SIRA penalises QBE for NSW CTP care payment delays

The State Insurance Regulatory Authority (SIRA) has imposed a $32,600 civil penalty on QBE Insurance Australia Limited in relation to its handling of treatment and care (TRAC) payments under the New South Wales compulsory third party (CTP) motor accidents scheme. SIRA issued the penalty under section 9.10(1)(a) of the Motor Accident Injuries Act 2017 after an investigation into QBE’s compliance with the Motor Accident Guidelines and its statutory obligations. The investigation identified historical issues with the insurer’s adherence to the TRAC provisions of the guidelines and subsequent breaches of the Act and QBE’s licence conditions.

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According to SIRA, QBE had prolonged delays in paying TRAC invoices to claimants and service providers from November 2023 to August 2025. The regulator found that these delays breached the Motor Accident Guidelines, the Motor Accident Injuries Act 2017, and SIRA’s Customer Service Conduct Principles, as well as QBE’s licence conditions within the NSW CTP scheme. SIRA concluded that the issues were systemic rather than isolated and that earlier remediation attempts had not resolved the delays within acceptable timeframes. The authority determined that a civil penalty was the appropriate enforcement response in this matter. QBE has paid the penalty. QBE has acknowledged SIRA’s concerns and, in response to the regulator’s actions, has undertaken remediation to address the identified non-compliance.

Effects on claimants and service providers

SIRA reported that QBE’s delays in reimbursement affected injured people and providers delivering treatment, rehabilitation, and care services in the CTP scheme. According to the regulator, some service providers stopped offering care when payments were not made, with flow-on effects for claimants relying on those services. Under the Motor Accident Injuries Act 2017, licensed CTP insurers are required to determine liability on claims within prescribed timeframes and, where liability is accepted, to commence payment of statutory benefits without delay. Insurers must provide access to “reasonable and necessary treatment, rehabilitation, and care” and are expected to make reasonable settlement offers as soon as practicable. SIRA has restated that it expects all licensed CTP insurers to comply with these obligations on an ongoing basis to support the objectives of the NSW scheme, including early treatment, recovery, and timely claims resolution.

Customer service conduct principles guide expectations

The QBE penalty is linked to SIRA’s Customer Service Conduct Principles, which set expectations for how licensed insurers deal with policyholders and people injured in motor accidents. SIRA states that the principles “aim to ensure policy holders and people who experience injury and loss are provided with fair, timely, respectful, inclusive, and appropriate services. They also provide the opportunity for feedback on the service they receive.” The five principles set out SIRA’s expectations for insurers’ customer-facing processes and internal controls:

• Under Principle 1, insurers must “be easy to engage and efficient,” keeping interactions simple and accessible so that the primary focus remains on recovery and resolution. 
• Principle 2 requires insurers to “act fairly, with empathy and respect,” including providing the same quality of service to all customers and recognising individual circumstances. 
• Principle 3 states that insurers should “resolve customer concerns quickly, respect customers’ time, and be proactive,” including resolving issues at the first opportunity and contacting customers when information is needed. 
• Principle 4 requires insurers to “have systems in place to identify and address customer concerns,” with mechanisms to seek customer views, address systemic issues, and maintain continuous improvement processes. 
• Principle 5 provides that insurers must “be accountable for actions and honest in interactions with customers,” acknowledging when harms are caused, expectations are not met, or legislative breaches occur, and taking corrective action.

These principles operate alongside the Motor Accident Guidelines and scheme regulations and inform SIRA’s assessment of insurer conduct in the CTP scheme.

Position within the NSW CTP regulatory framework

The enforcement action against QBE sits within the broader regulatory framework governing licensed insurers in the NSW Green Slip scheme. CTP insurers are authorised to sell Green Slips and manage claims, subject to requirements set out in the Motor Accident Injuries Act 2017, the Motor Accidents Compensation Act 1999 for legacy matters, the Motor Accident Guidelines, and the Motor Accident Injuries Regulation 2017.

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Insurers must maintain processes for selling and administering Green Slips that are accessible to customers, act in good faith, avoid unfair discrimination, and ensure their CTP products are available to eligible vehicle owners. In the claims environment, they are required to fund appropriate treatment and care in line with legislative and guideline settings, manage statutory benefits and damages claims within specified timeframes, and apply guidance on joint medical or other health-related assessments to limit multiple assessments of injured people.

SIRA also requires licensed insurers to notify it promptly of significant matters relating to policies, claims, or scheme operations so the regulator can identify and address emerging risks or systemic issues. For insurers and claims professionals, the QBE penalty signals SIRA’s attention to the timeliness of TRAC payments, the handling of treatment and care obligations, and alignment with customer service conduct principles as central elements of compliance within the NSW CTP scheme.