This annual report is presented to Parliament to meet the statutory reporting requirements of the Compulsory Third Party Insurance Regulation Act 2016.

This report is verified to be accurate for the purposes of annual reporting to the Parliament of South Australia.

Kim Birch
Chief Executive & CTP Regulator

From the Chief Executive

With the scheme maturing, in 2020-21 our focus shifted from implementation to increasing transparency in scheme performance and delivering continuous improvement of the experience and usability of the scheme for injured road users.

During the year, we published our first CTP Market Briefing which informs the premium setting and a scheme data dashboard which provides information about claims and premiums. Both publications will be updated annually.

We have seen more finalisations of complex injury claims with large costs during 2020-21. Settlement of claims requires claimants’ medical conditions to stabilise, which for serious injuries can take many years. Although 87% of claims from the first privately underwritten accident year, 2016-17, are now finalised, only 48% of the 2017 year’s expected ultimate claims costs have been paid out. In view of this there is still significant uncertainty around the ultimate accident year cost for the privately underwritten scheme.

Claim frequency has been dropping since the 2013 reform of the CTP legislation that introduced injury scale value thresholds for access to economic and non-economic loss payments. However, the latest actuarial estimates did not indicate any claim frequency reduction between accident year 2020-21 and the prior year. This may indicate that claim frequency has now plateaued making further decreases less likely.

In 2020-21 we engaged directly with motorists and claimants to improve the experience for those injured on our roads through a review of the injury and fatality claim forms. We received claimant insights through claimant experience surveys to monitor CTP Insurer performance and inform improvements. We connected with health providers to assist them in their interactions with injured road users to enable early access to the scheme. Internally we delivered a customer service framework to maximise customer experience by minimising delays, disputes, and disharmony, this framework is being embedded in our practice.

The CTP Insurer’s scheme compliance performance has improved over the past year. There were significantly fewer CTP Insurer breaches in 2020-21, a total of 26 breaches compared to 46 breaches in 2019-20.

Over the coming year, I look forward to continuing to deliver a competitive scheme that offers choice, ease and confidence to our motoring community through implementation of improved claim lodgement processes, increased information to the community on the scheme’s performance and preparing for a review of elements of the scheme competition model.

We will continue to engage with scheme stakeholders to improve the experience of those who interact with the scheme, including developing a protocol to support CTP Insurers and the Lifetime Support Authority to assist injured people who move between the schemes.

Finally, I thank our Regulator team for continuing to deliver our statutory functions and supporting each other through the challenges COVID-19 presents to us all.

Kim Birch

Chief Executive and CTP Regulator

Overview: about the CTP Regulator

The CTP insurance scheme is governed by South Australian legislation in the following Acts of State Parliament: Motor Vehicles Act 1959 (MV Act), Civil Liability Act 1936 and Compulsory Third Party Insurance Regulation Act 2016 in addition to contracts between the State and CTP Insurers.

The CTP Regulator oversees the scheme and regulates CTP Insurers. Fundamental aspects of the scheme are to support the recovery of people injured in motor vehicle accidents and provide a Policy of Insurance (policy) to protect motor vehicle owners against the financial impact of causing personal injury to other road users through the use of their vehicle anywhere in Australia.

CTP insurance premiums provide cover under the compulsory policy. The policy is attached to the vehicle, not an individual. The minimum terms and conditions of the policy, set by the Regulator are available on the Regulator’s website www.ctp.sa.gov.au.

Motorists actively choose their CTP Insurer based on a number of factors including brand, service, price, and approved incentives. The four government approved insurers, AAMI, Allianz, QBE and SGIC (CTP Insurers), commencing from 1 July 2016 underwrite the South Australian scheme and manage the claims against the policy of insurance.

In South Australia, claims for compensation under the scheme are fault-based common law claims modified by statute, primarily the Civil Liability Act 1936. This means injured road users may be eligible for injury recovery support, payment of reasonable and necessary treatment, and compensation when another party is at fault or partially at fault. Access to compensation requires the injured person to meet thresholds depending on the seriousness of the injury.

Nominal Defendant claims arise when the vehicle responsible for a motor vehicle accident in South Australia that results in injuries to other road users is either uninsured or unidentified. The Regulator is appointed as the Nominal Defendant under Part 4 of the MV Act. The Regulator assigns management of Nominal Defendant claims to the CTP Insurers in line with their market shares.

The scheme also provides reasonable and necessary treatment, care and support for children under the age of 16 years injured in an accident on South Australian roads, regardless of whether the child or a South Australian registered motor vehicle was at fault.

The CTP scheme is complemented by the Lifetime Support Scheme which operates separate to the CTP scheme. The Lifetime Support Scheme is a no-fault scheme which provides treatment, care and support for people who have sustained very serious lifelong injuries in motor vehicle accidents in South Australia.

The Regulator is established as an independent statutory authority under the Compulsory Third Party Insurance Regulation Act 2016 (the Act). The Regulator’s functions are set out in section 5(1) of the Act.

The Regulator is responsible for:

  • monitoring and reviewing the operations and efficiency of the CTP Scheme
  • oversight, monitoring and reporting of CTP Insurer activities
  • ensuring a fair and affordable scheme is maintained
  • continuing to improve Scheme outcomes for injured people
  • determining the minimum terms and conditions of the CTP insurance policy
  • determining CTP premiums
  • providing information to consumers about the Scheme and CTP insurers.

The Regulator is appointed as the Motor Accident Injury Accreditation Scheme (MAIAS) Administrator by the Attorney-General under section 76 of the Civil Liability Act 1936. The MAIAS Administrator has administrative and financial responsibility of the MAIAS which was established to accredit health professionals to undertake Injury Scale Value (ISV) medical assessments.

An ISV medical assessment is used to assist in determining an injured road user’s entitlement to compensation by assigning referred injuries to ISV Item numbers listed in Schedule 1 of the Civil Liability Regulations 2013. The ISV is a value between 0 and 100 that reflects the level of adverse impact of the injury on the person, based on medical evidence.

The MAIAS Administrator uses the MAIAS Rules to oversee the performance of the medical practitioners. The rules prescribe the regulatory and service standards required for medical practitioners to achieve and maintain accreditation.

The key objective of MAIAS is to create an independent system that provides consistent, objective and reliable ISV medical assessments. As administrator of MAIAS, the Regulator’s responsibilities include but are not limited to:

  • prescribing the processes and documentation of the MAIAS including accreditation training courses and overseeing their implementation
  • supporting Accredited Medical Practitioners (AMPs) and monitoring their performance to verify conformity with accreditation obligations
  • making recommendations to the Minister for approval of applicants who meet the accreditation criteria
  • maintaining and keeping an up to date register of all AMPs
  • continuing oversight of the MAIAS.

Deliver a high performing competitive CTP Scheme that offers choice, ease and confidence to the South Australian community.

Our valuesWhat this means for us
Outcomes driven

  • We look for practical solutions
  • We are decisive in our approach
Accountable

  • We do what we say we will do
  • We act in the best interests of the scheme
Collaborative
  • We listen to, and inform our community
  • We work together to bring positive change
Fair

  • Our practices reflect and uphold our independence
  • We make evidence based decisions
Supportive
  • We provide quality customer service
  • We respect the diversity of the people we serve

During 2020-21 the following changes were made to the Regulator’s structure:

  • The Director Operations has been replaced by the Executive General Manager.
  • The Director Performance has been replaced by the Director Analytics and Finance with the functions of injury recovery and support services, scheme performance and MAIAS transferring to the portfolio of the Executive General Manager.

Kim Birch is the CTP Regulator (Regulator) and Chief Executive (CE) responsible for carrying out the functions of the Regulator and the CE as determined by the Compulsory Third Party Insurance Regulation Act 2016. The Regulator is also the Motor Accident Injury Accreditation Scheme (MAIAS) Administrator under the Civil Liability Act 1936.

  • Kerry Leaver is the Executive General Manager, responsible for monitoring Scheme and CTP Insurer performance and providing information to motorists, as well as overseeing corporate functions.
  • Ivan Lebedev is the Director Analytics and Finance, responsible for information systems, data analytics, corporate finance and the process of determining premium ranges for premium classes.

  • Compulsory Third Party Insurance Regulation Act 2016
  • Part 4, Motor Vehicles Act 1959

The Regulator has a service level agreement with the Department of Treasury and Finance (DTF) for the provision of corporate services to keep administration costs down and support the effective functioning of the Regulator’s office.

Our significant relationships to support scheme efficiency and administration are with:

  • Department for Infrastructure and Transport for the collection and disbursement of CTP premiums.
  • Lifetime Support Authority and ReturntoWorkSA to share information to improve recovery outcomes for injured people.
  • Australian Prudential Regulation Authority to monitor the financial stability and solvency of the CTP Insurers.

In 2020-21 the Regulator had Memorandums of Administrative Arrangement (MoAA) with government agencies to provide the following services to the scheme:

  • Road safety: Department for Infrastructure and Transport and South Australia Police
  • Health and Emergency Services: Department for Health and Wellbeing; SA Ambulance Service; State Rescue Helicopter Service and Forensic Science SA (on behalf of Attorney-General’s Department)
  • Customer support and transaction processing:Department for Infrastructure and Transport.

MoAAs are funded from the administrative component of CTP premiums collectively known as the CTP Scheme Services fee. The CTP Scheme Services fees are detailed on page 28.

The Regulator's performance

In 2020-21 the Regulator continued to deliver on its strategic objectives to support the efficiency of the CTP scheme. Highlights include:

  • Conducted a review of the usability of the injury and fatality claim forms (claim forms). This review involved user experience testing with claimants and road users to understand ways to improve the claim forms. The review resulted in significant changes being proposed including the ability to lodge a claim form completely online. The implementation of the new claim forms will be achieved in 2021-22. More information on the injury claim form review is on page 22 of this report.
  • Expanded the claimant experience survey model to support the Regulator’s function of monitoring the efficiency of CTP scheme operations by measuring claimant experience at key intervals throughout the life of a claim and post claim closure. More information on the claimant experience survey results is on page 23 of this report.
  • Increased the information available on the scheme to all stakeholders through the publication of scheme data in the Scheme Data Dashboard and SA CTP Market Briefing, published on the Regulator’s website www.ctp.sa.gov.au. This was made possible by the scheme reaching a level of maturity sufficient to generate reliable scheme performance statistics.
  • Completed an independent review of the Regulator’s Scheme Compliance Framework which monitors the CTP Insurers against their legislative and contractual obligations. More information on the Regulator’s compliance framework is on page 20 of this report.
  • Delivered a number of internal frameworks to support the Regulator team to continue to grow and deliver against our mission and values. Including a Learning and Development Framework and a Competency Framework which provides clarity to staff on the essential knowledge, skills and behaviours required for optimum performance to assist in enhancing the team’s capability and promoting relevant growth opportunities.

The Regulator’s performance against the 2020-21 strategic plan commences on page 12.

During 2020-21 the Regulator:

  • monitored the impacts of Covid-19 on the scheme
  • supported staff in flexible working arrangements to continue to deliver services
  • extended the trial of telehealth consultations for pure mental harm GEPIC ISV medical assessments until April 2023.

The Regulator’s strategic objectives align with the Government’s priorities of delivering lower costs and better services.

The premium bands determined by the Regulator for the 2020-21 financial year delivered fair and reasonable premiums to motorists.

In 2020-21 the Regulator has focused on improving the customer service experience through a customer service framework. The framework provides a common understanding of good customer service, principles to deliver customer service and a quality assurance program.

The claimant surveys promote the importance of CTP Insurers providing better service to South Australian injured road users.

The Regulator’s various projects mentioned in this report contribute towards delivering better services and managing costs for South Australians.

The Regulator’s strategic objectives support delivery of statutory functions under section 5 of the Compulsory Third Party Insurance Regulation Act 2016.

The Regulator’s performance against strategic objectives is summarised below.

Performance indicator Target dateOutcome
Objective 1: Oversee a financially sustainable, efficient and effective scheme
Premium bands set for each premium class May 2021 Achieved
Implement Scheme Fraud Management Framework December 2020 Achieved
Negotiate Memorandums of Administrative Arrangement with SA Police and Dept. for Infrastructure and Transport June 2021 Achieved
Plan and prepare the scheme for automated vehicles and participate in the ‘Across Government Automated Vehicle Reform Working Group’ June 2022 On track
Plan for scheme underwriting model review in 2022 June 2022 On track
Objective 2: Promote an outcomes driven, early recovery and service focused approach to claims management
Develop proposal to improve usability of the claim forms June 2021 Achieved
Develop a proposal for a scheme protocol for arranging medico-legal assessments November 2020 Achieved
Introduce a survey process to measure claimants' experiences June 2023 On track
Objective 3: Meet our regulatory and statutory obligations
Introduce a sustainable, appropriate annual scheme risk and compliance planning cycle June 2020 Achieved
Procure a medical review panel for MAIAS September 2020 Achieved
Increase scheme performance transparency March 2021Achieved
Implement new MAIAS website and learning management system December 2021 Achieved
Implement AMP training plan 2020-2021 June 2021 Achieved
Deliver a risk-based scheme compliance plan June 2021 Achieved
Deliver a sustainable Motor Accident Injury Accreditation Scheme (MAIAS) quality assurance program June 2021 Achieved
Enhance website content and experience for stakeholders June 2021 Achieved
Connect with treatment services to provide scheme information for injured road users June 2021Achieved
Develop a proposal for enhancing data driven compliance June 2021 Achieved
Embed our Corporate Governance FrameworkMarch 2021 Achieved
Evaluate the Competition scheme engagement strategyAugust 2020Achieved
Plan for Accredited Medical Practitioner (AMP) accreditation in 2022September 2022On track

Objective 4: Enhance the capability of our team to lead the delivery of our vision and mission

Develop a CTP competency framework December 2020 Achieved
Establish a learning and development framework April 2021 Achieved
Deliver our customer service frameworkJune 2021Achieved
Develop systems and processes to analyse and act on staff feedbackOctober 2020 Achieved
Capacity building placement for people with disability February 2022On track

The Regulator commenced a pilot work placement program to build capacity of people with disability. This program aims to support strengthening confidence and capability to enable the person to compete in the jobs market. The learnings from this pilot program will provide us a blueprint for similar programs in the future.

Regulator staff access Department of Treasury and Finance’s (DTF) performance management and development systems. All staff have performance plans in place that are reviewed every six months.

Regulator staff are employed by DTF and seconded to the Regulator. Regulator staff access DTF’s work health, safety and return to work programs.
Regulator staff work health and safety breaches, workplace injury claims, notifiable incidents or improvement and prohibition notices are recorded and reported in the DTF annual report.

Executive classificationNumber of Executives
SAES Level 1
2
SAES Level 2
1

The Office of the Commissioner for Public Sector Employment has a workforce information page that provides further information on the breakdown of executive gender, salary and tenure by agency.

Financial performance

The following is a brief summary of the overall financial position of the Regulator. The information is unaudited. Full audited financial statements for 2020-2021 are attached to this report.

Statement of Comprehensive Income
2020-21 Budget
$000s
2020-21 Actual
$000s
Variation
$000s

Past year
2019-20 Actual
$000s
Total Income
78,831
79,850
1,019
65,356
Total Expenses
64,157
62,391
(1,766)
58,956
Net Result
14,674
17,459
2,785
6,400
Total Comprehensive Result
14,674
17,459
2,785
6,400
Statement of Financial Position2020-21 Budget
$000s
2020-21 Actual
$000s
Variation
$000s

Past year
2019-20 Actual
$000s
Current assets53,823
42,366
(11,457)
35,086
Non-current assets342
19
(323)
342
Total assets
54,165
42,385
(11,780)
35,428
Current liabilities
22,512
8,011
(14,501)
18,451
Non-current liabilities
510
448
(62)
510
Total liabilities
23,022
8,459
(14,563)
18,961
Net assets
31,143
33,926
2,783
16,467
Equity
31,143
33,926
2,783
16,467

The following is a summary of external consultants that have been engaged by the Regulator, the nature of work undertaken, and the actual payments made for the work undertaken during the financial year.

Consultancies Purpose$ Actual payment
All consultancies below $10,000 each - combinedVarious
$2,792

Consultancies
Purpose
$ Actual payment
Taylor Fry Pty LtdScheme actuarial services$443,230
PriceWaterhouseCoopersInternal audit$113,991
Total$560,013

See also the Consolidated Financial Report of the Department of Treasury and Finance for total value of consultancy contracts across the South Australian Public Sector.

The following is a summary of external contractors that have been engaged by the Regulator, the nature of work undertaken, and the actual payments made for work undertaken during the financial year.

Contractors
Purpose
$ Actual payment
All contractors below $10,000 each - combined
Various
$15,260

Contractors Purpose $ Actual payment
Biz Hub Australia Pty Ltd Personal Injury Register annual support $28,001
Dr Dwight Dowda MAIAS Training $12,395
Dr Michael Epstein

MAIAS Training

$12,834

Dr Beata M Byok

MAIAS quality assurance $15,942

Dr Michael Epstein

MAIAS quality assurance $13,359

Haymakr

Market research $236,948

Alto People

Organisation development $21,450

Alemba Pty Ltd

Customer relationship management $12,960

Gowland Consulting Pty Ltd

MAIAS QA sustainability review $39,500

Total

$408,650

The details of South Australian Government-awarded contracts for goods, services, and works are displayed on the SA Tenders and Contracts website. View the agency list of contracts.

The website also provides details of across government contracts.

Refer to the Reporting required under the Compulsory Third Party Insurance Regulation Act 2016 section of this report.

Risk management

The Risk and Audit Committee meets quarterly to provide assistance to the Governance Committee on the operation and effectiveness of the risk management framework and internal and external audit activities.

The Regulator also reports annually to the DTF risk and audit committee.

In the past year the committee fulfilled its responsibilities according to its terms of reference including:

  • Overseeing the 2020-21 internal audit plan (outsourced)
  • Updated the risk appetite statement
  • Updated the incident management policy
  • Enhancing risk register administration and maintenance
  • Monitoring the progress of implementing internal audit recommendations
  • Endorsing the 2021-22 internal audit plan

A Risk Culture Survey was conducted to measure Regulator staff understanding and behaviours towards risk management to inform opportunities for continuous improvement in the way risk is managed.

Survey results demonstrated a high awareness and understanding of risk and risk accountability among staff. The survey highlighted opportunity to tailor risk and compliance training to individual roles. As a result, quality management system training and lead auditor training were provided to all managers and roles involved in risk and compliance activities.

To further support staff to speak up in relation to risk it was recommended to share ‘lessons learned’ to reinforce the organisation-wide position on how mistakes are recognised as learning opportunities. This has been incorporated into our learning and development plan for 2021-22.

No fraud was detected.

The Regulator has a robust suite of policies and work instructions to address key risks and establish controls to mitigate the risk of fraud. These controls include but are not limited to:

  • segregation of duties
  • delegations of authority
  • user restrictions to financial software
  • asset register
  • triennial employee criminal history screening
  • independent internal audit function
  • financial management compliance program
  • staff training and education on policies and procedures
  • requirement of staff to adhere to the Public Sector Code of Conduct
  • annual Conflict of Interest Declaration process for all staff.

There were no occasions on which public interest information was disclosed to a responsible officer of the Regulator under the Public Interest Disclosure Act 2018.

Reporting required under the Compulsory Third Party Insurance Regulation Act 2016

This section of the report details the operational activities performed to meet the Regulator’s functions under the Act.

Key activities completed in 2020-21 include:

  • Determined new premium bands from 1 July 2021 resulting in sustained price competition across the majority of premium classes.
  • Updated the Regulator Rules to respond to changes where necessary. Updates were made to allow for GEPIC telehealth consults in response to Covid-19, update the definition of “complaint”, and make amendments in response to changes in the Uniform Civil Rules 2020.
  • Implemented a Fraud Management Framework to identify, monitor and manage cases of potential dishonesty or fraud within the scheme.
  • Developed a guideline for arranging joint independent medical assessments to assist claimants and CTP Insurers to jointly agree on the expert to conduct an assessment to minimise impacts on a claimant’s wellbeing. Providing information about the scheme

  • Increased scheme transparency with the publishing of the Scheme Data Dashboard. The dashboard provides an overview of the scheme, including CTP claims and insurer premiums, from 1 July 2016 up to 31 December 2020. In developing the dashboard, the CTP Regulator has added to the ways it provides information to consumers about the scheme and CTP Insurers. Transparent information also promotes South Australian community confidence in the scheme. The Scheme Data Dashboard will be updated annually.
  • Published the SA CTP Market Briefing prepared by the scheme actuary Taylor Fry which informs the premium setting. This will be published annually.
  • Connected with front line treatment service providers to provide scheme information for injured road users. Providing information to front line treatment providers allows them to pass the information on to injured road users to increase awareness and access to the scheme where appropriate.

The Regulator uses a suite of tools to oversee scheme performance and to identify areas for further investigation in scheme trends, CTP Insurer performance and data quality.

The Regulator monitors the compliance of CTP Insurers with contractual and legislative obligations using the compliance framework. The framework is risk based, targeting areas of highest priority for the scheme. The framework prescribes compliance activities, including:

  • claims management reviews
  • data analytics
  • mandatory declarations.

In 2020-21 the delayed 2019-20 program was completed, as well as the 2020-21 program. This resulted in one insurer having two audits conducted in the last year.

Audits address performance across each insurer’s business operations including:

  • service levels provided to claimants
  • compliance with legislative obligations
  • approval of treatments
  • complaints management and dispute resolution
  • payments and settlements
  • management of confidential information.

The 2020-21 compliance program saw overall CTP Insurer improvements compared to the 2019-20 year.

Areas of good performance include claim lodgement and management, liability communication and rehabilitation management, especially in informing claimants and providing reasons for decisions.

Identified areas of improvement include:

  • reducing unauthorised disclosures of personal information
  • meeting timeframes including the provision of information obtained via the prescribed authority within 21 days, response to funding requests and reimbursement of expenses within seven days
  • explaining the complaints and disputes process
  • providing the claimant with an assessment for each head of damage as part of the settlement offer.

Where the compliance program identifies findings, CTP Insurers are required to submit remediation plans that are tracked monthly against agreed deadlines and outcomes. Any areas considered non-compliant can result in CTP Insurers being issued with breach notices.

The Regulator observed the insurers strengthening their internal controls over 2020-21, resulting in a reduced number of breaches being issued compared to 2019-20. The following table shows 26 breaches were issued in 2020-21, of which six are open as at 30 June 2021 and remediation is being monitored by the Regulator.

The most common areas of breaches this past year reflect areas for improvement and include:

  • privacy breaches
  • providing reports/information to claimants over 21 days
  • responding in writing to funding requests over seven business days

CTP Insurer breaches issued in 2020-21

CTP InsurerBreaches 2019-20Breaches 2020-21
AAMI72
Allianz1619
QBE152
SGIC83
Total4626
Note – the number of breaches reported for Allianz in 2020-21 is higher due to COVID-19 interruptions which prevented the Regulator from completing its audit of Allianz in the 2019-20 financial year. This resulted in Allianz being audited twice in the 2020-21 financial year. The Regulator observed improvements in the number of obligations met by Allianz in the second audit of 2020-21 compared to the first.

In response to CTP Insurer Breaches, CTP Insurers paid five sanctions to the total of $120,000 to the State Government.

In response to an improved control environment, in the 2021-22 financial year, the Regulator will move from an annual to a bi-annual approach for insurer audits, auditing two insurers each financial year. By adopting this approach, the Regulator can demonstrate to the industry that the scale and scope of the compliance program is proportionate with performance. As the insurers are demonstrating increased compliance and performance against their obligations, the program is adapting to the current risk profile.

As part of the Regulator’s focus on continuous improvement and reviewing the operation and efficiency of the scheme, the Regulator commenced a review of the injury and fatality claim forms (claim forms).

The claim forms had not been reviewed since their introduction in 2013 (prior to the privately underwritten scheme). The purpose of the review was to determine their fitness for purpose and enhance the experience of injured people making a CTP claim in South Australia by improving the usability of the forms and the claim lodgement process.

The review was underpinned by four key principles focusing on: identifying and removing barriers to early access to funding of treatment; enabling CTP Insurers to receive early, relevant claim information; determining the viability of end-to-end electronic lodgement; enhancing data collection for scheme monitoring and future scheme design.

We sought the views of injured people with CTP claims (claimants), potential claimants (road users), CTP Insurers, the Royal Australian College of General Practitioners, general practitioners who treat injured people, the Law Society SA and personal injury legal practitioners on the claim form process.

The review identified the need to:

  • improve usability of the form by rewording and reordering questions for clarity
  • introduce end-to-end online form lodgement to increase ease of access to the scheme and accelerate the claim lodgement process
  • update questions to improve data collection for scheme monitoring (for example to measure scheme utilisation to initiate targeted educational campaigns if required)
  • introduce a prescribed medical certificate to be submitted with the claim form to support early access to reasonable and necessary treatment for injured people
  • make amendments to the prescribed authority to obtain information (authority) to reduce potential barriers to a claimant’s recovery and progression of their claim when an authority is revoked.

To make amendments to the authority and to prescribe a medical certificate, amendments to the Motor Vehicles (Third Party Insurance) Regulations 2013 were sought. These amendments were published in the Government Gazette on 1 July 2021, with an anticipated commencement date of 1 November 2021.

The new claim forms are anticipated to be implemented before the end of the 2021 calendar year. The implementation will see continued engagement with injured road users, frontline medical providers, legal providers and CTP Insurers to support a smooth transition as well as provide new communication tools.

Understanding the claimant experience through conducting surveys supports the Regulator to monitor and measure the operation and efficiency of the CTP Scheme. The survey results highlight to CTP Insurers areas for improvement to benefit claimants. Publication of survey results provides information to scheme stakeholders on CTP insurer performance.

Since 2019 the Regulator has conducted surveys with injured people approximately three months after they have made a CTP claim. The surveys determine an average Claimant Service Rating for each CTP Insurer which is published on registration renewal notices to assist vehicle owners to choose an insurer. The higher the number, the better the CTP Insurer’s service has been rated.

In July 2020 the Regulator commenced an additional survey for 12 months to follow-up with claimants approximately 10 months from lodging their claim. The purpose of the survey was to measure any change in service from the three month survey.  The survey provided an opportunity for claimants to communicate areas for improvement to the Regulator and CTP insurers.

The response rate was 59%, with over 600 people agreeing to be surveyed.

Most claimants (53%) believed the service stayed the same, 14% believed that service improved and 34% believed the service had declined in the period from the three month survey to 10 months after lodgement; this trend was relatively consistent across insurers (see the chart below). The most common reasons provided for the decline in claimant satisfaction were that insurers were slow to respond to claimants, and claimants were dissatisfied with the progress of their claim.

Survey question: Compared to the first 3 months of your claim, would you say that the service you have received from the insurer has…

More than three in five claimants reported they would recommend their insurer 10 months into their claim, this represents a decline from the first survey where almost four in five would recommend their insurer: see the table below.

Whole of industry

3 months into claim10 months into claimChange
Likely to recommend the CTP insurer77%61%– 16 points

Claimants were asked to rate a range of elements of the CTP Insurers service. Despite an overall decline from the three month to 10 month survey, the friendliness and helpfulness of insurer staff was rated highly, 75 out of 100, at the 10 month survey: see the table below.

Change in average score between 3-month survey and 10-month survey

Includes 3-month survey results for claims lodged in the same months as the claims included in the 10-month survey.
The first number is the 3-month survey results, the second is the 10-month follow-up, and the change is given in brackets.
The colour is based on the change value, with yellow for small declines, moving to orange and then red for larger declines.

In the 2021-22 financial year, claimant surveys commence at key milestones in the claim process: claim lodgement, liability decision, after an ISV medical assessment and after settlement.

The findings will be used to monitor and review the efficiency of the scheme and determine any necessary improvements to drive a better experience for claimants across the scheme.

The objective of MAIAS is to create an independent system that provides consistent, objective and reliable Injury Scale Value (ISV) medical assessments. It accredits health practitioners to undertake ISV medical assessments which includes assigning injury Item Numbers based on the assessment of injuries sustained in motor vehicle accidents. The assessment reports assist claimants and CTP Insurers in the claims settlement process.

Telehealth for GEPIC ISV medical assessments

The COVID-19 pandemic led to a review of processes that could be amended to support claimants during pandemic conditions. A trial was commenced for the use of telehealth consultations for pure mental harm GEPIC assessments where it is safe and clinically appropriate to do so. The trial has been extended to April 2023 to allow for enough experience to be reported by claimants for the MAIAS to conduct an evaluation of the trial’s effectiveness in early 2023.

Quality Assurance (QA) program

In 2020-21 new training materials were developed to engage with AMPs in quality ISV medical assessment report writing.

MAIAS completed three QA reviews throughout the year to assess the quality of ISV medical assessment reports (ISV reports) against the Civil Liability Act 1936, Civil Liability Regulations 2013 and the accreditation criteria from the MAIAS Training Manual.

Throughout the year 108 physical ISV reports produced by 20 AMPs and 23 GEPIC ISV reports produced by five AMPs were reviewed. This equates to a review of 6% of physical ISV reports and 18% of GEPIC ISV reports.

As a result of feedback from AMPs, the quality assurance review was conducted on an ongoing basis to provide more timely results of recently completed assessments and allow sufficient time to implement feedback before further quality assurance activity was undertaken.

Performance in GEPIC ISV report quality in 2020-21 improved or remained the same as in 2019-20 with all measures seeing very high levels of compliance.

For physical ISV reports, the results highlighted the need for focus in the following areas:

  • stating stability for each of the referred injuries
  • addressing each referred injury under the opinion section
  • accuracy of determining and recording of WPI and ISV Item Numbers.

Focus areas are addressed individually with AMPs and used in designing future training and accreditation materials to better support all AMPs.

In October 2020, the MAIAS Administrator sought an independent review of the QA program, which included feedback from AMPs, to make recommendations for a sustainable program. The review showed a strong history of continuous improvement. Key recommendations were provided to strengthen the program including through the consolidation of tools, development of a framework and increased transparency.

In the coming year, the MAIAS will focus on implementing the recommendations from the review, and plan for the new AMP accreditation cycle by reviewing training and accreditation materials. The delivery of the accreditation training will be supported by implementation of a learning management system.

Changes to MAIAS ISV report templates and Rules

In 2020-21 amendments were made to the ISV report templates—based on advice from the medical peer reviewers—to provide clearer instructions and guidance to support AMPs to produce consistent, quality ISV medical assessment reports. MAIAS Rule changes in April 2021 incorporated changes required for the trial of telehealth consultations.

Insured vehicles by type

(Registrations as at 30 June 2021)

Type of vehicleVehicles%

Private passenger

1,084,272

57.26%

Public passenger: no fare

660

0.03%

Taxis: metropolitan

942

0.05%

Taxis: country

271

0.01%

Hire cars

7,489

0.40%

Rideshare

4,692

0.25%

Public passenger: small

761

0.04%

Public passenger: medium

1,061

0.06%

Public passenger: heavy

651

0.03%

Public passenger: omnibus

1,077

0.06%

Goods carrying: light

219,969

11.62%

Goods carrying: medium

15,568

0.82%

Goods carrying: heavy

10,228

0.54%

Goods carrying: primary producers

30,279

1.60%

Motorcycles: ultra light

3,232

0.17%

Motorcycles: light

8,592

0.45%

Motorcycles: medium

13,040

0.69%

Motorcycles: heavy

20,476

1.08%

Tractors

53,532

2.83%

Historic and left hand drive vehicles

34,014

1.80%

Special purpose vehicles

15,651

0.83%

Car carriers: light

1

0.00%

Car carriers: medium

22

0.00%

Car carriers: heavy

1

0.00%

Car carrier trailers

122

0.01%

Trailers

365,001

19.27%

Unregistered vehicle permits

106

0.01%

Motor trade plate

2,008

0.11%

Total

1,893,718

100.00%

Source: Department for Infrastructure and Transport policy data.

Ratio of class 1 premium(1) to South Australian average weekly earnings (AWE)(2)

Annual premium(1)State AWE(2)Ratio

2020-21

$295.40

$1,543

19%

2019-20

$296.77

$1,504

20%

2018-19

$411.25

$1,462

28%

2017-18

$400.75

$1,442

28%

2016-17

$389.00

$1,446

27%

(1) Note: Premium is the weighted average lowest priced Class 1 District 1 public passenger vehicle (private use, no input tax entitlement) on offer over the financial year.
(2) Source: Australian Bureau of Statistics, 6302.0 Average Weekly Earnings, Australia. Earnings; Persons; Full Time; Adult; Ordinary time earnings; South Australia; Series Id: A84989336X, November (in given financial year).

Premium and fee collection

(1 July 2020 to 30 June 2021)

Description$'000

Insurers' premiums*

316,323

Stamp duty

41,916

Road safety

14,173

Emergency transport, hospital and forensic services

32,480

Customer support and transaction processing

10,632

CTP Scheme regulation and administration

7,444

Total insurance premiums collected

422,968

Note: *Includes GST.

Market share of in-force premium

AAMIAllianzQBESGIC

30 June 2021

20%

18%

21%

41%

30 June 2020

28%

27%

21%

24%

30 June 2019*

30%

15%

35%

20%

30 June 2018*

30%

15%

35%

20%

30 June 2017*

30%

15%

35%

20%

Note: *All insurers had contractually agreed market share for the first three years.

Number of changes to filed premiums

2019-20 premium changes2020-21 premium changes
Type of vehicleDistrict 1District 2District 1District 2

Private passenger

6

6

1

1

Public passenger: no fare

6

6

7

7

Taxis: metropolitan

6

 

5

 

Taxis: country

6

 

6

 

Hire cars

6

6

7

7

Rideshare

7

7

5

5

Public passenger: small

8

8

7

6

Public passenger: medium

6

8

7

7

Public passenger: heavy

8

8

6

6

Public passenger: omnibus

6

 

7

 

Goods carrying: light

6

6

1

1

Goods carrying: medium

8

8

7

7

Goods carrying: heavy

6

6

6

7

Goods carrying: primary producers

7

7

4

7

Motorcycles: ultra light

7

8

6

6

Motorcycles: light

8

8

6

6

Motorcycles: medium

7

8

6

6

Motorcycles: heavy

8

7

6

6

Tractors

8

8

3

3

Historic and left hand drive vehicles

8

8

3

3

Special purpose vehicles

7

7

7

7

Car carriers: light

8

8

4

4

Car carriers: medium

6

8

5

5

Car carriers: heavy

8

8

5

4

Car carrier trailers

7

7

4

4

Unregistered vehicle permits

1

1

1

1

This is an indicator of premium price competition in the CTP scheme. Premium classes for taxis and omnibuses do not depend on the district, but counted with district 1 in the table.

Claimant service rating results

Publication monthAAMIAllianzQBESGIC

June 2021

77

78

75

79

June 2020

81

72

77

85

June 2019

69

72

71

70

Note: The score published each month is the average claimant service rating from claimants surveyed in the previous six months.

Number of accidents by region(Accidents from 1 July 2020 to 30 June 2021)

Region
Accidents
%

Adelaide City / Suburbs

1,332

86.8%

Outer Adelaide

125

8.1%

Murraylands

30

2.0%

South

16

1.0%

Northern

5

0.3%

Eyre

8

0.5%

Interstate

18

1.2%

Total

1,534

100%

Note: The recent accident years’ data is immature due to accidents where a claim is yet to be reported.

Claim lodgement by development year

(All claims for accidents from 1 July 2016 to 30 June 2021)

Accident year Development yearTotal
12345

2016-17

2,376

630

49

29

16

3,100

2017-18

2,116

470

56

23

 

2,665

2018-19

1,931

426

45

  

2,402

2019-20

1,552

344

   

1,896

2020-21

1,737

    

1,737

Total

11,800

Note: Development year 1 means claims lodged in the accident year (year means financial year), development year 2 means claims lodged in the next year after the accident year, etc.

Claims by current status

(All claims for accidents from 1 July 2016 to 30 June 2021)

Accident yearClaims lodgedClaims openClaims closed% closed

2020-21

1,737

1,417

320

18%

2019-20

1,896

985

911

48%

2018-19

2,402

778

1,624

68%

2017-18

2,665

545

2,120

80%

2016-17

3,100

404

2,696

87%

Claimants by demographic

(All claims for accidents from 1 July 2016 to 30 June 2021)

Age groupMalesFemalesTotal%

16 years and under

275

286

561

5%

17 to 24 years

602

844

1,446

12%

25 to 34 years

988

1,299

2,287

19%

35 to 44 years

956

1,123

2,079

18%

45 to 54 years

1,054

1,154

2,208

19%

55 to 64 years

858

901

1,759

15%

65 years and over

620

835

1,455

12%

Unspecified

3

2

5

0%

Total

5,356

6,444

11,800

100%

Claimants by accident role

(All claims for accidents from 1 July 2016 to 30 June 2021)

RoleClaims%

Driver

7,425

63%

Passenger

2,549

22%

Cyclist

815

7%

Pedestrian

735

6%

Other

276

2%

Total

11,800

100%

Claims by severity

(Closed claims for accidents from 1 July 2016 to 30 June 2021)

AIS* severityClaims%

Minor

4,787

62.4%

Moderate

827

10.8%

Serious

301

3.9%

Severe

20

0.3%

Critical

8

0.1%

Maximum

127

1.7%

Admin Only

1,601

20.9%

Total

7,671

100%

Note:

*Injury severity based on injuries coded under the Abbreviated Injury Scale 2008 (AIS 2008).

“Minor” category includes claims where a region-specific injury code was reported with a severity of 9 (“not further specified”).

“Maximum” injury severity usually indicates a fatality.

“Admin” means there were no physical injuries caused by the accident or there was no medical evidence available for injury coding.

Claims by dominant injury body region

(Closed claims for accidents from 1 July 2016 to 30 June 2021 excluding claims without a dominant injury recorded)

Body regionClaims%

Cervical spine

1,823

25%

Shoulder

1,534

21%

Thoracic spine or lumbar spine

867

12%

Other

691

10%

Pelvis or hip

554

8%

Pure mental harm

445

6%

Other lower limb

426

6%

Knee

300

4%

Central nervous system and head

252

3%

Chest

204

3%

Wrist

165

2%

Total

7,261

100%

Rates of legal representation

(Accidents from 1 July 2016 to 30 June 2021)

Accident yearClaims% Legal rep% Litigated% Trial

2020-21

1,737

26%

0.0%

0%

2019-20

1,896

33%

0.2%

0%

2018-19

2,402

32%

1.3%

0%

2017-18

2,665

40%

10.3%

0%

2016-17

3,100

41%

18.3%

0%

Note: The recent accident years’ data is immature due to the long tail nature of CTP claims.

Legal costs

(All legal cost payments for accidents from 1 July 2016 to 30 June 2021)

Accident yearSolicitor client costsPlaintiff - Legal ($'000)Defendant - Legal ($'000)Grand total ($'000)

2020-21

Unknown

3

40

44

2019-20

Unknown

380

288

668

2018-19

Unknown

1,855

861

2,715

2017-18

Unknown

6,707

3,182

9,888

2016-17

Unknown

11,328

7,628

18,956

Total

20,273

11,999

32,271

Note: Solicitor client costs are unknown because there is no legal requirement for solicitors to provide their solicitor client costs to the managing insurer of a claim and so they are not reported to the CTP Regulator.

Claim duration by CTP Insurer

(Closed claims for accidents from 1 July 2016 to 30 June 2021 where relevant data is available)

TimeframeAAMIAllianzQBESGICAverage

Notification date to compliance date

38

48

18

54

36

Notification date to liability decision date

106

69

115

96

101

Notification date to closure date

478

411

460

389

443

Note: Timeframe is average days.

Heads of damage breakdown

(Closed claims from 1 July 2020 to 30 June 2021 for accidents from 1 July 2016 to 30 June 2021)

Heads of damageClosed claimsTotal ($’000)% Closed payments

Economic Loss

809

53,148

44%

Non-Customer Benefits

1,662

23,982

20%

Treatment

1,886

20,020

17%

Care

999

18,086

15%

Non-Economic Loss

324

4,467

4%

Other Customer Benefits

471

657

1%

Total

2,009

120,363

100%

Note:

“Care” category includes payments for past and future care and home services, care-related travel and voluntary services.

“Non-customer benefits” category includes investigation costs, the costs of medical reports from treating medical providers and ISV medical assessors, and plaintiff and defendant legal costs.

“Other customer benefits” category includes claimant travel expenses and reasonable funeral costs. In the 2018-19 annual report this category included payments to surviving spouse and/or children for the loss of family member, payments to partners of injured persons for the loss of companionship, and rehabilitation costs. These payment types have now been moved to other heads of damage in the table.

“Treatment” category includes payments for past and future medical, allied health and hospital services, excluding public hospital services funded from the administrative fee component of CTP premiums.

Nil claims (zero payments) have been excluded from the data.

Nominal defendant claims received by accident year

(Accidents from 1 July 2016 to 30 June 2021)

Year of accidentUnidentified vehiclesUnregistered vehiclesTotal

2020-21

42

29

71

2019-20

44

21

65

2018-19

59

21

80

2017-18

70

24

94

2016-17

87

18

105

Note: The recent accident years’ data is immature due to accidents where a claim is yet to be reported.

Communications

TypeNumber of instances

Complaints about CTP Insurers

34

Complaints about the scheme

1

Complaints about the Motor Accident Injury Accreditation Scheme

2

Complaints about the Regulator

0

Enquirer sourceNumber of enquiries

General Public

4,238

CTP Insurer

508

Medical

328

Legal

153

Government Department

128

Other

11

Total

5,367

Enquiry categoryNumber of enquiries
Claims
2,030
Registration or other insurance*
1,703
CTP Scheme
401
Competition Scheme
46
Complaints
28
Nominal Defendant
18
MAIAS
12
Total
4,238

Note: *Registration or other insurance enquiries include calls about comprehensive insurance and vehicle registration outside the responsibility of the CTP Regulator. The number for “Complaints” does not match the number of complaints listed in the public complaints section of this annual report because each complaint can involve a number of enquiries and this category also includes questions about the complaints process that do not result in a complaint being lodged with the Regulator.