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 us.
All MDOs and MIIs (incorporated in Australia) may make an application for an indemnity scheme payment under the High Cost Claim Indemnity Scheme, Run-Off Cover Indemnity Scheme and Exceptional Claims Indemnity Scheme providing the claim meets the relevant criteria.
Applications for indemnity payments must be lodged by the MDO/MII on our approved form.
More information about medical indemnity claims is available through the Department of Health website.
Incurred But Not Reported (IBNR) Indemnity Scheme
The IBNR scheme is designed to fund the IBNR liabilities of medical defence organisations where they do not have adequate reserves to cover their liabilities. Under the Act, medical defence organisations 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 medical defence organisation to actively participate in the IBNR indemnity scheme.
- Incurred but not reported Indemnity Scheme Medical Indemnity payment application (MO009)
- Information you need to know about your Incurred-but-not-reported Indemnity Scheme Medical Indemnity payment application (MO010)
High Cost Claim Indemnity Scheme (HCCS)
The HCCS enables the government to fund 50% of the cost of payouts by medical defence organisations and medical indemnity insurers that are greater than the applicable threshold amount, up to the limit of a practitioner’s indemnity cover.
- Information you need to know about your High Cost Claim Indemnity Scheme Medical Indemnity payment application (MO011)
- High Cost Claim Indemnity Scheme Medical Indemnity payment application (MO012)
Run-Off Cover Indemnity Scheme (ROCS)
The ROCS assists medical defence organisations and medical indemnity insurers to cover 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.
- Information you need to know about your Run-off Cover Indemnity Scheme Medical Indemnity payment application from (MO005)
- Run-off Cover Indemnity Scheme Medical Indemnity payment application form (MO004)
- Run-off Cover Indemnity Scheme – for Medical Practitioners – Medical Certificate maternity or permanent disability form (MO032)
- Run-off Cover Indemnity Scheme for Midwife Medical Certificate for maternity or permanent disability form (MO043)
- Statutory Declaration Run-off Cover Indemnity Scheme – Deceased medical practitioner form (MO033)
- Statutory Declaration Run-off Cover Indemnity Scheme – Medical practitioner aged 65 years of age or over who has ceased either private or all remunerated medical practice form (MO031)
- Statutory Declaration Run-off Cover Indemnity Scheme - Medical practitioner who has ceased medical practice because of maternity form (MO037)
- Statutory Declaration Run-off Cover Indemnity Scheme – Medical practitioner who has ceased medical practice because of permanent disability form (MO036)
- Statutory Declaration Run-off Cover Indemnity Scheme – Medical practitioner who has not engaged in either private or remunerated medical practice during the preceding 3 years form (MO034)
- Statutory Declaration Run-off Cover Indemnity Scheme – Overseas medical practitioner form (MO035)
Exceptional Claims Indemnity Scheme (ECS)
The ECS assists medical defence organisations and medical indemnity insurers where settlement amounts of claims exceed a practitioner's indemnity insurance contract limit.
Prior to submitting an application under the ECS you should contact us at the Medical Indemnity contact centre.
Request to aggregate payments
If you want to aggregate payments for the same claim, complete the form Request to aggregate payments for the same claim form(MO008).
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:
- audit and compliance may direct the recovery of monies if a previously assessed application is found to be incorrectly assessed or contrary to legislation
- the application (medical defence organisation or medical indemnity insurer) may apply for a refund if they have recovered, or identified, money claimed but not expended
The debt recovery process may be instigated by either:
- the applicant, or
- the Department of Human Services, which will notify the applicant that monies are to be recovered and the reasons why
- by filling in a Medical Indemnity refund application form (MO007)
- if you are filling in a Medical Indemnity refund application form, read the guidelines Information you need to know about your Medical Indemnity refund application form (MO006)
Insurers must complete the relevant form for the scheme they are applying for.
A checklist in the application form allows insurers to check that they have provided the required documentation to support their claim.
Send applications for medical indemnity payments, along with supporting documentation to:
Department of Human Services
PO Box 1001
Tuggeranong DC ACT 2901
Or scan and email to the medical indemnity team.
You will receive a notification with advice that we have received your claim and that it is under assessment. You will also be sent a letter to notify you of the outcome of your claim.
For additional assistance, go to Medical Indemnity on the contact us page.