Investigación de campo

The terms of reference for this review identifies the importance of reducing the deficit of the Scheme, and the efficiency of the Scheme. This is relevant for the consideration of principle 2 in relation to ‘optimal insurance arrangements’. An Issues Paper released by the NSW Government prior to the reforms stated that it was ‘acting urgently to ensure its long-term sustainability to provide injured workers with the support they deserve while remaining affordable, fair and competitive for NSW’. Ensuring financial sustainability is a necessary but not sufficient condition to the effective operation of the scheme. When finances are sound, then benefit distribution can be stronger.

Arguably, the most significant of driver of the reforms was the Scheme’s poor financial performance. There has been a rapid recovery of the Scheme since the reforms to a surplus of $1 361.3 million in 2013.73 _{While stakeholders are divided on the merits of the pace with} which the Scheme was returned to a surplus, there was a valid, substantive and structural problem in the Scheme financials prior to the amendments.

71 Submission to Joint Select Committee on the NSW Workers Compensation Scheme, 2012.

72 _{NSW Long-term fiscal pressures report: NSW Intergenerational Report, Budget Paper No. 6.} 73 PricewaterhouseCoopers, 2014, WorkCover NSW Full Report: Actuarial valuation of outstanding

Booth 74 _{commented that ‘a deficit of that size’ could be the result of poor investment} strategies leading to capital losses in the fund (particularly in the very difficult investment climate of recent years), generous benefits, inadequate pricing, poor claims management practices, and impairment or inefficient operation of legal processes. 75

That said, some submissions deny that the Scheme was in financial crisis, and that the positive turnaround in investment earnings could have been predicted. Hence, without changes to benefit funding, the Scheme could have returned to positive territory without dramatic premium increases.

While it is true that the improvement in investment returns contributed to the improved financial performance of the Scheme, it remains appropriate that financial sustainability is a core principle for workers compensation arrangements in NSW. Moreover, it is believed to be appropriate that the 2012 reforms sought to reduce the deficit and improve the efficiency of the Scheme.

■ _{Prior to the reforms, the Scheme was not meeting reasonable prudential objectives. In its}

2008-09 Corporate Plan, WorkCover outlines a target range for the funding ratio to remain between 90 per cent and 110 per cent, and in the 2010-2015 Corporate Plan establishes a target for the average funding ratio over a five-year rolling period of greater than 95 per cent76_{. The funding ratio (of assets to liabilities) was 78 per cent in 31} December 2011

■ _{In the absence of improvements to investment performance, the Scheme would not have}

returned to a surplus by December 2013. Despite the change in investment returns and external factors such as the discount rate assumptions following the reforms (see chart C.7), these factors alone would have been insufficient to support financial recovery. In the six months leading to the reforms (to December 2011), the Scheme deteriorated by $1 719 million to a deficit of $4 083 million. Most of the deterioration in the six months prior to the reforms was due to revisions to the market outlook.77

However, the external peer review of this actuarial evaluation stated that the assumptions, including changes to the risk free discount rates underpinning the deterioration in the budget position, were not unreasonable. Ernst and Young independently reviewed the actuarial statement by PwC and stated that it was likely the deteriorating trend would continue and Scheme liabilities would further increase ‘unless an intervention of circuit breaker is applied (i.e. legislative changes)’ despite WorkCover’s best efforts to implement remediation actions.78

74 Booth, D. 2012. Government intervention in insurance markets. Geoff Masel Lecture 2012.

75 _{Booth, D. 2012. Government intervention in insurance markets. Geoff Masel Lecture 2012,}

Australian Insurance Law Association.

76 PwC, 2011. WorkCover NSW: Paper 2 Solvency Management: Discussion Paper.

77 Changes to risk-free discount rates were made in accordance with accounting standards. For instance, accounting standard AASB 1023 states that outstanding claims liability shall be discounted using risk-free discount rates that are based on current observable, objective rates that relate to the nature, structure and term of the future obligations a (PwC, 2014).

78 _{Ernst and Young, 2012, identify risks due to Workplace Injury Damages, Section 66 and}

C.7 Contribution to changes in surplus/deficit

Data source: PwC, letter to Gary Jeffery of NSW WorkCover, 2014.

Moreover, the deterioration in the Scheme from a surplus in 2008 of $1.1 billion to a large deficit of $4.1 billion in 2011 was predominantly caused by the sustained increase in liabilities from changes in claims experience since 2008 (chart C.8).

This was caused by an increase in the number of weekly benefit claims remaining on benefits, an increase in medical expenditure, and a significant increase in the number of Workplace Injury Damage claims, which accounted for 80 per cent of outstanding liabilities in December 2011 and 95 per cent of the deterioration in outstanding claims liabilities since 2008. It was also caused by increases to ‘top up’ payments for Permanent Impairment (Section 66) and the utilisation of Pain and Suffering (Section 67) payments.

C.8 Increase in Scheme liabilities from changes in claims experience/actuarial assumptions

Note: Changes in economic assumptions and investment earnings, which are outside the control of WorkCover, are excluded. Data source: External peer review of outstanding claims liabilities of the Nominal Insurer as at 31 December 2011.

-6 -5 -4 -3 -2 -1 0 1 2 3 4

Jan-08 to Dec-11 Jan-12 to June-12 Jul-12 to Jun-13

$

bi

ll

io

n

Underwriting result Investment returns relative to expectations External factors inc discount rate assumptions Total change in surplus / deficit

0 500 1 000 1 500 2 000 2 500

Jun-08 Dec-08 Jun-09 Dec-09 Jun-10 Dec-10 Jun-11 Dec-11

($

m