Australian Government, Australian Government Actuary

Appendix 1: Eligible Practitioners and Run-Off Cover Scheme Contracts

Eligible persons

A.1.1 Eligible persons are those who fit one or more of the following eligibility categories at the time the claim (or medical incident) is first notified to the MII or MDO (section 34ZB(2) of the Medical Indemnity Act and Medical Indemnity Regulations 2003 regulation 12):

  • A medical practitioner 65 years or older who has permanently retired from paid medical practice.
  • A medical practitioner who has not engaged in paid medical practice during the preceding three years. (Note: unlike other categories, eligibility does not occur immediately upon ceasing practice).
  • A legal representative of a deceased medical practitioner (provided that a claim can be made against the deceased’s estate).
  • A medical practitioner who has ceased paid medical practice due to permanent disability.
  • A medical practitioner who has ceased paid medical practice because of maternity.
  • An overseas trained medical practitioner, who worked in Australia under an appropriate visa, has permanently ceased medical practice in Australia and does not reside in Australia.

Provision and notification of compulsory run-off cover

A.1.2 The practitioner’s last medical indemnity insurer is required to provide run-off cover to an eligible practitioner under section 26A of the PSPS Act.

A.1.3 The compulsory run-off cover must encompass the same nature and range of incidents as the last medical indemnity cover held by the eligible practitioner (subsection 26A(4)(b)).

A.1.4 Section 26D compels MIIs to notify eligible practitioners of:

  1. the nature and range of incidents encompassed by the compulsory run-off cover; and
  2. the terms and conditions on which it is provided.

A.1.5 The compulsory run-off cover is taken to be a contract of insurance between the MII and the eligible practitioner for the purposes of the PSPS Act (section 26E).