Incurred But Not Reported Indemnity Scheme

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.

Relevant legislation         

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

For more information see Medical Indemnity for insurers or contact us.

Eligibilty

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

Claiming under the IBNR

You need to submit an application to claim.

Read more about claiming under the IBNR.

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 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

Your right to privacy

You have a right to have your personal information kept private.

Read more about your right to privacy and how we collect and use your information.

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: 1 August 2018