MEDICAL INDEMNITY ACT 2002

Commonwealth Consolidated Acts

[Index] [Table] [Search] [Search this Act] [Notes] [Noteup] [Download] [Help]

MEDICAL INDEMNITY ACT 2002

TABLE OF PROVISIONS

Long Title

PART 1--PRELIMINARY

1. Short title [see Note 1]
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. Net IBNR exposure of an MDO
9. External Territories

PART 2--COMMONWEALTH PAYMENTS

Division 1--IBNR

Subdivision A--Introduction

10. Guide to the IBNR indemnity provisions

Subdivision B--Participating MDOs

11. Participating MDO
12. Minister may determine that MDO not a participating MDO
13. Process for determining whether a determination should be made under section 12

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
22. Minister to determine unfunded IBNR factor for a participating MDO
23. Process for determining unfunded IBNR factor under section 22

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--The IBNR Claims Protocol

27A. Minister may determine a protocol dealing with various matters
27B. The Chief Executive Medicare may request information

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--The High Cost Claims Protocol

34AA. Minister may determine a protocol dealing with various matters
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
34B. Definitions
34C. Treatment of deductibles
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 a 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 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--The Exceptional Claims Protocol

34X. Minister may determine a protocol dealing with various matters
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 externally-administered 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--The Run-off Cover Claims and Administration Protocol

34ZN. Minister may determine a protocol dealing with various matters
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 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 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 or run-off cover indemnity
37. Payment date for IBNR indemnity, high cost claim indemnity or run-off cover indemnity
37A. Application for exceptional claims indemnity
37B. Payment date for exceptional claims indemnity

Subdivision C--Information gathering and record keeping

38. Chief Executive Medicare may request information
39. Main record keeping obligations
40. Participating 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. Minister may formulate subsidy scheme
44. Chief Executive Medicare may request information
44A. Chief Executive Medicare may notify medical indemnity insurers or MDOs of UMP support payments
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

PART 3--PAYMENTS TOWARDS THE COST OF PROVIDING INDEMNITIES

Division 1--UMP support payment

Subdivision A--Introduction

50. Guide to the UMP support payment provisions

Subdivision B--Who pays UMP support payment

51. Who is liable to pay the UMP support payment
52. Exemptions
53. Comprehensive insurance cover determination

Subdivision C--Determining amount of UMP support payment

54. Annual subscription for base year

Subdivision D--Annual reassessment of participating MDO's IBNR exposure

55. Object of this Subdivision
56. Process for annually reassessing IBNR exposure

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 2A--Competitive advantage payment

Subdivision A--Introduction

59A. Guide to the competitive advantage payment provisions

Subdivision B--Who pays competitive advantage payment

59B. Who is liable to pay the competitive advantage payment
59C. Exemptions

Subdivision C--Annual reassessment of participating MDO's net IBNR exposure

59D. Object of this Subdivision
59E. Process for annually reassessing net IBNR exposure

Division 3--Administration of the medical indemnity payments

Subdivision A--Introduction

60. Guide to this Division

Subdivision B--Payment and collection of medical indemnity payments

61. When medical indemnity payment must be paid
62. Deferral of payment day for UMP support payment
65. Late payment penalty
66. Method of paying certain amounts
66A. Collection of UMP support payments by medical indemnity insurers and MDOs
66B. Late payment penalty for medical indemnity insurers and MDOs

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

73. Failing to give information
74. Failing to notify
74A. Failing to comply with requirements for collecting UMP support payments

PART 4--MISCELLANEOUS

75. General administration of this Act and medical indemnity payment legislation
76. Additional functions of the Chief Executive Medicare
77. Officers to observe secrecy
78. Act not to apply in relation to State insurance within a State
79. Regulations

AustLII: Copyright Policy | Disclaimers | Privacy Policy | Feedback