MEDICAL INDEMNITY ACT 2002
Table of Provisions
PART 1--PRELIMINARY
- 1 Short title
- 2 Commencement
- 3 Objects of this Act and the medical indemnity payment legislation
- 4 Definitions
- 5 Medical defence organisation (MDO)
- 6 Member of an MDO
- 7 Incident - occurring based cover
- 8 IBNR exposure of an MDO
- 8A Eligible related claims
- 8B Treatment of deductibles for the exceptional claims indemnity scheme and the allied health exceptional claims indemnity scheme
- 9 External Territories
PART 2--COMMONWEALTH--PAYMENTS
Division 1--IBNR (incurred but not reported) indemnity scheme
Subdivision A--Introduction- 10 Guide to the IBNR indemnity provisions Subdivision C--Incidents covered by the IBNR indemnity scheme
- 14 Incidents covered by the IBNR indemnity scheme Subdivision D--IBNR indemnity
- 15 IBNR indemnity may be payable under either section 16 or 17
- 16 IBNR indemnity for payment made by MDO or insurer
- 17 IBNR indemnity for MDO or insurer in external administration
- 18 Clarification of circumstances in which IBNR indemnity payable
- 19 Exceptions
- 20 Payment partly related to treatment of public patient in public hospital
- 21 Amount of the IBNR indemnity Subdivision E--Recovery of amount paid to MDO or insurer after IBNR indemnity paid
- 24 Recovery if certain amounts paid to MDO or insurer after IBNR indemnity paid
- 25 MDO or insurer to inform Chief Executive Medicare of certain amounts
- 26 Chief Executive Medicare to notify MDO or insurer of repayable amount
- 27 Penalty imposed if an amount is repaid late Subdivision F--Regulations may provide for payments
- 27A Regulations may provide for payments in relation to IBNR claims
- 27B The Chief Executive Medicare may request information Subdivision G--IBNR exposure
- 27C Process for annually reassessing IBNR exposure
Division 2--High cost claim indemnity scheme
Subdivision A--Introduction- 28 Guide to the high cost claim indemnity provisions
- 29 High cost claim threshold Subdivision B--High cost claim indemnity
- 30 Circumstances in which high cost claim indemnity payable
- 31 Aggregating amounts paid or payable by an MDO and insurer
- 32 Exceptions
- 33 Payment partly related to treatment of public patient in public hospital
- 34 Amount of high cost claim indemnity Subdivision C--Regulations may provide for payments
- 34AA Regulations may provide for payments in relation to high cost claims
- 34AB The Chief Executive Medicare may request information
Division 2A--Exceptional claims indemnity scheme
Subdivision A--Introduction- 34A Guide to the exceptional claims indemnity provisions
- 34D Interaction with high cost claim indemnity scheme and run - off cover indemnity scheme Subdivision B--Certification of qualifying claims
- 34E When may the Chief Executive Medicare certify a claim as a qualifying claim?
- 34F What is the relevant threshold?
- 34G Setting the exceptional claims termination date
- 34H Application for a qualifying claim certificate
- 34I Time by which an application must be decided
- 34J Obligation to notify the Chief Executive Medicare if information is incorrect or incomplete
- 34K Revocation and variation of qualifying claim certificates Subdivision C--Exceptional claims indemnity
- 34L When is an exceptional claims indemnity payable?
- 34M Qualifying liabilities
- 34N Treatment of a claim that partly relates to a public patient in a public hospital
- 34O Treatment of a claim that relates to a series of incidents some of which occurred after the exceptional claims termination date
- 34P The amount of exceptional claims indemnity that is payable
- 34Q How exceptional claims indemnity is to be applied
- 34R Who is liable to repay an overpayment of exceptional claims indemnity? Subdivision D--Payments that would have reduced the amount paid out under the contract of insurance
- 34S Amounts paid before payment of exceptional claims indemnity
- 34T Amounts paid after payment of exceptional claims indemnity
- 34U Obligation to notify the Chief Executive Medicare that amount has been paid
- 34V The Chief Executive Medicare to notify of amount of debt due
- 34W Penalty imposed if an amount is repaid late Subdivision E--Regulations may provide for payments
- 34X Regulations may provide for payments in relation to exceptional claims
- 34Y The Chief Executive Medicare may request information Subdivision F--Miscellaneous
- 34Z Modifications and exclusions
Division 2B--Run-off cover indemnity scheme
Subdivision A--Introduction- 34ZA Guide to the run - off cover indemnity provisions
- 34ZB Eligible run - off claims Subdivision B--Run-off cover indemnities
- 34ZC Circumstances in which run - off cover indemnities are payable
- 34ZD MDOs and medical indemnity insurers that are Chapter 5 bodies corporate
- 34ZE Aggregating amounts paid or payable by an MDO and medical indemnity insurer
- 34ZF Clarification of circumstances in which run - off cover indemnities are payable
- 34ZG Exceptions
- 34ZH Amount of run - off cover indemnities Subdivision C--Payments that would have reduced the amount of run-off cover indemnity
- 34ZI Amounts paid before run - off cover indemnity
- 34ZJ Amounts paid after payment of run - off cover indemnity
- 34ZK Obligation to notify the Chief Executive Medicare that amount has been paid
- 34ZL The Chief Executive Medicare to notify of amount of debt due
- 34ZM Penalty imposed if an amount is repaid late Subdivision D--Regulations may provide for payments
- 34ZN Regulations may provide for payments in relation to run - off claims
- 34ZO The Chief Executive Medicare may request information Subdivision E--Effect of terminating the run-off cover indemnity scheme
- 34ZP Commonwealth's obligations on termination of the run - off cover indemnity scheme
- 34ZQ Affected medical practitioners
- 34ZR Payments in relation to affected medical practitioners
- 34ZS Total run - off cover credits
- 34ZT Medical indemnity insurers must provide information attributing run - off cover support payments Subdivision F--Miscellaneous
- 34ZU Chief Executive Medicare must be notified of a person ceasing to be covered by the run - off cover indemnity scheme
- 34ZV Invoices for medical indemnity cover
- 34ZW Reports on the run - off cover indemnity scheme
- 34ZX Modifications and exclusions
Division 2C--Allied health high cost claim indemnity scheme
Subdivision A--Introduction- 34ZY Guide to the allied health high cost claim indemnity provisions
- 34ZZ Eligible MDOs and eligible insurers
- 34ZZA Allied health high cost claim threshold Subdivision B--Allied health high cost claim indemnity
- 34ZZB Circumstances in which allied health high cost claim indemnity payable
- 34ZZC Aggregating amounts paid or payable by an MDO and insurer
- 34ZZD Exceptions
- 34ZZE Payment partly related to treatment of public patient in public hospital
- 34ZZF Amount of allied health high cost claim indemnity Subdivision C--Regulations may provide for payments
- 34ZZG Regulations may provide for payments in relation to allied health high cost claims
- 34ZZH The Chief Executive Medicare may request information
Division 2D--Allied health exceptional claims indemnity scheme
Subdivision A--Introduction- 34ZZI Guide to the allied health exceptional claims indemnity provisions
- 34ZZJ Interaction with allied health high cost claim indemnity scheme Subdivision B--Certification of qualifying allied health claims
- 34ZZK When may the Chief Executive Medicare certify a claim as a qualifying allied health claim?
- 34ZZL What is the relevant allied health threshold?
- 34ZZM Setting the allied health termination date
- 34ZZN Application for a qualifying allied health claim certificate
- 34ZZO Time by which an application must be decided
- 34ZZP Obligation to notify the Chief Executive Medicare if information is incorrect or incomplete
- 34ZZQ Revocation and variation of qualifying allied health claim certificates Subdivision C--Allied health exceptional claims indemnity
- 34ZZR When is an allied health exceptional claims indemnity payable?
- 34ZZS Qualifying allied health liabilities
- 34ZZT Treatment of a claim that partly relates to a public patient in a public hospital
- 34ZZU Treatment of a claim that relates to a series of incidents some of which occurred after the allied health termination date
- 34ZZV The amount of allied health exceptional claims indemnity that is payable
- 34ZZW How allied health exceptional claims indemnity is to be applied
- 34ZZX Who is liable to repay an overpayment of allied health exceptional claims indemnity? Subdivision D--Payments that would have reduced the amount paid out under the contract of insurance
- 34ZZY Amounts paid before payment of allied health exceptional claims indemnity
- 34ZZZ Amounts paid after payment of allied health exceptional claims indemnity
- 34ZZZA Obligation to notify the Chief Executive Medicare that amount has been paid
- 34ZZZB The Chief Executive Medicare to notify of amount of debt due
- 34ZZZC Penalty imposed if an amount is repaid late Subdivision E--Regulations may provide for payments
- 34ZZZD Regulations may provide for payments in relation to allied health exceptional claims
- 34ZZZE The Chief Executive Medicare may request information Subdivision F--Miscellaneous
- 34ZZZF Modifications and exclusions
Division 3--Administration of the indemnity schemes
Subdivision A--Introduction- 35 Guide to this Division Subdivision B--Applications for, and payment of, indemnity scheme payments
- 36 Application for IBNR indemnity, high cost claim indemnity, run - off cover indemnity or allied health high cost claim indemnity
- 37 Payment date for IBNR indemnity, high cost claim indemnity, run - off cover indemnity or allied health high cost claim indemnity
- 37A Application for exceptional claims indemnity or allied health exceptional claims indemnity
- 37B Payment date for exceptional claims indemnity or allied health exceptional claims indemnity Subdivision C--Information gathering and record keeping
- 38 Chief Executive Medicare may request information
- 39 Main record keeping obligations
- 40 Certain insurers and MDOs to keep additional records Subdivision D--Overpayments of the indemnities
- 41 Recovery of overpayments Subdivision E--Recovery of repayment or overpayment debt
- 42 Chief Executive Medicare may collect money from a person who owes money to a person
Division 4--Medical indemnity premium subsidy scheme
- 43 Regulations may provide for subsidy scheme
- 44 Chief Executive Medicare may request information
- 44B Chief Executive Medicare may notify run - off cover credits
Division 5--Offences
- 45 Failing to give information
- 46 Failing to notify
- 47 Failing to keep and retain records
- 47A Failing to include required information in invoices
Division 6--Finance
- 48 Appropriation
Division 7--Reinsurance contracts
- 49 Indemnity scheme payments disregarded for purposes of reinsurance contracts
Division 8--Monitoring
PART 2A--UNIVERSAL--COVER OBLIGATION
Division 1--Introduction
- 51 Guide to the universal cover obligation provisions
- 51A Winding up of medical indemnity insurer
Division 2--Requirements in relation to providing professional indemnity cover
- 52 Division applies for the purposes of the AFCA scheme
- 52A Universal cover obligation
- 52B Medical indemnity insurer to notify of refusal
- 52C Risk surcharge requirements
- 52D Medical indemnity insurer may be required to offer interim cover until complaint is finalised
Division 3--Records, reporting and information
- 53 Records
- 53A Failing to keep and retain records
- 53B Medical indemnity insurer must report annually
- 53C Failing to report
- 53D Secretary may request information
- 53E Failing to give information
PART 3--PAYMENTS--TOWARDS THE COST OF PROVIDING INDEMNITIES
Division 2--Run-off cover support payment
Subdivision A--Introduction- 57 Guide to the run - off cover support payment provisions Subdivision B--Who pays run-off cover support payment
- 58 Who is liable to pay the run - off cover support payment
- 59 Exemptions
Division 3--Administration of the run-off cover support payments
Subdivision A--Introduction- 60 Guide to this Division Subdivision B--Payment and collection of run-off cover support payments
- 61 When run - off cover support payment must be paid
- 65 Late payment penalty
- 66 Method of paying certain amounts Subdivision C--Refunds
- 67 Refund of overpaid amounts Subdivision D--Recovery of payment debt
- 68 Recovery of payment debt
- 69 Chief Executive Medicare may collect money from a person who owes money to a person
- 70 Evidentiary certificates Subdivision E--Information gathering processes
- 71 Chief Executive Medicare may request information
- 72 Chief Executive Medicare must be notified of a change in circumstances etc.
Division 4--Offences
PART 4--MISCELLANEOUS
- 75 General administration of this Act and medical indemnity payment legislation
- 76 Additional functions of the Chief Executive Medicare
- 76A Chief Executive Medicare may use computer programs to take administrative action
- 76B Delegation by Secretary
- 77 Officers to observe secrecy
- 78 Act not to apply in relation to State insurance within a State
- 78A Evaluation of medical indemnity market
- 79 Regulations
- 80 Rules