Run off Cover Indemnity Scheme

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:

  • secure
  • free
  • based on the medical indemnity insurance they last held

Relevant legislation

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

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

Eligibility

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

Claiming under the ROCS

You need to submit an application to claim.

Read more about claiming under the ROCS

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

Your right to privacy

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

Read more about your right to privacy

Resources

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.

Read more about Insurance Statistics Australia specialty codes (ROCS)

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: 5 July 2018