You need to submit an application to claim under the Run off Cover Indemnity Scheme.
You’ll need a separate Medical Indemnity payment application for each member or policy holder subject to the same claim.
We’ll give your Medical Indemnity payment application a unique claim reference number. You must use the claim reference number for all claims or correspondence relating to this claim.
Submit 1 application if the member or policy holder is part of multiple claims for the same patient or plaintiff and incident. For example, there might be a coronial inquest and a civil claim.
What you can’t claim under ROCS
You can’t put in a claim under ROCS for:
- incidents or a series of related incidents which didn’t occur within the course of, or in connection with, a person’s practice as a medical practitioner
- incidents or a series of related incidents notified to the insurer before 1 July 2004
- incidents or a series of related incidents the MDO or MII is not liable to pay in relation to the claim
- insurer to insurer payments
- incidents or a series of related incidents not normally covered in the MDO’s or MII’s ordinary course of business
Amounts you can’t claim
In the Medical Indemnity payment application you need to deduct any amounts:
- other parties are responsible for, or
- that relate to incidents or claims not payable under ROCS
Claiming High Cost Claim Indemnity Scheme as part of ROCS
Where the total cost of the Medical Indemnity payment application exceeds the relevant High Cost Claims Scheme (HCCS) threshold, complete the ROCS Medical Indemnity payment application only.
High Cost Claims Scheme thresholds
|Notification date||HCCS threshold|
|1 January 2003 to 21 October 2003 (inclusive)||$2,000,000|
|22 October 2003 to 31 December 2003 (inclusive)||$500,000|
|1 January 2004 to 30 June 2018 (inclusive)||$300,000|
|On or after 1 July 2018||$500,000|
Read more about the High Cost Claim Indemnity Scheme.
Filling out the application
You must apply for ROCS using the approved Medical Indemnity payment application.
You must use the same Department of Human Services' claim reference for all subsequent claims or correspondence about the same claim.
- the Run off Cover Indemnity Scheme Medical Indemnity payment application
- the statutory declaration that matches your situation
You must attach supporting documents to your Medical Indemnity payment application. You can’t provide evidence of maternity or permanent disability with a statutory declaration only.
Supporting documents may include:
- a copy of the death certificate if the member or policy holder is deceased
- a copy of the visa that permitted the holder to work in Australia
- the original maternity or permanent disability certificate completed by a medical practitioner who is not the member or policy holder
If you can’t send a copy of the visa with your application you must attach the original statutory declaration outlining the circumstances satisfying eligibility requirements. The member or policy holder must sign the statutory declaration.
If you can’t give us a copy of the death certificate the legal personal representative of the deceased person must complete the statutory declaration.
There’s a checklist on the Medical Indemnity payment application to remind you of what we need to:
- verify ROCS eligibility
- assess whether the claim is payable
Send us the necessary supporting documents to prevent delays in assessing your application.
Apportionment is how liability between parties to a claim are decided.
Cost sharing arrangements apply if there’s an agreement between parties to share the costs or disbursements.
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.
A MDO and a MII may aggregate amounts paid or amounts payable for the same claim against a member or policy holder.
Under section 38 of the Medical Indemnity Act 2002 the Chief Executive Medicare may ask you for more information.
You can send us your application and supporting documents by post or email.
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.
Page last updated: 6 May 2019