Specialised insurers

A specialised insurer is licensed by us to underwrite workers compensation liabilities and manage workers compensation claims for employers within a defined industry.

Because these insurers focus on the special needs of a defined industry (instead of providing insurance across a wider range of different businesses), they can develop targeted work health and safety, return to work, and injury management programs, as well as affordable insurance pricing.

A standard licence lasts up to five years. However, failure to meet our licensing requirements may result in a non-standard licence term of less than five years.

Market Practice and Premiums Guidelines

Market Practice and Premiums Guidelines apply to all licensed insurers offering policies of insurance. The Guidelines require licensed insurers to provide a premium filing to SIRA prior to issuing policies from 30 June 2016.

The development of these Guidelines is the first step in establishing SIRA’s regulatory framework for workers compensation insurers. SIRA will consult further during 2016 with a view to issuing revised Guidelines for the 2017-2018 policy year, which will further progress the transition towards risk-based regulation and supervision of workers compensation insurers’ financial and prudential requirements.

Licensed Insurer Business Plan Guidelines

Licensed Insurer Business Plan Guidelines apply to all licensed insurers offering policies of insurance. The Guidelines require licensed insurers to provide to SIRA details of their business plans and strategies for their workers compensation business. Business plans are required to be submitted to SIRA by 30 September 2016 for the 2016/17 financial year and subsequent forward planning.

Licensing requirements

Our licensing requirements ensure specialised insurers obtain appropriate authorities, are financially viable and maintain high standards of injury management and case management throughout the term of the licence.

We monitor these requirements and failure to meet them may reduce the length of a specialised insurer licence.

Licensing requirements include:

Our licensing framework explains our requirements in more detail.

For more information refer to the list of specialised insurer publications on the right hand side of this page.

Australian Prudential Regulation Authority Authorisation

If you're a specialised insurer you must hold an authority from the Australian Prudential Regulation Authority (APRA) to carry out insurance in Australia (unless exempted by specific legislation).

Ownership and control specifications

Specialised insurers must be incorporated with 50 per cent of the shares and paid up capital held by the relevant professional, business or other industry bodies with 50 per cent of the voting rights.

Strong financial viability and strength

To be a specialised insurer you must:

  • 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 cash flow
  • lodge your annual report (including audited financial statements) each financial year

Financial security

If you're a specialised insurer you're required to provide financial security to ensure you're able to meet your workers compensation liabilities .

Our security policy sets out the types of security and the terms under which security will be accepted.

Reinsurance

If you're a specialised insurer you must obtain appropriate reinsurance cover for your workers compensation risks that is acceptable to APRA.

Case management practices

We will conduct case management audits periodically throughout a licence term in accordance with the Insurer audit manual. This manual assists specialised insurers to monitor compliance with legislation and identify opportunities for improvement in case management. Specialised insurers will also be required to report self-audit results at least annually.

OHS Loss Management program

Specialised insurers are required to demonstrate that they have an OHS Loss Management program in place to assist insured employers maintain strong work health and safety standards.

The OHS Loss Management program should focus on systematic approaches to injury and/or illness prevention based on industry-specific problem areas utilising OHS risk management principles.

Our specialised insurer loss management assessment criteria has more information on loss management programs and our expectations.

List of specialised insurers

Catholic Church Insurances Limited

Licensed to provide workers compensation insurance to employers whose main business or industrial activity applies to the Roman Catholic Church and its religious institutions.

Original approval started:  31/03/1983
Current approval expires:  31/10/2019

Coal Mines Insurance Pty Ltd

Licensed to provide workers compensation insurance to employers in the coal industry under the Coal Industry Act 2001.

Original approval started:  Not applicable
Current approval expires:  Not applicable

Guild Insurance Limited

Licensed to provide workers compensation insurance to pharmacies operating and registered in NSW.

Original approval started:  15/01/1964
Current approval expires:  30/04/2021

Hospitality Employers Mutual Limited

Licensed to provide workers compensation insurance to the NSW hospitality industry including, pubs, bars, taverns, accommodation and clubs in NSW (members of Clubs NSW).

Original approval started:  31/03/2008
Current approval expires:  31/03/2019


Racing NSW

Licensed to provide workers compensation insurance to employers whose main business or industrial activity falls under the Thoroughbred Racing industry in NSW under the Workers Compensation Act of 1987.

Original approval started:  01/08/1998
Current approval expires:  31/03/2020

StateCover Mutual Limited

Licensed to provide workers compensation insurance to local councils in NSW.

Original approval started:  30/06/2001
Current approval expires:  30/06/2018

Call 13 10 50 for more information about specialised insurers or email self&specialisedinsurers@workcover.nsw.gov.au.