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The Private Practice
Autumn 2013
COVERING UP
The Medical Indemnity (Prudential
Supervision and Product Standards)
Act 2003 Cth
requires an insurer to
make a compulsory offer covering all
`otherwise uncovered prior incidents'.
This means a medical indemnity
insurer has to provide you with
`retroactive cover'. There are two
important items you need to address
when switching insurers:
1. You must provide the new insurer
with the correct `retroactive
date'. This date should be
stated on your current policy
schedule ­ it will depend on your
circumstances and may be:
·Thedateyoufirstcommenced
practice or first registered
in Australia.
·Thedateyourinsurancecover
moved from an `occurrence' policy
to a `claims made' policy (the
MDOsmovedto`claimsmade'
policies between 1997 and 2004).
·Ifyouhavepurchasedarun-off
policy with a previous insurer
and continue that cover, your
new policy may provide a
retroactive date starting at the
end of the run-off policy.
2. Before you cancel your current
policy or allow it to lapse, you must
report to your existing insurer all
claims and all circumstances in
which a reasonable person would
expect may result in a claim being
made against you in the future.
Even if you are not switching
insurers, it's wise to check that the
retroactive date noted on your policy
coversyoucorrectly.YourMDOwillrely
on the retroactive date you declare ­ if
it's wrong, you risk a gap in your cover.
If you discover the date is not correct,
simplyputinacalltoyourMDO.
WORTH NOTING
Medical indemnity insurance in
Australia is generally provided under
a `claims made and notified' policy.
This means the `trigger' is the date
you first become aware of a claim (or a
circumstance that a reasonable person
would expect may result in a claim)
and first report it to your insurer.
Generally, claims-made policies
require you to report the claim to
the insurer during the policy period.
Some policies provide `continuous
cover', which we recommend as a key
policy feature when advising clients at
Medical and General Risk Solutions.
Ourgeneralruleis:`Ifindoubt­
report it!' This is particularly relevant
when you are switching insurers.
Medical and General Risk Solutions is a Corporate Authorised Representative
of Insurance Advisernet Australia Pty Limited, Australian Financial Services
Licence No 240549, ABN 15 003 886 687. Authorised Representative
No 436893. Chris Mariani, Authorised Representative No 434578. The
information provided in this article is of a general nature and does not take
into account your objectives, financial situation or needs.
Please refer to the relevant Product Disclosure Statement before purchasing
any insurance product. If you have any questions or would like to arrange an
obligation-free discussion and review, contact Chris Mariani on 02 9905 7005
or 0419 017 011, or email
Topic
Summary
Claims
reporting
Ensure your tail is covered with the new insurer. This means selecting the appropriate `retroactive date' with
the new insurer. Secondly, ensure you report all claims and circumstances to your current insurer before you
switch. If in doubt, report it!
Continuous
cover
Some of the MDO policies provide `continuous cover', which means as long as you stay continuously insured
with that MDO, you can `late notify' a claim that you should have notified in an earlier policy with that MDO.
You lose this benefit when switching insurers.
Policy
coverage
Compare the actual policy coverage of your current policy to the new policy. Does the new policy cover suit you
and your practice structure and risks. Some policies do not provide cover for employment and hospital disputes,
tax audits or Medicare audits. Some policies include cover for the doctor's practice entity and employed staff,
but the extent of cover varies widely and you need to read the fine print closely. Also read the insurer's category
guide to check you are covered for all of the procedures and aspects of healthcare you provide.
Membership
benefits
Weigh up what membership benefits will you lose when leaving your current MDO, if any, against those you
may gain from the new MDO. For example, one MDO may provide a loyalty payment that increases based on
tenure, therefore reducing premiums over time.
Future
premiums
Don't just look at the premium quoted. Ask what the premiums will be in future years, especially where you
are starting out in private practice or changing specialities or billings ­ all of which can significantly change.
WHAT TO CONSIDER
If the time has come to consider
switching, what should you review
in making your decision? While each
practitioner's circumstances will be
different, the following provides a
general overview of the items you
should query.