Medical Indemnity for insurers
To strengthen the availability of medical services in Australia, in 2002 the government introduced medical indemnity legislation.
The legislation provides a package of financial assistance which helps keep medical indemnity insurance premiums at an affordable level. It does this by providing financial support to medical defence organisations (MDOs) and medical indemnity insurers (MIIs).
The Medical Indemnity Act 2002 (the Act) enables participating MDOs and MIIs to make claims under four medical indemnity schemes which are administered by Medicare Australia.
All MDOs and MIIs (incorporated in Australia) may make an application for an indemnity scheme payment under the HCCS, ROCS and ECS schemes providing the claim meets the relevant criteria.
Applications for indemnity payments must be lodged by the MDO/MII on the Medicare Australia approved form.
More information about medical indemnity claims is available on the Department of Health and Ageing
website.
Incurred But Not Reported Indemnity Scheme (IBNR)
The IBNR scheme is designed to fund the IBNR liabilities of MDOs where they do not have adequate reserves to cover their liabilities. The Act provides that all MDOs that existed on 30 June 2002 may participate in the IBNR scheme unless the Minister determines otherwise. To date, the Minister has determined that United Medical Protection Limited is the only MDO to actively participate in the IBNR indemnity scheme.
Applications for IBNR indemnity payments, along with all supporting documentation, are to be sent to:
The Director
Medical Indemnity
Department of Human Services
PO Box 1001
TUGGERANONG DC ACT 2901
High Cost Claim Indemnity Scheme (HCCS)
HCCS enables the government to fund 50 per cent of the cost of payouts by MDOs and MIIs that are greater than the applicable threshold amount up to the limit of a practitioner’s indemnity cover.
Applications for HCCS indemnity payments, along with all supporting documentation, are to be sent to:
The Director
Medical Indemnity
Department of Human Services
PO Box 1001
TUGGERANONG DC ACT 2901
Run-Off Cover Indemnity Scheme (ROCS)
ROCS is a reinsurance run-off vehicle to assist MDOs and MIIs in respect of claims made against medical practitioners who have retired, have a permanent disability, are on maternity leave, or who have permanently left private medical practice in Australia.
Applications for ROCS indemnity payments, along with all supporting documentation, are to be sent to:
The Director
Medical Indemnity
Department of Human Services
PO Box 1001
TUGGERANONG DC ACT 2901
Fax. 02 6124 7088
- ROCS payment application form guidelines [PDF, 404Kb]
- ROCS payment application form [PDF, 204Kb]
- ROCS statutory declarations [PDF, 127Kb]
- ROCS medical certificates [PDF, 58Kb]
Exceptional Claims Indemnity Scheme (ECS)
The ECS scheme is designed to assist MDOs and MIIs where settlement amounts of claims exceed a practitioner’s indemnity insurance contract limit.
Applicants wishing to submit an application under the ECS scheme must first contact Medical Indemnity on:
Phone: 1800 813 167
email: medical.indemnity@humanservices.gov.au
Debt recovery process
Money may be recovered from payments made under the IBNR, HCCS, ROCS and ECS indemnity schemes. Debt recovery will be undertaken for a number of reasons. In some cases, audit and compliance will direct the recovery of monies should a previously assessed application be found to be incorrectly assessed or contrary to legislation. The applicant (MDO/MII) may also apply for a refund, indicating that they have recovered money or identified money claimed yet not expended.
The debt recovery process may be instigated either by the applicant or by Medicare Australia notifying the applicant that monies are to be recovered and the reasons why.
Applications for refund of indemnity payments, along with all supporting documentation, are to be sent to:
The Director
Medical Indemnity
Department of Human Services
PO Box 1001
TUGGERANONG DC ACT 2901
Fax. 02 6124 7088
Contact details
If you require additional assistance to complete an application form, please contact Medicare Australia 's Medical Indemnity Claims Section from Monday–Friday on:
Phone: 1800 813 167
email: medical.indemnity@humanservices.gov.au
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Last updated: 15 February, 2012