High Cost Claim Indemnity Scheme

Under this scheme the government funds 50% of the amount of claims exceeding the appropriate threshold, up to the limit of a medical practitioner’s indemnity.

You need to know

About the scheme

The Australian Government introduced the High Cost Claim Indemnity Scheme (HCCS) legislation on 1 January 2003.

Read more about the scheme

Eligibility

To be eligible for the High Cost Claim Indemnity Scheme (HCCS) you must meet certain criteria.

Read more about eligibility

Claiming

Claiming under the HCCS

You need to fill out an application to submit a claim.

Read more about claiming under the HCCS

Apportionment arrangements

Apportionment is how liability between parties to a claim are decided.

Read more about apportionment arrangements

Cost sharing arrangements

Cost sharing arrangements apply if there’s an agreement between parties to share the costs or disbursements.

Read more about cost sharing arrangements

Settlement and judgment costs

You need to take settlement and judgment costs into account in your claim.

Read more about settlement and judgment costs

Plaintiff costs

Plaintiff costs are the legal costs for the person who has brought the action against the medical practitioner.

Read more about Plaintiff costs

Request to aggregate payments

A MDO and a MII may aggregate amounts paid or amounts payable for the same claim against a member or policy holder.

Read more about request to aggregate payments

Request for information

Under section 38 of the Medical Indemnity Act 2002 the Chief Executive Medicare may ask you for more information.

Read more about requesting information

Returning your Medical Indemnity payment application

You can send us your application and supporting documents by post or email.

Read more about Returning your Medical Indemnity payment application

When we’ll pay your claim

We’ll pay you before the end of the month immediately following the month we get your application.

Read more about when we’ll pay your claim

Recovering payments

We can recover overpayments and incorrect payments.

Read more about recovering payments

Resolving conflict

The internal review is an administrative service that we provide to any MDO or MII.

Read more about resolving conflict

Managing

Letting us know if things change

You must let us know if circumstances change after we’ve made a payment to an applicant.

Read more about letting us know if things change

Resources

Insurance Statistics Australia specialty codes

The below list of Insurance Statistics Australia (ISA) specialty codes can be used in your Medical Indemnity payment application.

Read more about Insurance Statistics Australia specialty codes

Glossary for Medical Indemnity

Some terms used in Medical Indemnity insurance claims have specific meanings depending on which scheme they apply to.

Read more about the Glossary for Medical Indemnity

Page last updated: 7 January 2019