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Claims data

FrequencyMonthlyMonthlyMonthlyMonthly14 daysMonthly

Annually
MonthlyMonthlyMonthly or as per directed by the CommissionMonthly
TimingBy the 15th day of the following monthBy the 30th day of the following monthBy the 8th day of the following monthWithin14 days from the end of the monthBy fortnightly schedule agreed between ReturnToWorkSA and employerBy the 7th day of the following monthTypically, by the 10th day of the following monthBy the 7th day of the following monthBy the 5th working day of the following monthAt the end of each month, and no later than 15 working days
FormatElectronic lodgment

Specifications in accordance with Workers Compensation Insurer Data Reporting Requirements (WCIDRR).

Electronic data transfer and reporting:

  • remuneration
  • count of standardised claims
  • count of > 10 day claims
  • count of > 15 day claims (or >13 weeks over excess claims)
  • total standardised payments on standardised claims
  • total standardised payments on > 10 day claims
  • number of companies in the comparator group.
Electronic data interchangeElectronic

Meets WorkCover WA Data Directions

WorkCover. WA’s National Insurer Data Specification Guidelines
Electronic Data Interchange

Claim data as detailed in Schedule 3 to the Return to Work Regulations 2015.
Electronic data submissionElectronic data transferElectronic data interchangeElectronic data interchange/NDS3 formatElectronic data submission as defined in the Accredited Employers Programme Monthly Claim File Specification
More informationN/AN/AWorkers’ Compensation Insurers’ Interface Data SpecificationData Directions

WorkCover. WA’s National Insurer Data Specification Guidelines

Insurer and Self-Insurer Principles and Standards of Practice 
Schedule 3 Return to Work Regulations 2015

Code of Conduct for Self-Insured Employers
Determination No. 1 of 2013Contact WorkSafe ACTWorkers Compensation Best Practice Guidelines for Approved Insurers and Self-Insurers in the Northern TerritoryLicence Compliance and Performance ModelContact ACC

Annual financial information

Annual report/ financial statementsAnnual report including audited financial statements within 4 months of end financial year.

Local government self-insurers must submit within 5 months of financial year end, once tabled in parliament.
Annual report / audited financial statements within 4 months of the self-insurer’s balance date.Audited financial statements within 20 business days of becoming publicly available

Annual report within 20 business days of becoming publicly available

Wages declaration for NDS purposes only by 31 August each year
Return on investment required for initial application and for annual reviewAudited financial statements/Annual Report within 5 months of the end of the employer’s financial yearTo be made available following end of financial yearA copy of the applicant ’s audited financial statements (or, if it is not available, equivalent information) for each of the previous 3 years upon application.Audited financial statements by 31 August each year

Annual report by 31 August each year
Audited financial statements must be provided annually within 131 days of the end of the relevant financial year.

Statements must show that provision has been made for meeting the workers’ compensation liability as advised in the actuarial report.
Audited financial statements with notes for initial application and annual re-application

Credit report for initial application
Actuarial report/ assessment of claims liabilitiesActuarial assessment of claims liabilities as at balance date provided within 4 months of end of financial year.

Self-insurer s189 business information requirements
Actuarial assessment of claims liabilities submitted within 3 months of the self-insurer’s balance dateActuarial assessment on claims liabilities within 20 business days after the end of each year of the Licence or such other time as agreed between the Regulator and the licenseeClaims liability as a % of net assets required for initial application and for annual review

Gearing ratio required for initial application and for annual review
Actuarial report on outstanding claim liability within 3 months of the end of the employer’s financial year or at such other time as may be agreed between ReturnToWorkSA and the employer.Independent financial Audit Report by 31 August each yearUpon application, actuarial report containing an estimate of the applicant’s existing outstanding liability, the applicants expected liability each year for a 2-year period, and the total expected payments in satisfaction of the applicant’s liability for compensable injuries likely to be made each year for the 2-year period.Actuarial assessment of claims liabilities by 31 August each yearAn annual actuarial assessment of claims liabilities is required within 131 days of the licensee’s end of financial year.The Accredited Employer may be required to provide estimates of future costs of claims in a format, to a methodology, and at intervals, not more frequently than monthly, prescribed by ACC
Guarantees/ audit certificatesGuarantee or security as required following annual assessment of actuarial report and determination of security required.Audit certificate submitted within 6 months of the self-insurer’s balance date. Self-insurer notified of guarantee coverage adjustment within 2 weeks of receipt of the actuarial assessment by the regulator. Amended guarantee submitted by self-insurer within 4 weeks of regulator’s notificationSelf-insurer notified of bank guarantee amount following assessment of actuarial reportBank guarantee required as security –whichever is the greater of 150% of the central estimate of outstanding claims liability (rounded up to the next $100,000), or $2 million.

Balance sheet test, quick liquidity, current liquidity, interest coverage, return on investment required for initial application and for annual review
Update financial guarantee.

As required in correspondence, normally within one month of submission of actuarial report

Schedule 3 Return to Work Regulations 2015
Update guarantee as required following assessment of actuarial report and determination of quantum of guarantee required.It is a condition of a self-insurer licence that the employer maintain a bank guarantee.Update guarantee as required following assessment of actuarial reportDeed between the Commission, Comcare and a bank or insurer for an amount that can be called upon by the Commission if a self-insurance licence is suspended or revoked. The guarantee is usually provided annually.

If required, it must be provided within 170 days of the start of the licensee’s financial year to which the guarantee relates.
Financial eligibility check for initial application and annual re-application.

Audit certificate needs to be submitted with the financial statements
Evidence of excess of loss insurance or reinsuranceEvidence of current Excess of Loss reinsurance to be provided to SIRA at all times.Annual certificate of currency of the contract of insurance submitted within 21 days of expiry of the previous certificate of currency (seamless coverage).

New/revised contract of insurance submitted within 21 days of the contract of insurance being altered or affected with a different insurer
Reinsurance policy/ Certificate of currency submitted annuallyN/AEvidence of existence of Excess of Loss Insurance policy within 3 months of the annual renewal of the policyEvidence of existence of Excess of Loss Insurance annuallyN/AClaims liabilities and evidence of Excess of Loss Insurance by 31 August each yearRequired to maintain an appropriate level of reinsurance to limit its liability to pay compensation and other amounts under the SRC Act in accordance with the scope of the licence.

Provide a copy of the current certificate of currency for the reinsurance policy within 130 days of the start of the financial year to which the certificate of currency relates; provide a copy of the policy, if amended or from a new provider, within 130 days of the start of the financial year to which the policy relates.
ACC offers 2 liability caps to Accredited Employers as specified in table 7.5

Any reinsurance is prohibited under the legislation 

Other company information

Number of employees/FTENumber of employees by 31 August each yearNumber of FTEs by 31 August each yearNumber of FTEs (Minimum 500 if licence issued pre-March 1999 and 2000 if licence after March 1999) annually and at licence renewal — reporting annually and varies by insurerSelf-insurers approved after 1 July 2024 must employ or engage at least 500 workers as defined in the Act (including workers employed by any related entities to be covered under a group self insurer licence) at the time of application and in any subsequent review.Number of FTEs, not specifically required to report onWorkers and wages report by 21 July each yearNumber of employees by end of financial yearNumber of employees by 31 August each yearFTE (estimated and actual) to be provided annually in July, and throughout the year if required.Number of FTE for initial application and annual re-application 
Remuneration or wages declarationRemuneration by 31 August each yearRateable remuneration return submitted by 31 August each yearRemuneration by 31 August each yearAggregate remuneration paid to workers and each related entity (if part of a group licence) for the current year, and estimate for the next financial year at time of application.Remuneration by 31 July each yearWorkers and wages report by 21 July each yearWages by end of financial year.Remuneration by 31 August each yearRemuneration by 31 July each yearN/A
OtherPredominant industry/Workers Compensation Industry Classification by 31 August each year

By 31 August each year:

  • opened/closed workplaces during the reporting period
  • workplace location
  • predominant industry / WorkCover Industry Classification

Self-audit results by 31 August each year:

  • claims management obligations of employers & other requirements
Rehabilitation policy and procedures (once per licence period — up to 4 years).

The insurer’s accredited return to work program is reviewed once per licence period – up to 4 years.

Self-assessment required for self-insurers at the mid term of the licence period.
  • Manage disputes and complaints arising out of the activities of a licensed self insurer effectively
  • Comply with any requirements or timeframes imposed by the Act 
  • Comply with any condition of the licence, whether imposed by the Act or WorkCover WA
  • Provide a high standard of claims management and injury management to optimise return to work outcomes 
  • establish processes to provide information as required to WorkCover WA 
Advice of any change in structure or financial relationships that may affect the consideration of the viability of the employer as soon as possible after a change has occurred.N/AInsurer data specification reported monthly. Typically, by the 10th day of the following month.Claims paid and occupation of workers by 31 August each year.N/ACopy of the agreement between the Accredited Employer and Third Party Administrator (if used for workplace injury management) 

Irregular reporting requirements

Changes to Company structure ownership or controlSelf-insurers must notify the Authority in writing within 10 business days of becoming aware of any change in the effective control of the self-insurer or any change in the ownership of the self-insurer exceeding 20% of its shareholding. In such an event the continuity of the licence will be subject to review by the Authority. 

Except with the Authority’s prior written approval, the self-insurer  must not transfer, or agree to transfer, the whole or any part of its self-insurer liabilities (as defined in the  Workers Compensation Act 1987, s 213). The Authority may give or refuse to provide such approval as it sees fit, and any such approval may be given upon such terms as the Authority sees fit
Notify within 28 days of the occurrence of any circumstance under s384 of the Workplace Injury Rehabilitation and Compensation Act 2013.

Notify within one week after becoming aware of a strategically significant matter.
Report within 5 business days of the proposed change: any event that could reasonably be expected to materially impact on the licensee’s net tangible assets

any event that could reasonably be expected to materially impact on the licensee’s financial viability or ability to meet its liabilities for claims, and

any intention of the licensee to withdraw or reduce the bank guarantee or cash deposit lodged with the Regulator
The self-insurer must notify WorkCover WA within 7 days of any significant corporate changes Report financial and structural details as early as possible (or in advance) any action affecting the corporate structure of the group including disposal of subsidiary, acquisition of subsidiary, formation of new subsidiary, appointment of receivers, administrators or liquidators and takeover of the company etcReport as soon as practicable any changes in ownership, directors, structure or financial circumstancesN/AReport as soon as practicable any material changesLicensee must notify in writing as soon as practicable when it becomes aware of any changes to its legal structure, ownership or control.The Accredited Employer must give written notice to ACC of any material changes in the circumstances under which the Accreditation Agreement was entered into as soon as practicable, and where possible, before it occurs. 

Including, by way of example: Change in ownership, change to the composition of the Accredited Employer group, or change in the nature of the business
Changes to key personnel responsible for OHS or injury managementNotify within 10 business days of any change or vacancy in the senior management position responsible for claims or injury management or the senior management position with overall responsibility for workers’ compensationN/AAny intention to change the manner in which any claims are administered or the manner in which the rehabilitation of workers is managedSelf-insurer must notify WorkCover WA within seven daysChanges of personnel should be reported to ReturnToWorkSA once they are known as required by the CodeN/AN/AReport any changes to personnel managing claims in the Northern Territory as they occurN/AAccredited Employer must notify ACC of changes in claim management arrangements and key personnel
Breaches or failures to comply with licence conditions or changes likely to result in sameSelf-insurers must comply with the Significant Matter Notification Requirements A self-insurer must immediately notify WorkSafe Victoria if they are unable to pay any debts as and when they fall due or they become aware of any event that may prevent them from meeting any other requirement for approval and operation as self-insurer in accordance with (i) the Act or the regulations; or (ii) any terms or conditions of its approval as a self-insurer; or (iii) a Ministerial Order; or (iv) any other subordinate instrument made under the Act or regulationsReport within 5 business days of the proposed change: any event that could reasonably be expected to materially impact on the licensee’s financial viability or ability to meet its liabilities for claimsThe self-insurer must notify WorkCover WA within three days if they may be unable to discharge in full any obligations as a self-insurer including related entities covered by a group self-insurer licence or the licence holder or related entity may be in the process of being wound up, or a receiver or manager has been appointed, or the body corporate has been placed under administration. Immediately report any changes of the self-insurer that would impact the self-insurance registrationN/AImmediately report any changes of the self-insurer that would impact the self-insurance licenceN/A

Licensee must notify in writing as soon as practicable when it becomes aware that it has not complied with, or is not likely to comply with, a condition of licence.

Licensee must notify in writing as soon as practicable when it becomes aware of any event that may materially impact upon its suitability to hold a licence, including its capacity to meet its liabilities under the SRC Act or of any material change in its financial position.

If the Accreditation Agreement is breached, the non-defaulting Party may give written notice to the defaulting Party describing the breach and requesting that it be remedied within 10 working days or that a negotiated strategy for its remedy be reached within 10 working days. 
Changes to predominant industry/ employee numbers / risk profile of workN/AN/AReport within 5 business days of the proposed change: any event that could reasonably be expected to materially impact on the number of fulltime workers employed in Queensland by the licensee; Any proposed changes to personnel responsible for managing and deciding claimsThe self-insurer must notify WorkCover WA within seven days of any significant corporate / structural changes.Self-insurer must notify ReturnToWorkSA immediately when it becomes aware of any significant change in its employee numbers or significant change in the risk profile or employment operations

Self-insurer must notify ReturnToWorkSA in writing immediately of any group structure changes including acquisitions, sales etc
N/AN/AN/ALicensee must notify in writing as soon as practicable when it becomes aware of any significant change in its employee numbers or significant change in the risk profile of the work undertaken by its employees.The Accredited Employer (AE) must promptly notify and fully report to ACC in writing on any change to the operations of the AE that affects or may affect the levy classifications applicable to that AE.
OtherN/ANotify WorkSafe Victoria within 28 days of wholly acquiring a scheme-insured or self-insured employer of its election to assume (or not) the tail claims liability of the entity that has been acquiredN/AN/AN/AN/AN/AN/ALicensees must inform Comcare as soon as practicable of court or tribunal proceedings in relation to a claim managed by a licensee under the SRC Act

The licensee must not make any submission to a court or tribunal in relation to the interpretation of a provision of the SRC Act that Comcare or the Commission requests the licensee not to make

The licence requires licensees to report certain workers’ compensation and other data to Comcare on a regular basis
The Accredited Employer (AE) must notify and report to ACC in writing on any:

“serious ongoing claim” or claim for a treatment injury, as soon as practicable after becoming aware that a claim is or is likely to be of that kind, 
actual or anticipated event that would reasonably likely cause ACC to review the employer’s AE Status;

actual or anticipated difficulty in complying with the AE’s obligations to manage claims and any proposed action to address the situation; 

claims where the AE believes that ss 119, 120, 121 or 122 of the Accident Compensation Act may apply

insolvency

WorkSafe investigation or report

event or issue that would result in public adverse comment about the AE Programme, or
matters relating to Accreditation Agreement or any particular claim where a report is requested by ACC.