NSW workers’ compensation claims: The system at a glance

Peter Little

Founder. Director. Accredited Specialist

Everyone has the right to go to work each day, knowing they’ll come home safely. If you’ve been injured or become ill at work you may be entitled to make a claim for workers’ compensation to cover lost wages, medical and rehabilitation costs, retraining expenses or a lump sum payment for permanent injuries. There have been a lot of changes to arrangements in NSW for seeking workers’ compensation in recent years. You could be forgiven for being a little confused about where to start. After all, workers’ compensation laws and entitlements are already a little hard to keep up with because they vary between states and territories and may be known as WorkCover, CTP or WorkSafe. Compensation and benefits can vary greatly depending on your injury and on the law you’re covered by.

If you’ve been injured at work in NSW, Littles has you covered. This blog explores the three types of insurers in the NSW workers’ compensation system; icare; self-insurers; and specialised insurers.

The basics

The NSW workers’ compensation system provides support and assistance in the form of

compensation for lost wages;
medical, hospital and rehabilitation treatment;
return to work assistance;
and, in certain cases, compensation for non-economic loss.

The State Insurance Regulatory Authority (SIRA) is the NSW Government agency responsible for regulating the NSW workers compensation system.

There are types of insurers in the NSW workers compensation system:

icare

icare is a NSW Government agency that provides insurance and care services to statutory authorities and to people with injuries under various compensation schemes. This includes the Workers Compensation Nominal Insurer, providing workers compensation to more than 326,000 employers and 3.6 million workers in NSW.

icare acts for the Workers Compensation Nominal Insurer and engages insurers Employers Mutual NSW Limited (EML), Allianz, GIO and QBE to manage workers compensation claims on its behalf. EML is the default claims service provider for the Nominal Insurer scheme.

Although all employers are required to hold a valid workers compensation insurance policy, should an employer not have a valid policy in place, an injured worker can still make a claim through the Uninsured Liability Scheme.

Self insurers

Self insurers are employers approved by SIRA to manage their own workers compensation claims.

A self-insurer employer can manage and administer their own workers’ compensation claims, instead of obtaining a workers’ compensation policy from icare.

A self-insurer is responsible for:

the direct ownership and management of workplace and workers compensation risks
the experience and outcomes for injured workers
workforce relationships

Employers need to obtain a self-insurer licence from SIRA to become a self-insurer.

Specialised insurers

Specialised insurers are licensed by SIRA to provide workers compensation insurance cover and manage workers compensation claims and liabilities for employers in a specific industry.

Regardless of which type of insurer is involved, all have an obligation to support your patient in their recovery and return to work, as well as managing claims to ensure they receive the correct entitlements.

Take me to the icare website

IMPORTANT: There are strict time limits for making and disputing a claim, so take advantage of our FREE initial consultation and get in touch. You have nothing to lose by speaking to one of our compensation law experts. The sooner we determine your eligibility to make or appeal a claim, the sooner we can help you to obtain or continue getting funding from the insurer so your rehabilitation can proceed smoothly.

Free advice and no upfront fees

Not only do we offer a FREE initial consultation we handle most insurance claims on a no win, no fee basis.

The Head of our NSW team, Jessica Cheung, is an expert in NSW workers’ compensation claims. If you think you might have a claim, reach out to Jessica and her team for high quality legal advice.

Please note that this information is intended to provide general guidance only. You should not act or refrain from acting on the basis of such information. Appropriate professional advice should be sought based upon your individual circumstances. For further information, please contact Littles.