The Incurred But Not Reported Indemnity (IBNR) Scheme helps Medical Defence Organisations (MDO) where they are not able to cover their IBNR liabilities.
You need to know
About the Incurred But Not Reported Indemnity Scheme
This information will assist you to fill out a Medical Indemnity payment application form under IBNR.
The Australian Government introduced the IBNR Indemnity Scheme legislation on
1 January 2003.
The legislation was designed to fund claims where Medical Defence Organisations (MDOs) didn’t have enough reserves to cover their liabilities.
The following legislation applies to IBNR:
- Acts Interpretation Act 1901
- Medical Indemnity Act 2002
- Medical Indemnity Regulations 2003
- Medical Indemnity (IBNR Claims Protocol 2006)
Finding out more
To be eligible to claim under IBNR you must be a participating MDO.
An MDO is part of the IBNR Indemnity Scheme if they were in existence on 30 June 2002 unless the Minister determines otherwise.
Only 1 MDO is currently determined as being able to participate in IBNR.
The IBNR covers an incident if the incident:
- leading to the claim occurred on or before 30 June 2002
- occurred in the course of, or in connection with, the practice of a medical profession by a person
Before 1 July 2002 the MDO must not be notified of:
- the occurrence of the incident
- any claim against or by the person in relation to the incident
Claiming under the IBNR
You need to submit an application to claim.
Apportionment is how liability between parties to a claim are decided.
Cost sharing arrangements
Cost sharing arrangements apply if there’s an agreement between parties to share the costs or disbursements.
Settlement and judgment costs
You need to take settlement and judgment costs into account in your claim.
Plaintiff costs are the legal costs for the person who has brought the action against the medical practitioner.
Request for information
Under section 38 of the Medical Indemnity Act 2002 the Chief Executive Medicare may ask you for more information.
Returning your Medical Indemnity payment application
You can send us your application and supporting documents by post or email.
When we’ll pay your claim
We’ll pay you before the end of the month immediately following the month we get your application.
We can recover overpayments and incorrect payments.
The internal review is an administrative service that we provide to any MDO or MII.
Letting us know if things change
You must let us know if circumstances change after we’ve made a payment to an applicant.
Your right to privacy
You have a right to have your personal information kept private.
Insurance Statistics Australia specialty codes
The below list of Insurance Statistics Australia (ISA) specialty codes can be used in your Medical Indemnity payment application.
Glossary for Medical Indemnity
Some terms used in Medical Indemnity insurance claims have specific meanings depending on which scheme they apply to.