Medical indemnity for insurers

Medical indemnity legislation strengthens the availability of medical services in Australia.

About

The Medical Indemnity Act 2002 (the Act) provides financial assistance to help keep medical indemnity insurance premiums affordable.

It does this by enabling participating medical defence organisations (MDOs) and medical indemnity insurers (MIIs) to make claims under 4 medical indemnity schemes we administer.

MDOs and MIIs must be incorporated in Australia to participate.

You can read more about the medical and midwife professional indemnity schemes on the Department of Health website.

Apply

To apply for a medical indemnity scheme payment, MDOs and MIIs fill in the relevant form and attach supporting documents. We can only accept applications from indemnity insurers that use the approved form.

Use the checklist in the application form to make sure you’ve given us the necessary documents to support your claim.

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

  • Email to medical indemnity team. You will need to scan your application form and supporting documents.
  • Mail to:
    Medical Indemnity
    Department of Human Services
    PO Box 1001
    Tuggeranong DC ACT 2901

We’ll let you know we have your claim and that it ’s being assessed.

We’ll also notify you of the outcome of your claim.

Medical indemnity schemes

The Medical Indemnity Act enables insurers to make claims under the 4 schemes.

The schemes are:

  • Incurred But Not Reported Indemnity Scheme
  • High Cost Claim Indemnity Scheme
  • Run-off Cover Indemnity Scheme
  • Exceptional Claims Indemnity Scheme

Incurred But Not Reported (IBNR) Indemnity Scheme

The IBNR scheme is designed to fund the IBNR liabilities of MDOs where they don’t have enough reserves to cover their liabilities.

Under the Act, an MDO may participate if they existed on 30 June 2002, unless the Minister determines otherwise.

Before you make a claim, please read the Information you need to know about your Incurred But Not Reported Indemnity Scheme medical indemnity payment application.

Then fill out the Incurred But Not Reported Indemnity Scheme medical indemnity payment application  form and send it to us.

High Cost Claim Indemnity Scheme (HCCS)

The HCCS allows the government to fund 50% of the cost of payouts by MDOs and MIIs. The costs must be greater than the threshold amount that applies, up to the limit of a practitioner’s indemnity cover.

Before you apply, please read the Information you need to know about your High Cost Claim Indemnity Scheme Medical Indemnity payment application.

Then fill out the High Cost Claim Indemnity Scheme Medical Indemnity payment application form and send it to us.

Run Off Cover Indemnity Scheme (ROCS)

The ROCS helps MDOs and MIIs cover claims made against medical practitioners who:

  • have retired
  • have a permanent disability
  • are on maternity leave, or
  • have permanently left private medical practice in Australia

Before you apply, please read the Information you need to know about your Run Off Cover Indemnity Scheme Medical Indemnity payment application.

Then fill out the Run off Cover Indemnity Scheme Medical Indemnity payment application form and send it to us, along with the relevant supporting documentation:

Exceptional Claims Indemnity Scheme (ECS)

The ECS helps MDOs and MIIs if the settlement amount for a claim is more than the limit of a practitioner's indemnity insurance contract.

Before you apply for the ECS you should contact us to discuss your claim.

Manage

Request to aggregate payments

If you want to aggregate payments for the same claim, fill out the Medical Indemnity Request to aggregate payments for the same claim form.

An authorised representative of the insurer must fill out and sign this form and it must be sent with a medical indemnity payment application form.

Debt recovery

There are occasions when money from payments made under the IBNR, HCCS, ROCS and ECS indemnity schemes needs to be recovered:

  • audit and compliance may ask for payments to be recovered if a previously assessed application is found to be incorrectly assessed or contrary to legislation
  • the MDO/MII may apply for a refund if they have recovered, or identified, money claimed but not spent

The debt recovery process can be started by:

  • the applicant, or
  • the Department – we’ll tell you that monies are to be recovered and why

Before you apply, read the Information you need to know about your Medical Indemnity refund application form.

Then fill out the Medical Indemnity refund application form.

For more assistance contact us.

Related payments and services

Page last updated: 12 April 2018