This scheme helps Medical Defence Organisations (MDO) and Medical Indemnity Insurers (MII) cover claims made against medical practitioners who are not working.
You need to know
About the Run off Cover Indemnity Scheme
This information will assist you to fill out a Medical Indemnity payment application form under the Run off Cover Indemnity Scheme (ROCS).
The Australian Government introduced ROCS legislation on 1 July 2004.
The legislation was developed following recommendations by the Medical Indemnity Policy Review Panel. The panel’s concern was that medical practitioners wouldn’t be able to pay for run off cover when they no longer earned an income from medical practice.
The Scheme ensures eligible medical practitioners have Medical Indemnity cover that is:
- based on the medical indemnity insurance they last held
The following legislation applies to ROCS:
- Acts Interpretation Act 1901
- Medical Indemnity Act 2002
- Medical Indemnity Regulations 2003
- Medical Indemnity (Prudential Supervision and Product Standards) Act 2003
- Medical Indemnity (Prudential Supervision and Product Standards) Regulations 2003
- Medical Indemnity (Terms and Conditions) Determination 2004
- Medical Indemnity (Run-off Cover Claims and Administration) Protocol 2006 (No. 2)
Finding out more
The person against whom the claim was made must be eligible for ROCS when the claim was first notified to the MDO or MII.
They must meet 1 or more of the following eligibility classes.
The person against whom the claim was made must be aged 65 years or over and:
- permanently retired from paid private medical practice, but continue to work for pay in the public sector
- permanently retired from all paid medical practice, or
- apart from providing free medical services in private medical practice, retired from practice as a medical practitioner
In the 3 years before the date of the claim the person against whom the claim was made must:
- not be engaged in any paid medical practice, or
- not practice as a medical practitioner, apart from providing free medical services in private medical practice
The person against whom the claim was made must have temporarily or permanently:
- ceased remunerated medical practice due to maternity
- ceased practice as a medical practitioner, apart from providing free medical services in private medical practice due to maternity
- ceased paid medical practice because of permanent disability, or
- ceased practice as a medical practitioner, apart from providing medical services free of charge in private medical practice because of permanent disability
The person against whom the claim was made must:
- be the legal personal representative of a deceased person who had been a medical practitioner, or
- hold a temporary visa - within the meaning of the Migration Act 1958 - and nominate their occupation as a medical practitioner, recognised by the relevant authority in Australia as entitling the visa holder to practice as a medical practitioner
The Medical Indemnity Act 2002 gives more details on maternity and permanent disability in this context.
Claiming under the ROCS
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 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.
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.
Insurance Statistics Australia specialty codes (ROCS)
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.