NSW’s State Insurance Regulatory Authority is seeking submissions on ways to improve healthcare provider oversight in the state’s personal injury schemes.

A discussion paper has been released as part of a review led by Sue Dawson.

“Effective regulation is central to meeting the grounding purpose of returning people with an injury to work or other life activities and to the viability of the workers’ compensation and motor accidents insurance schemes,” the paper says.

“It is well recognised that current regulatory settings are not meeting these objectives.”

The paper says the cost of health services is a major consideration, driven by SIRA’s statutory obligation to promote the efficiency and viability of the personal injury schemes.

It notes costs in the NSW schemes are now close to $1.8 billion a year, after substantial escalation in recent years.

Healthcare expenditure in the workers’ compensation component topped $1.51 billion in 2024-25 and has risen by $399.16 million in the past five years. The compulsory third party scheme recorded a 20% increase to $269.63 million last year.

“Major drivers of these increasing health service costs include but go beyond inflation and increased numbers of claims,” the paper says. “Increases in the number and type of services approved and provided per claim are significant systemic factors in cost escalation across both schemes.”

The paper says in workers’ compensation there is evidence of service delivery with questionable benefits to injured people.

“Billing anomalies are also apparent in some care and treatment segments.”

The paper says CTP scheme care costs have increased substantially since 2017 – the year the no-fault program was introduced.

“The increases are a combination of increased active claims, alongside increased number of services per claim.

“Of note is that expenditure growth is significantly higher for the legally represented cohort, across all categories of injury severity.”

The closing date for submissions is February 16. See the paper here.