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Responding to compliance or performance concerns

For: Employers and managers Information seekers

If a problem is identified, we notify the self-insured licensee in writing and let them know they are required to resolve the issue in a timely manner.


When a problem is identified

Where a problem is identified, the Safety, Rehabilitation and Compensation Commission (SRCC) expects that the self-insured licensee will voluntarily rectify any breach of their licence condition or any performance issue raised as soon as possible.

We can work with the self-insured licensee to verify the result and will give the licensee an opportunity to resolve the problem.

We can also determine that due to concerns with compliance or poor performance, an escalated, more formal regulatory response is required. This response can occur during any phase of the self-insurance licence.

The SRCC’s principles of regulation guide the approach the SRCC takes to any regulatory response.

Stages of a regulatory response

If a regulatory response is required, we usually take a set of staged responses. This approach means:

  • the response we impose is proportionate to the risk
  • we can escalate or de-escalate the regulatory action taken.

At all stages, we seek to be open with the affected self-insured licensee and inform them, in writing, of regulatory decisions that impact them. At any point during the process, an affected self-insured licensee can make written representation to the SRCC regarding the matter and the regulatory response.

The SRCC may undertake a mix of actions from different stages at the same time, depending on the breach or issue. This can help communicate how seriously the SRCC views the non-compliance and poor performance.

1. Encouragement

Encouragement focuses on education and voluntary compliance.

This would usually be undertaken by Comcare, on behalf of the SRCC, and may include activities such as:

  • interaction between the relevant Comcare account manager and the self-insured licensee
  • a Comcare executive member meeting with the self-insured licensee
  • information and presentations provided by Comcare
  • sending a letter requesting an action or information
  • a request for evidence of contextual information, corrective action plans and their implementation, to verify claims.

2. Direction

Direction focuses on a formal requirement to undertake action to rectify the failure to comply with the SRCC’s requirements.

The SRCC activities in the Direction stage can encompass:

  • issuing a letter of statutory warning to the self-insured licensee’s Principal Officer or requesting information, such as a report
  • requesting that the Principal Officer of the self-insured licensee attend an SRCC meeting to discuss the issue
  • a visit to the self-insured licensee
  • reporting the self-insured licensee’s poor performance or breach of the conditions of licence in the SRCC Annual Report and website
  • directing an action, such as a targeted review, be undertaken to address the issue.

Targeted reviews

The SRCC may request a targeted review of a self-insured licensee as part of its response to a compliance or performance issue.

This is a likely response if the contextual information provided by the self-insured licensee fails to satisfy the SRCC.

A targeted review approach will be developed by the SRCC, focused on the specific concerns which have arisen with the self-insured licensee.

Aim of a targeted review

The aim of a targeted review is to:

  • determine the extent of non-conformance
  • identify specific avenues to improve performance
  • assist the SRCC to be satisfied that ultimately the performance issue can be resolved.

A targeted review can be designed to:

  • test the accuracy of information a self-insured licensee has provided to the SRCC
  • specifically target an area of a self-insured licensee’s claims management, rehabilitation or prevention operations
  • identify and assess underlying issues or drivers behind poor performance.

A targeted review has a clear objective of what needs to be achieved. It is not a general audit of the relevant system.

See the Self-insurance Licence Compliance and Performance Model (PDF, 2.0 MB) for more information and examples of some of these actions, listed against the performance standards and measures.

Who conducts targeted reviews

Different skill sets are needed, depending on the activities and focus of the review. In the proposal to the SRCC, a recommendation is made about who should conduct the review.

Comcare may, on behalf of the SRCC, source an external suitably qualified person to conduct the review, the cost of which will be recovered through self-insurance licence fees. The SRCC can also determine that the review be undertaken by Comcare, should Comcare have the capacity at that time, or that the self-insured licensee itself source an independent person to conduct the review.

Outcomes of a targeted review

At the conclusion of a targeted review, a report is produced that:

  • sets out findings from the review clearly addressing the objective set for the review
  • identifies corrective actions or areas for improvement with set timeframes
  • includes consultation with the relevant self-insured licensee on the outcomes and recommendations to the SRCC.

Any disputes over findings are considered using the SRCC’s dispute resolution process.

3. Restriction

Restriction focuses on limiting activities the self-insured licensee can carry out under its licence in order to address an increased risk that the SRCC’s requirements are not able to be met.

In the restriction category, the SRCC may consider:

4. Revocation or suspension

The SRCC will usually only consider revoking or suspending a self-insurance licence for serious or systemic issues, or where a self-insured licensee has resisted or been unable to achieve voluntary compliance.

The SRCC can only suspend (not revoke) the licence of a Commonwealth authority (currently Australian Capital Territory, Australian National University, Australia Post and the Reserve Bank of Australia).

Reporting of compliance and performance issues

Self-insured licensee performance issues are reported to the SRCC at its quarterly meetings or outside meetings if appropriate, such as if a breach of licence has occurred.

Comcare will report the situation to the SRCC for action or potential regulatory response if:

1. Compliance with self-insurance licence conditions

  • The non-compliance cannot be resolved
  • The same or a related non-compliance is detected for more than two consecutive relevant periods. A relevant period refers to the frequency of compliance required, for example, as needed, monthly, quarterly or annually.
  • There is a trend of non-compliance generally.

2. Performance results

  • The performance result cannot be explained.
  • Poor performance is detected for two relevant consecutive periods. A relevant period refers to the most relevant period for performance assessment, for example ad hoc, monthly, quarterly or annually.

Self-insured licensees are given the opportunity to respond or provide further information to the SRCC as part of Comcare’s report.

Delegating actions or functions

When considering responses to non-compliance or poor performance by a self-insured licensee, the SRCC can consider delegating an action or function to:

  • a formal or informal sub-committee of the SRCC
  • a specific Commissioner, or
  • the Comcare CEO.

As part of any decision to delegate an action or function the SRCC will agree the period for the delegation and mechanism or timeframes for review.

Actions in response to compliance issues

In the Direction or Restriction stages of our regulatory response we can:

In the Restriction, Suspension or Revocation stages of our regulatory response we can:

Page last reviewed: 08 April 2021
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SRCC
GPO Box 9905, Canberra, ACT 2601
1300 366 979 | www.comcare.gov.au

Date printed 03 Dec 2021

https://www.srcc.gov.au/current-self-insurers/responding-to-concerns