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HomePlatformsClaim ManagementGovernment Workers' Comp Claims Management Faces Challenges, SIRA Audit Reveals

Government Workers’ Comp Claims Management Faces Challenges, SIRA Audit Reveals

The State Insurance Regulatory Authority (SIRA) has wrapped up its comprehensive assessment of the Treasury Managed Fund (TMF), shedding light on the management of workers’ compensation claims by government employers.

This evaluation, a part of SIRA’s ongoing efforts to ensure systems are running smoothly, dug deep into TMF agencies’ adherence to workers’ compensation legislation and best practices. Through meticulous file reviews and stakeholder interviews, SIRA left no stone unturned, examining 951 claim files and gathering insights from various players in the field.

Dr. Petrina Casey, SIRA’s interim chief executive, underscored the seriousness of the review, highlighting that what started as routine quickly escalated into a focused regulatory investigation. Where lapses were identified, regulatory action was swift, including liability decisions, ongoing monitoring, and penalty notices.

The audit pinpointed five areas of concern regarding TMF workers’ compensation claims, ranging from structural complexities to challenges in returning to work. To address these issues, SIRA laid out a series of recommendations aimed at boosting performance and compliance.

From refining stakeholder engagement to overhauling performance programs, SIRA’s recommendations touch on various aspects of TMF operations. The focus is on clarifying roles, enhancing feedback mechanisms, and streamlining processes to align with compensation system objectives.

Moreover, SIRA emphasizes the need for collaboration and ongoing monitoring to ensure the effectiveness of these initiatives. With support from stakeholders, including government agencies and claims service providers, SIRA remains confident in the potential impact of its recommendations.

Looking ahead, SIRA remains committed to its regulatory framework and will continue to work closely with stakeholders to monitor progress and drive improvements in the management of workers’ compensation claims.