Evaluating licence compliance

The SRC Commission’s approach to evaluating licence compliance is through its annual Licensee Improvement Program (LIP). The LIP involves the annual evaluation of licensees with respect to:

compliance with prudential and financial conditions of licence
reporting against Determining Authority KPI Specifications (DAKPI) [pdf]
audit outcomes in prevention, rehabilitation, claims management and data integrity
results of any OHS investigations
provision of an annual performance report by each licensee which provides an overview of key activities undertaken by the licensee in the previous 12 months, outcomes achieved in that period, and objectives for the next 12 months.

Licence compliance results and performance outcomes are then assessed in the context of the tier model. The tier model is the lever for continuous improvement as it identifies the level of regulatory oversight to be applied in the following year through the assignment of a tier status in each of prevention, rehabilitation and claims management.

The tier status that is applied to each of prevention, rehabilitation and claims management functions is based on the self-insurer’s capacity to meet the SRCC’s requirements and capacity to effectively self-manage the function(s). Under the tier model, licensees with a function(s) in the first tier are subject to external audit by Comcare, on behalf of the SRCC. Licensees with a function(s) in the second tier are subject to a desktop review by Comcare of their own audits. Licensees with a function(s) in the third tier must provide executive summaries of their own audits to Comcare. All licensees are subject to external audit in the last year of licence regardless of the tier status.

First Tier (Elementary Level)	Second Tier (Secondary Level)	Third Tier (Advanced Level)
Focus is on compliance through the establishment of policies, procedures, resources and management systems.	Focus is on development of quality assurance and self audit capabilities.	Focus is on positive and material corporate change in prevention and injury management.
Applies to new licensees or licensees with a newly contracted claims management service provider or licensees experieencing difficulties in compliance.	Applies to compliant and conformant licensees who are developing strong management systems and who may wish to seek self audit status in the future.	Applies to licensees with a high standard of internal quality assurance and strong management systems who are achieving corporate change. Licensees must have self audit status to be at this level.
Comcare Audits each year. Higher Cost	Comcare assesses the qualtiy of licensee audits each year (desktop review). Comcare audits in the last year of licence. Medium Cost	Comcare audits in last year of licence. Lower cost

Evaluating licence compliance

First Tier (Elementary Level)

Second Tier (Secondary Level)

Third Tier (Advanced Level)