New South Wales paramedics are facing the State Government at the Industrial Relations Commission (IRC) amid a dispute about death and disability payouts.

Some paramedics face losing up to half-a-million dollars worth of entitlements if Government changes to the scheme go ahead.

The Health Services Union (HSU) has attented a conciliation meeting with the Government at the IRC.

Before the talks, paramedic and union delegate Steven Fraser said the HSU had to hold up against the Government's plan to scrap the death and disability award.

“We want to stop that and we want to talk about sensible options that we can create to stop paramedics being injured in the first place, and then to give them some protection financially for their family,” he told reporters.

The HSU says that if a paramedic were to be seriously injured right now, their payout would range from $685,642 to $253,515 depending on their age (younger ambulance officers receive more).

Under the proposed changes to the scheme, the HSU says paramedics would receive just $185,197, no matter their age or injury.

The HSU said it was a slap in the face to paramedics who are already twice as likely to be injured on the job than police, and six times more likely than any other worker to be killed at work.

“Being a paramedic is one of the most dangerous professions,” Mr Fraser said.

“The importance for this is, once you can't work as a paramedic, that's what we're trained to do, that's what we love to do and we don't want to be abandoned by the government.

NSW Health said it needed to review entitlements because insurer Zurich had significantly increased its premiums.

“Under the current Death and Disability Award, which was made with the consent of the HSU, a review is triggered when the long-term cost to the Government is likely to exceed 3.6 per cent of salaries,” a Health Department spokesperson said.

“As a result [of the rise in insurance costs] NSW Health has brought this matter to the Industrial Relations Commission for the determination of a new award to introduce a changed scheme.

“All parties have been unsuccessful in identifying an alternative insurer for the current scheme.

“The proposed changes, incorporating a death benefit and an income protection benefit, are aimed at bringing the scheme back within the financial parameters agreed when the scheme was established.”

Mr Fraser said increasing insurance premiums should not be an excuse to punish frontline workers.

“What we'd like to do is look at ideas for self-insuring, self-funding with the Government, but mainly working with the Government to reduce injuries so there'd be no claims,” Mr Fraser said.

Insurance company Zurich says disability claim rates are increasing for all customers.

“Our recent pricing review follows significant and continuing deterioration in the claims experience of this particular scheme and reflects the true cost of us continuing to provide cover to its members,” the spokesman said.

“Our overarching commitment is to maximise our ability to support members at claim time.”

Arbitration before the IRC is set for December.