The State Insurance Regulatory Authority (SIRA) recorded a broad range of enforcement actions across its two major personal injury schemes in the three months to March 31, 2026 (Q1 2026), including 25 new remediation plans, one compliance letter directed at an insurer, fraud referrals totalling 58 new cases, and financial security reviews affecting 32 entities in the workers compensation sector. The quarter’s activity spanned the Compulsory Third Party (CTP) and Workers Compensation schemes, with SIRA also monitoring 18 active prosecution matters before the NSW Local Court across both programs.
Within the CTP scheme, SIRA holds licensing authority over six insurers:
A single letter of compliance was issued during the quarter. It was directed at NRMAI on March 11, 2026, and concerned two separate failings: charging policyholders premiums that differed from those filed with and approved by SIRA and providing a customer with information that was neither clear nor accurate.
Seven remediation plans also began in the CTP scheme between February and March 2026. Five of the seven were tied to each insurer’s self-assessment against the Motor Accident Injuries Act 2017 (MAIA) for 2025. The remaining two involved QBE – one concerning recovery plan obligations and the other arising from the same MAIA self-assessment process – and NRMAI, which was placed under a separate plan connected to the same premium and customer information matter cited in its compliance letter.
Five plans that were already open at the start of the quarter were closed after SIRA determined the relevant insurers had reached what it defines as substantial and sustained compliance. The total count of open CTP remediation plans at quarter’s end stood at 19. On the fraud side, 12 new referrals came into SIRA during the period, leaving 27 matters under active investigation. Eleven of those are currently in the NSW Local Court for prosecution. SIRA also logged 23 significant matter notifications in the CTP scheme during the quarter:
Under SIRA’s notification requirements, the “other” category covers matters that could affect a regulated entity’s ability to meet its scheme obligations or that involve serious or systemic fraud, gross negligence, or intentionally misleading conduct.
The NSW Workers Compensation Scheme encompasses four categories of insurer:
Dimeo Group Holdings became the one insurer to receive special licence conditions during the quarter, effective Feb. 24, 2026. The conditions require the company to put an approved remediation plan in place and submit quality assurance updates on a scheduled basis. Across the scheme, 22 insurers carry open special licence conditions as of March 31, 2026. Six remediation plans started in the workers compensation sector during the period. Five followed annual self-audits conducted by the relevant entities. The sixth, involving the Treasury Managed Fund, concerned an underpayment of weekly benefits to Ambulance NSW workers.
A total of 37 additional remediation plans in the workers compensation sector remain open. SIRA finalised 32 financial security reviews during the quarter, a function it carries out under the Workers Compensation Act 1987. The legislation requires self-insurers and specialised insurers to lodge financial security with SIRA, intended to protect other NSW employers from bearing the cost of unpaid claims if an insurer cannot meet its liabilities. Of the 32 reviews concluded this quarter, 10 resulted in increased security requirements, six in decreases, and 16 were left unchanged. Employer insurance compliance: $3 million in premiums recovered, 8,271 additional workers covered.
A separate arm of SIRA’s workers compensation work focuses on employers who appear to carry an insurance obligation but have no current policy. The regulator contacts these businesses directly, and the outcomes are tracked against subsequent policy uptake.
The 893 new policies brought an additional 3,274 employees under workers compensation coverage and generated $3,072,980 in premiums identified for collection. Where investigations escalated to formal notices, SIRA issued 58 Penalty Infringement (PIN) Notices and 36 Double Avoided Premium (DAP) notices, routed through Revenue NSW for collection. PINs totalled $63,950; DAP notices totalled $995,872.62. Under-insurance investigations identified $16,755,710.20 in premiums for icare to pursue and a further 8,271 workers gained coverage as a result.
Forty-six cases were referred to SIRA for fraud review during the quarter, with 48 cases sitting under active investigation at quarter’s end. Seven are currently before the NSW Local Court for prosecution – a figure that, combined with the 11 CTP fraud prosecutions, puts 18 matters before the courts across the two schemes. Eight significant matter notifications were recorded for the Workers Compensation Scheme during the quarter: six legal matters and two privacy or information breaches.
SIRA’s Regulatory Priorities 2025-26, released in July 2025, identify three broad themes guiding its enforcement decisions:
The priorities document notes that SIRA calibrates the intensity of supervision to the level of risk a given entity poses to scheme users, and that the publication of those priorities is intended to allow regulated entities to assess their own performance in advance.
