lodge a copy of your annual report (including audited financial statements) each financial year.
If you are not an exempt employer, you are required to provide financial security to ensure other employers in NSW will not be required to meet the cost of claims if you are not able to meet your workers compensation liabilities under your licence.
Our security policy for self insurers, specialised insurers and retro-paid loss participants sets out the types of security and the terms under which they will be accepted.
Security is determined by referencing the annual actuarial report that you provide us as part of your actuarial requirements.
You must obtain and maintain unlimited reinsurance cover to restrict liabilities to a maximum amount for any one event.
Injury management and claims management
You are required to comply with statutory requirements regarding injury and case management.
You can do this by ensuring you have:
- developed an injury management program and return to work program
- capable, skilled and experienced staff with a thorough knowledge of workers compensation legislation and administration
- appropriate systems to report monthly in accordance with the Claims Technical Manual
We may approve outsourcing arrangements for claims management and data reporting to a suitably qualified third party.
We will conduct audits on self-insurers periodically throughout the licence term in accordance with the insurer audit manual. In addition, self-insurers will be required to report self-audit results at least annually.
Work health and safety (WHS)
You must demonstrate that your WHS systems and practices comply with WHS laws.
We will conduct audits on self-insurers periodically throughout the licence term in accordance with the Self-Insurer National Audit Tool (NAT). The required scoring methodology is 75 per cent conformance for each of the two NAT audit categories audited.
You will also be required to report self-audit results against the elements of the NAT at least annually.
Should you no longer hold a licence, you will still be held responsible for the management of the tail of claims incurred while licensed as a self-insurer. Security will continue to be held by us until we're satisfied that all claims have been discharged or adequately provided for.
We have created three resources to help you comply with these criteria.