Indemnity in detail
When you start to review and compare indemnity policies it can become complex very quickly. There are many similarities between providers and key differences may be buried in policy wording.
MIPS' indemnity policy for doctors, dentists, oral health practitioners, nuclear medicine technologists and healthcare students is the same document. Some conditions apply depending on your membership classification, for example, communicable diseases cover is only applicable for student and recent graduate members.
Comparing MIPS with other providers
24hr clinico-legal advice from practitioners
Members can speak a variety of dental and medical specialists not an administrator in times of need, even after hours. Other providers typically have a 24hr support line, however, the quality of advice will differ and on most occasions, you can’t speak with a healthcare practitioner. Some providers will provide a limited consultation with a para-legal or lawyer whereas MIPS provides unlimited 24hr phone support and appoints legal representation when appropriate.
Independent
MIPS is the only organisation selling MIPS membership. So no matter whatever additional covers or services you use, you won’t be charged an additional fee beyond the membership that accurately describes your practice. Some brokers are re-selling membership to MDOs or the policies of commercial insurers – this means you may be paying a middle-man a premium for the service.
One membership. One fee.
MIPS only sells the one product, membership. Commercial insurers will sell you separate policies for indemnity, practice entity, cyber cover and personal accident, however, MIPS membership includes all of these if you are eligible. Other providers may charge an additional fee for some insurance products.
$20M indemnity cover
This is a common standard across the industry. Some providers may offer a lower $10M limit for some types of practitioners. In MIPS’ experience, the $20M limit has never been reached and is more than sufficient. Most cases are settled for less than $10,000 and very few exceed $500,000. However, record cases run into the millions.*
No sub-limits for indemnity
MIPS only has one indemnity limit and it’s $20M. While most healthcare indemnity providers are using a $20M limit, they typically place sub-limits of say $200,000, $300,000 or $1M on certain events, such as disciplinary board or coronial inquiries. What is often marketed as benefits are in fact limits on cover.
MIPS Protections unlimited discretionary cover
A unique benefit which provides flexible assistance for your clinical activities not otherwise covered by insurance (eg assisting you with a dispute with a colleague, employer or regulator). All medical indemnity cover in Australia used to be discretionary but was then changed to be managed through contracts of insurance. MIPS is the only provider to retain a form of discretionary cover for added protection.
External legal counsel
Our legal representation for members is handled by expert, external legal firms. MIPS appoints legal practitioners that have the appropriate specialist expertise and experience for the jurisdiction and the subject matter. This approach provides superior legal representation and defence outcomes. Other providers use a mix of in house and external legal services. This has not been MIPS’ approach because:
•Inhouse legal teams can be overcome at busy times
•Head offices may have no local jurisdiction knowledge (given there’s 8 states/territories in Australia)
•In house legal is too small to have all the specialist expertise required
Not-for-profit mutual
MIPS is a membership organisation and MDO (ie medical defence organisation). Despite our name we insure both medical and dental practitioners. In the marketplace there are other membership organisations, commercial insurers and insurance brokers.
Telehealth
MIPS does not exclude this and it is handled like any other form of healthcare.
Telehealth FAQs. Other providers may or may not include telehealth and may place some restrictions on what is covered. You should familiarise yourself with any restrictions. Under Australian law, the location of the patient is where telehealth is considered to be provided.
Membership Quote
Legal defence and damages
MIPS' indemnity can respond to complaints, claims and investigations in relation to any acts, errors, breaches or omissions you make in the provision of healthcare.
When providing indemnity MIPS is actively:
- defending members in the event of:
- complaints from patients
- civil suits, eg when you have been sued by a patient
- investigations such as those conducted by AHPRA, HCCC, coroners or hospital
- assisting members with their responses to Medicare, colleges, coroners or any other healthcare authorities
- paying damages or other civil liabilities you are ordered to pay by a court
- paying legal costs of a professional body, court or tribunal you are ordered to pay
- representing members with hospital inquiry defence/removal from proceedings. This may be before a hospital administrative tribunal
- representing members at disciplinary hearings of a professional body such as a college
- representing/assisting members with AHPRA (or other authority) investigations
- defending a subpoena to provide medical/dental records
- defending a complaint against a mandatory report
- defending a complaint made about you because you have reported a patient or practitioner for child abuse/neglect
- representing your interests in an indemnity dispute where your employer should provide indemnity for an incident. This is most common where you have treated a public patient in a public hospital but also relevant to smaller clinics/practices
- funding an appeal where there is merit and reasonable prospects of success
Example one
Patient complaint
A psychiatric registrar consultation with a patient in an ED, led to a complaint to AHPRA made by a community legal service.
The complaint alleged mismanagement, the patient being held against his will; and inappropriate examinations and medication. The complaint was investigated by AHPRA. The member contacted MIPS and was provided support and assistance to effectively respond to the hospital and AHPRA.
It was found that the patient was a regular visitor to the ED, often seeking treatment for spurious conditions, as well as shelter and food. MIPS was able to bring this to the Board's attention and the Board determined that at all times the patient had been treated fairly and appropriately and good patient records kept. No action was taken against the member.
Example two
Civil Suit (ie being sued)
Rahul visited a GP with a wrist injury. The GP, Joanna, advised an X-ray and upon inconclusive examination referred Rahul to a physiotherapist.Rahul found the physio treatment painful and unhelpful so he returned to Joanna who referred him for a scan at the local hospital. This scan revealed a broken scaphoid bone in the wrist.Rahul called Joanna to complain and seek compensation for his pain, insisting that she should have known about this earlier and should not have referred him to the ‘unhelpful’ physio.
Joanna notifies the matter under the Indemnity Insurance Policy and the claim is accepted. Legal proceedings are commenced against Joanna seeking compensation of $100,000. MIPS, on behalf of the insurer, appoints a lawyer to act for Joanna. The claim against Joanna is settled for $40,000 plus legal costs. The cost for the lawyer to defend Joanna is $20,000. Both of these amounts are paid under the Indemnity Insurance Policy.
MIPS' indemnity policy specifically excludes:
- Tax audits, however you can request assistance through MIPS Protections
- Replacement or restoration of lost medical records, however, MIPS does have limited cover for this under the cyber cover also available as part of membership
- Fines and penalties (generally speaking, cover for fines and penalties is not insurable under any indemnity policy in Australia as this would be tantamount to insuring illegal activity). This does NOT refer to civil liabilities such as damages you may be ordered to pay by a court in you were sued and lost a case for medical negligence, which are covered.
When making a medical indemnity insurance comparison in Australia it is important to consider both the policy features and if the pricing includes the same retroactive cover.
MIPS Protections
Where MIPS' indemnity policy cannot respond, MIPS provides assistance through MIPS Protections or MIPS' other insurance policies: Practice Entity, Cyber Private Enterprise and Personal Accident + Travel Extension.
MIPS Protection provides discretionary assistance to members for disputes that arise in connection with employment, training, industrial relations and non-clinical registration and board issues. MIPS Protections applies to non-medical indemnity matters.
Unlike insurance, MIPS Protections does not have a financial limit nor is it restricted in the nature of assistance (eg it could defend, prosecute or solicit a variety of professional services to support and protect members).
The types of things that MIPS Protections covers
- Employment disputes: MIPS Protections likely to apply.
- Reports about others: MIPS clinico-legal advisers are exempt from mandatory reporting and can provide guidance if you need to make a report or if someone makes a report concerning you. MIPS Protections may provide discretionary assistance in relation to these incidents.
- Private health fund defence: MIPS Protections may provide discretionary assistance in relation to these incidents and investigation costs of MIPS covered under the MIPS Members’ Indemnity Policy.
- Indemnity dispute pursuit: MIPS Protections provides discretionary assistance relating to concerns that the member’s employer is not meeting or where it is unable to meet their obligations to them (eg due to conflict of interest).
- Personal safety: MIPS Protections can provide discretionary assistance in relation to these incidents.
- Public relations expenses: MIPS Protections may provide discretionary assistance in relation to these incidents.
- Advice on goods sold: We provide cover for the prescribing of a product that is registered under the Therapeutic Goods Act 1989 (Cth). There is no cover for any claim, investigation or proceeding arising out of the importation, manufacture, distribution or sale of any product except for dental practitioners.
See examples of MIPS Protections cover.
Further support with MIPS' other insurance policies
MIPS membership benefits have been tailored for healthcare practitioners. In designing membership, MIPS added three insurance policies to further protect members. These are available as part of membership at no additional cost.
This protects members from their exposure through a private practice in which they have an interest. For example, if your reception staff endanger the life of a patient even before you provide healthcare.This is typically where you are the sole doctor or one of a small number of practitioners who own and run your own private practice. See eligibility requirements and explanation of cover.
Cyber cover is only available as an extension to the Practice Entity Indemnity Policy.This provides cover for a variety cyber perils that can affect healthcare practices. The cover provides compensation for financial losses, eg if systems are damaged by viruses and sums you are ordered to pay as a result of a security breach, eg stolen credit card information.
The personal accident cover provides financial support for a number of listed injuries.You can also receive travel cover for approved healthcare placements and gratuitous aid outside of Australia, which includes medical expenses of up to $2 million.Student and Recent Graduate members are provided communicable disease cover of $25,000.
Membership Quote
This is a summary only, you should read the full list of member benefits, including any terms and conditions which are outlined in the MIPS Membership Benefits Handbook and Insurance Covers Handbook.
An informed voice for an informed choice
MIPS is serious about providing comprehensive cover for healthcare practitioners. If our policies don't meet your expectations, then we'd like to hear about it and how you think we could extend or vary our support and protection to better serve healthcare professionals and students in Australia. Read our article What do I need to know about choosing indemnity?
*Australian Institute of Health and Welfare, Australia’s medical indemnity claims 2012–13, published 11 July 2014.
**For more information about the Medical Indemnity Act of 2002, visit the Federal Register of Legislation.