Membership Benefits Handbook

2019/20

Combined Financial Services Guide, Product Disclosure Statement incorporating the Membership Classification Guide

PDF version

Supplementary Product Disclosure Statement

Date of preparation: 2 July 2019
This is a Supplementary Product Disclosure Statement (SPDS) issued by MIPS Limited ABN 64 007 067 281 AFSL 301912.

This SPDS supplements the Membership Benefits Handbook Combined FSG and PDS prepared on 8 May 2019. The PDS incorporates the Membership Classification Guide and the Members' Insurance Covers Handbook both of which were prepared on 8 May 2019.

This SPDS should be read together with the PDS and any other SPDS issued for this PDS. Information in the PDS is subject to change from time to time and any updates can be found at mips.com.au/publications. Paper copies of the Membership Benefits Handbook, Membership Classification Guide and Insurance Covers Handbook and this statement are available on request free of charge by contacting info@mips.com.au

Purpose of this SPDS

The purpose of the Membership Benefits Handbook Combined FSG and PDS is to summarise the features and benefits of MIPS membership. The purpose of this SPDS is update the Membership Benefits Handbook and Insurance Covers Handbook to:

  1. clarify that international students will incur a membership fee.
  2. make a correction to the 'Dentists in training' basis description about the limits of cover.
  3. make a correction to the 'Gratuitous services outside of Australia' endorsement description.
  4. clarify the product liability for dental members who manufacture, distribute or sell products.

International students

In the Membership Benefits Handbook on page 2 it states:

An annual membership fee applies for members other than students.

This should read and is replaced with the following:

An annual membership fee applies for practitioners and international students. Membership is free for students enrolled in an AHPRA approved program of study (see www.ahpra.gov.au) from an Australian Institution that qualifies the graduate for registration as a Medical, Dental or Nuclear Medicine Technologist health practitioner.

Dentists in training

In the Membership Benefits Handbook on pages 38 and 39 it states:

Dentist in training applies if you are a general dentist and you have commenced a specialist dental qualification. Cover is provided for additional non-employer indemnified (private) practice outside of your training program, covered under your category, as long as that practice does not constitute more than 50% of your hours worked per week (annualised) and is commensurate with your training, qualifications and experience with appropriate supervision arrangements in place (if applicable).

This basis will exclude non-employer indemnified (private) practice if 'Employer indemnified only' is appended to your basis. This basis is not eligible for the 'Minor cosmetic extension' endorsement.

Members who already hold an Australian specialist qualification are not eligible for the 'Dentist in training' basis.

This should read and is replaced with the following:

Dentist in training applies if you are a general dentist and you are currently enrolled in an AHPRA approved program of study for dental specialist registration. Cover under this classification is provided for non-employer indemnified (private) practice as long as that practice does not constitute gross billings of more than $100,000 in a 12 month period and is commensurate with your training, qualifications and experience with appropriate supervision arrangements in place (if applicable).

This basis will exclude non-employer indemnified (private) practice if 'Employer indemnified only' is appended to your basis. This basis is not eligible for the 'Minor cosmetic extension' endorsement.

Members who already hold an Australian specialist qualification are not eligible for the 'Dentist in training' basis.

Gratuitous services outside of Australia

In the Membership Benefits Handbook on page 41 it states:

Gratuitous services outside of Australia is required if you have been approved for an extension of cover for practice outside of Australia to provide gratuitous aid work services to disadvantaged locals. Refer to 'Gratuitous Services' for further information.

  • Indemnity insurance cover is capped at 6 calendar months or 184 days (the same as the travel cover)
  • Excludes matters within the USA, US territories or where US law applies
  • Cover is extended to you and a limit of one employee accompanying you

These dot points are omitted and accordingly this paragraph is replaced with the following:

Gratuitous services outside of Australia is required if you have been approved for an extension of cover for practice outside of Australia to provide gratuitous aid work services to disadvantaged locals. Refer to 'Gratuitous Services' for further information.

Product liability

In the Members' Insurance Covers Handbook on page 11 it states:

We will not insure you:

12.5.7 for any claim, investigation or proceeding arising out of the importation, manufacture, distribution or sale of any product with the exception of prescribing products on the Australian Register of Therapeutic Goods. However, Dental members are covered for the use of products not on the Register that are not required to be to be registered under the Therapeutic Goods Act 1989.

This should read and is replaced with the following:

We will not insure you:

12.5.7 for any claim, investigation or proceeding arising out of the importation, manufacture, distribution or sale of any product, however we will insure you for:

  1. prescribing a product listed on the Australian Register of Therapeutic Goods (ARTG);
  2. the manufacture, distribution or sale of a product, including a dental product, if you are a dental practitioner and that product is listed on the ARTG or is a material not required to be registered on the ARTG.

Indemnity, protection and support

Healthcare careers require specialist support and protection. At MIPS we are here to protect and support members during some of their most difficult career moments. When the circumstances call for action, we are prepared.

MIPS carefully considers every application for membership and attaining membership is a valuable professional asset. MIPS' measured approach has resulted in year on year strengthening of financial security, membership growth and improvements to the benefits of membership.

As a member you do not need to be under the threat of being sued to contact us. Our members-only advice and support line is available to assist even before any complaint, claim or investigation arises.

A core benefit of MIPS membership is indemnity insurance. Adverse or unexpected events can affect any healthcare professional. We are here to protect you in the event of complaints, legal actions (such as being sued) and investigations.

It is important to remember that even if your employer provides indemnity for negligent actions or omissions, you may not be covered by them for your individual professional risks – such as a coronial inquest or investigation by the Australian Health Practitioner Regulation Agency (AHPRA).

Who can apply to join?

MIPS membership is available to:

Healthcare practitioners

Healthcare students

AHPRA registered medical, dental and nuclear medicine technologist practitioners.

Students studying a course that will lead them to become an AHPRA registered medical, dental or nuclear medicine technologist practitioner.

Students currently studying a medical or dental healthcare discipline at a recognised education provider outside of Australia and undertaking a temporary placement in Australia.

All membership applications are subject to eligibility rules and processes. An annual membership fee applies for members other than students. The benefits of MIPS membership, including the insurance covers, cease upon cancellation or lapse of membership.

About this handbook

Date of preparation: 8 May 2019

This handbook is a combined Financial Services Guide (FSG) and Product Disclosure Statement (PDS).

It is designed to help you make an informed decision when applying for MIPS membership.

It describes the features and benefits of MIPS membership for the 2019/20 membership period. You should read it before making a decision about joining MIPS.

As a MIPS member you can be protected under four discrete insurance policies, each covering different aspects of professional practice and risk. MIPS has acquired these policies on behalf of members. MIPS Protections discretionary assistance is also provided by MIPS for non-medical indemnity matters.

Policy

Underwriter

MIPS Members' Indemnity Insurance Policy (Indemnity Insurance Policy)
MIPS Members' Practice Entity Insurance Policy (Practice Entity Policy)

MIPS Insurance Pty Ltd

Cyber Private Enterprise Policy

CFC Underwriting Limited on behalf of Underwriters at Lloyd's

MIPS Members' Personal Accident Policy (Personal Accident Policy)

360 Underwriting Solutions Pty Ltd on behalf of Certain Underwriters at Lloyd's

MIPS is the custodian and policyholder of the Indemnity Insurance Policy, the Practice Entity Policy and the Personal Accident Policy. Insurance cover for members under these policies is a benefit of membership. Policy documents are available at mips.com.au/publications or on request free of charge.

Indemnity Insurance Policy

The Indemnity Insurance Policy covers you for claims arising out of the provision of healthcare. It covers claims for acts, errors, breaches and omissions. This is a claims-made policy, which means it covers claims made against you and reported to MIPS in the period of insurance (or any extended reporting period).

What we pay (ie policy limits)

The limit of cover for each claim under the Indemnity Insurance Policy is $20 million unless your registration requires an automatic reinstatement (eg dental practitioner) to meet AHPRA's requirements for registration. If this is the case, the limit per claim is $10 million plus one reinstatement of the same value.

Your Member Benefit Statement sets out the limits that apply to you.

The maximum the insurer will pay in the aggregate for all claims notified by a member during the membership year under the Indemnity Insurance Policy, including defence costs, is $20 million.

What we cover

Types of events, liability, cost or expense Cover Aggregate limit of indemnity for all claims
Defending you in the event of complaints or civil suits from patients $20 million
Representing you in an investigation conducted by AHPRA, HCCC, coroner, Medicare or other healthcare authorities
Assisting with responses to investigations or disciplinary hearings by your employer, colleges or professional body
Paying legal costs, damages or other civil liabilities you are ordered to pay
Representing you with hospital inquiry defence/removal from proceedings
Representing you at disciplinary hearings of a professional body such as a college
Pursuing your rights to be indemnified by your employer for a civil claim, complaint
Responding to a subpoena to provide healthcare records
Defending a complaint against a mandatory report
Defending a complaint where there is a dispute with a government department or statutory authority in relation to your healthcare
Defending a complaint made about you because you have reported a patient or practitioner for child abuse/neglect
Funding an appeal where MIPS considers there is merit and reasonable prospects of success
Telehealth cover for non-employer indemnified (private) telehealth activities. Refer to 'Telehealth Services' in the Classification Guide. Subject to assessment and approval.
Clinical trials cover for non-employer indemnified (private practice) clinical trials. Refer to 'Clinical Trials' in the Classification Guide.
God Samaritan acts cover in all countries except the US or where US law applies. Good Samaritan acts are where you provide healthcare voluntarily, without remuneration, in relation to unexpected events and where you wouldn't normally be expected to be available to provide healthcare. All countries except the US or where US law applies.

Cover under the Indemnity Insurance Policy meets the professional indemnity requirements of AHPRA for healthcare practitioners. For full details of the terms and conditions of the Indemnity Insurance Policy see the Members' Insurance Covers Handbook.

Indemnity for practice outside of Australia

Cover under the Indemnity Insurance Policy can be extended, based on approval from MIPS, to you while conducting temporary healthcare placements outside of Australia (excludes the US or where US law applies). Extension of cover may result in an additional fee for your membership.

Scenarios where this extension of cover, if granted, can apply are listed:

Scenario Cover
Student activities under appropriate supervision
Employer indemnified placement (eg employee in a hospital)
Gratuitous aid healthcare services to disadvantaged locals
Healthcare services when accompanying an Australian sporting and/or cultural group.

Student members are automatically covered provided they meet required criteria, see the Student category in the Classification guide of this handbook or visit mips.com.au/placement

Other members must complete the Cover for Healthcare Services Outside of Australia form available at mips.com.au/forms

This is a summary only. See the 'Membership classification guide' in this handbook and the Indemnity Insurance Policy in the Members' Insurance Covers Handbook available from mips.com.au/publications for full policy terms, conditions and exclusions.

Exclusions

The Indemnity Insurance Policy does not cover all events and circumstances or all types of claims arising from your provision of healthcare.

Examples of circumstances where cover does not apply include:

  • any incidents previously known to you including incidents notified, or should have been notified, to a previous insurer
  • any incidents prior to your retroactive date
  • providing healthcare outside of your membership classification
  • business related incidents not related to the provision of healthcare
  • your provision of healthcare as an employee where you are employer indemnified (eg working as a medical officer in a public hospital). However, we will pursue your right to indemnity through your employer.
  • providing healthcare without appropriate supervision by trainees or registrars on your behalf
  • providing complementary medicine not in accordance with the RACGP, AHPRA or Medicare guidelines (eg homeopathy)
  • practising where you are not registered to practice
  • practising where you are in breach of any conditions of your registration or those set by your employer or college
  • providing healthcare outside of Australia, unless agreed in writing by us
  • the transmission of a contagious disease or virus with which you were infected
  • providing services to a pharmaceutical company
  • where you did not have the appropriate training, qualifications or experience for the healthcare you provided
  • where you are entitled to indemnity through an arrangement other than with us
  • where we ask you to cease a treatment, procedure or practice within 14 days and you fail to do so
  • payment of refunds to patients, fines for civil or criminal penalties and any punitive, aggravated, additional or exemplary damages
  • claims relating to the importation, manufacture, distribution or sale of any product with the exception of products on the Australian Register of Therapeutic Goods. However, Dental members are covered for the use of products not on the Register that are not required to be to be registered under the Therapeutic Goods Act 1989.
  • unlawful sale of a prohibited substance (eg S8 drugs such as morphine)
  • any claims, investigation or proceeding alleging or arising out of dishonesty or fraud
  • loss or damage to electronic or hardcopy healthcare records
  • any proceedings for sexual harassment, sexual misconduct or unlawful discrimination where you have been charged, or a finding has been made against you or you admit to the offence. MIPS will provide you support, investigation and defence costs where you deny the allegations but will withdraw this if you are charged with a criminal offence. If subsequently, proceedings against you are dismissed/dropped or you are found not guilty, MIPS will consider reimbursement of reasonable defence expenses.
  • libel, slander, defamation, plagiarism or falsification
  • claims relating to the naltrexone implants with the exception of those done in an accredited research setting or where agreed in writing by MIPS
  • vaginal or external genital surgery that does not meet RANZCOG standards or is provided to a person under 18 years old other than in a public hospital.

This is a summary only. Refer to the Members' Insurance Covers Handbook for comprehensive details of exclusions that apply.

MIPS Protections

MIPS Protections is discretionary cover that may provide assistance for non-healthcare personal and professional risks arising from your clinical activities that may not otherwise be covered by insurance arrangements.

MIPS has an Australian Financial Services Licence that authorises it to provide this type of protection and support to its members. MIPS Protections is not insurance cover. It does not provide assistance for medical indemnity claims or any claims covered by any insurance policy under which you are entitled to claim.

Assistance, including payment of legal costs, may be provided for disputes that arise in connection with employment, training, industrial relations and non-clinical registration and board issues. For example:

  • workplace discrimination or harassment allegations that have the potential for adverse professional consequences
  • AHPRA decisions that do not relate to your provision of healthcare but may limit your ability to practice
  • Medicare audits
  • contract disputes with your employer in certain circumstances such as if your employer denies you natural justice, breaches its procedures or unfairly denies indemnity when they have an obligation to do so
  • training disputes where you have been subjected to unfair evaluation or lack of due process or procedural fairness
  • motor vehicle licence defence if you are penalised unfairly driving to provide healthcare
  • defending a complaint made about you because you have reported a patient or practitioner for child abuse/neglect.

Under MIPS Protections, MIPS will consider your claim for protection in accordance with the MIPS Constitution and the law. You can have a realistic expectation that claims under MIPS Protections will be accepted if the claim comes within the scope of the protection provided by MIPS.

The Board has discretion to accept or refuse assistance in whole or in part, or may decide not to accept a MIPS Protections claim, or withdraw cover, if you misrepresent any information to MIPS, or withhold information, about a material matter. MIPS may refuse to pay or reduce the amount it will pay, for a claim if it is any way fraudulent. If MIPS exercises its discretion not to pay your MIPS Protections claim or to pay only part of your claim, or withdraw cover, we will inform you of that decision.

Why MIPS Protections?

Example: Allegation of Inappropriate Conduct

Member: Sam, medical registrar at a public hospital

Whilst on night duty Sam has a lengthy conversation with one of the nursing staff who expresses her condolences regarding the recent passing of Sam's father. They also have a chat about the nurse's recent holiday in Europe. The next day Sam receives an email from HR requesting a meeting with him and the Director of Medical Services. The email details allegations that whilst he was on duty he had a 3-hour conversation with another staff member and during this time the other staff felt unable to approach him regarding patient issues.

Sam contacted MIPS and a medico-legal adviser arranged to accompany him to the HR meeting as a support person. Prior to the meeting Sam and the MIPS adviser (also an experienced practitioner) had a chat regarding the incident and Sam admitted that the conversation had been inappropriately lengthy considering his work commitments. The interview with HR went well with Sam demonstrating insight into his behaviour and the matter did not go any further.

APRA regulates insurance companies, such as MIPS Insurance (a wholly owned subsidiary of MIPS which underwrites the Indemnity Insurance Policy), under the Insurance Act 1973 (Cth), which establishes a system of financial supervision of general insurers in Australia.

MIPS Insurance is authorised to carry on insurance business in Australia but MIPS is not. APRA does not regulate the discretionary assistance provided through MIPS Protections, nor MIPS itself, which is regulated by the ASIC as an Australian Financial Services licensee.

Practice Entity Policy

The MIPS Members' Practice Entity Policy provides cover for claims against a member's practice entity and/or their practice staff. Practice staff includes any administrative or management staff that work in your practice (eg receptionist, clerk, practice manager). Claims against other healthcare practitioners that are required to be AHPRA registered are excluded (eg nurses, physiotherapists and other allied health professionals).

The insurer of the Practice Entity Policy is MIPS Insurance. Cover is only applicable to members who are undertaking private (non-employer indemnified) practice. It is not applicable to student members.

What we pay (ie policy limits)

The maximum the insurer will pay for each claim, and in the aggregate for all claims, notified in a membership period under the Practice Entity Policy, including defence costs, is $20 million less any amount paid or payable under the Indemnity Insurance Policy for any covered claim.

Eligibility for cover

To be eligible for cover under the Practice Entity Policy, you must be a current MIPS member and your practice entity must fit one of the following scenarios:

  • Any company in which you have a proprietary interest and the majority of shares are owned by MIPS members who are also the majority of working practitioners in the entity.
  • Any partnership in which a MIPS member is a partner and the majority of partners are MIPS members who are also the majority of working practitioners in the entity.
  • Any entity notified by a member to MIPS and agreed in writing by us.

Example of Practice Entity cover

A person comes into your general practice without an appointment on a day you are fully booked. The person advises the receptionist they have recently fallen and have a bad headache. Despite their insistence on an appointment, your receptionist is firm and tells them they cannot see you.

The person returns home and dies that day due to a massive bleed (extra-dural haemorrhage) of their brain. Shortly after, the family makes a demand for compensation against your practice and threaten to take legal action.

In this example, you have not seen the person nor provided healthcare but the practice and receptionist may be liable.

 

Is my practice entity eligible?

= MIPS member and working practitioner
= Non MIPS member and working practitioner
= Silent non-working partner

Eligible practice structure
Ownership 25% 25% 25% 25%
Working 25% 25% 25% 25%
  • Majority of owners of the entity are MIPS members
  • Majority of the entity's healthcare is undertaken by those MIPS members.
Ineligible practice structure
Ownership 25% 25% 25% 25%
Working 33.3% 33.3% 33.3% 0%
  • Majority of owners of the entity are NOT MIPS members (must be greater than 50%)
  • Majority of the entity's healthcare is undertaken by those MIPS members.
  • Entity must meet both the ownership and working MIPS member requirements.

To obtain confirmation your practice structure is eligible complete the Practice Entity Cover Enquiry form at mips.com.au/forms

Exclusions

The Practice Entity Policy does not cover all events and circumstances or all types of claims arising from the operation of the practice entity.

Examples of circumstances where cover does not apply include:

  • any incidents previously known to practice staff including incidents notified, or should have been notified, to a previous insurer
  • any incidents prior to your retroactive date
  • claims not connected with the provision of healthcare by the entity
  • where practice staff do not meet the definition of practice staff under the policy (eg Physio, nurse that must be AHPRA registered and have an indemnity arrangement in place)
  • midwifery, except in a medical emergency
  • provision of healthcare outside of Australia
  • where you or any practice staff are under the influence of an intoxicant or narcotic
  • payment of refunds to patients, fines for civil or criminal penalties and any punitive, aggravated, additional or exemplary damages
  • discrimination disputes
  • claims relating to the importation, manufacture, distribution or sale of any product with the exception of products on the Australian Register of Therapeutic Goods. However, Dental members are covered for the use of products not on the Register that are not required to be to be registered under the Therapeutic Goods Act 1989.
  • unlawful sale of a prohibited substance (eg S8 drugs such as morphine)
  • any claims, investigation or proceeding alleging or arising out of dishonesty or fraud
  • loss or damage to electronic or hardcopy healthcare records
  • failure of, or damage to, computers or electronic equipment
  • claims arising from alleged or actual sexual harassment, sexual misconduct or unlawful discrimination
  • the transmission of a contagious disease or virus with which any practice staff were infected
  • libel, slander, defamation, plagiarism or falsification
  • providing services to a pharmaceutical company
  • claims or investigations in relation to tax audits, purchase/sale of property/investment or business disputes
  • claims relating to the naltrexone implants with the exception of those done in an accredited research or where agreed in writing by MIPS
  • vaginal or external genital surgery that does not meet RANZCOG standards or is provided to a person under 18 years old other than in a public hospital.

This is a summary only. Refer to the Members' Insurance Covers Handbook available from mips.com.au/publications for:

  • comprehensive details of exclusions that apply
  • definition of 'practice staff' and 'practice entity'
  • full policy terms and conditions.

Cyber Private Enterprise Policy

The Cyber Private Enterprise Policy is available on application only. It can provide cover for a variety of cyber and privacy risks of your practice entity such as:

  • a virus or malware that deletes health records
  • hackers who encrypt data and demand a ransom
  • malware infections contracted through email or browsers that cause software to fail
  • privacy breaches (eg theft of credit card details)
  • liability associated with published media (eg printed media and social media)

Cover may extend to costs for damage to computer systems (both hardware and software), business interruption, crisis communication and court attendance. The underwriter for the Cyber Private Enterprise Policy is CFC Underwriting, a coverholder for Lloyds.

Example of Cyber Private Enterprise cover

You open a Word document emailed to you and inadvertently infect your computer with a virus. The virus encrypts files and locks access to the payments and billing software.

You continue to see patients but the business is disrupted because you cannot bill them as you normally would. You contact an IT firm to assist but they advise that they cannot guarantee success and suggest a replacement PC would be cheaper.

In this scenario you may be able to claim costs for both a reduction in profits and system damage.

What we pay (ie policy limits)

Cover under the Cyber Private Enterprise policy is subject to limits that apply to different types of claims.

These limits are set out below and are the most the insurer will pay for each claim and in the aggregate for all claims, against each member's practice entity. Daily limits and deductibles also apply for certain losses and these are also set out below. You will receive a policy schedule once cover is approved which will set out the limits that apply.

Area of cover Limit of liability for each and every claim Deductible for each and every claim
Cyber incident response
Incident response costs $100,000 $0
Legal and regulatory costs $100,000 $1,000
It security and forensic costs $100,000 $1,000
Crisis communication costs $100,000 $1,000
Privacy breach management costs $100,000 $1,000
Third party privacy breach management costs $100,000 $1,000
Post breach remediation costs $50,000 subject to a maximum of 10% of all sums we have paid as a direct result of the cyber event $1,000
Cyber crime
Funds transfer fraud No cover given
Theft of funds held in escrow No cover given
Theft of personal funds No cover given
Extortion $100,000 $1,000
Corporate identity theft No cover given
Telephone hacking No cover given
Phishing No cover given
System damage and business interruption
System damage and rectification costs $100,000 $1,000
System business interruption $100,000 $1,000
Consequential reputational harm $100,000 $1,000
Loss adjustment costs $25,000 $0
Network security & privacy liability
Network security liability $100,000 including costs and expenses $1,000 excluding costs and expenses
Privacy liability $100,000 including costs and expenses $1,000 excluding costs and expenses
Management liability $100,000 including costs and expenses $1,000 excluding costs and expenses
Regulatory fines $100,000 including costs and expenses $1,000 excluding costs and expenses
PCI fines, penalties and assessments $100,000 including costs and expenses $1,000 excluding costs and expenses
Media liability
Defamation $100,000 including costs and expenses $1,000 excluding costs and expenses
Intellectual property rights infringement $100,000 including costs and expenses $1,000 excluding costs and expenses
Technology errors and omissions No cover given
Court attendance costs Aggregate $100,000 sub-limited to $2,000 per day $0

Policy application

Cover under the Cyber Private Enterprise Policy is NOT automatic. You must apply to MIPS. MIPS will assess you application based on the following steps:

Step 1: To be eligible to apply for cover under the Cyber Private Enterprise Policy you must be a current MIPS member and the practice for which you are applying must meet the eligibility requirements for the MIPS Members' Practice Entity Policy. The policy is only applicable to members who are undertaking private (non-employer indemnified) practice. It is not applicable to student members.

Step 2: Your application for your practice entity will be subject to individual acceptance and approval by the insurer who will consider a number of risk factors. These include whether your practice entity:

  • has anti-virus installed on all computers and servers
  • has firewalls installed
  • takes regular back-ups of critical data
  • stores patient data in a responsible manner
  • meets the Payment Card Industry Security Standard (PCI DSS) compliance if it stores credit card data.

MIPS will advise members of the outcome of each application. Approved practice entities will be issued a certificate of insurance when a policy is approved. The premium for the policy is paid by MIPS.

Exclusions

The Cyber Policy does not cover all events and circumstances or all types of claims arising from your provision of healthcare. Examples of circumstances where cover does not apply include:

  • known claims and circumstances including those notified to any other insurer
  • technology errors and omissions in the provision of technology services
  • funds transfer fraud (eg theft of money from your bank by electronic means)
  • theft of funds held in an escrow account
  • theft of personal funds (ie any personal loss suffered by practice staff because of the practice's operation)
  • corporate identity theft and phishing (eg the fraudulent misuse of your practice's identity to obtain credit or exploit your patients though fake emails and websites)
  • telephone hacking
  • core internet infrastructure failure
  • domain name suspension or revocation
  • misleading advertising
  • patent infringement
  • unlawful surveillance.

Cyber cover is issued by CFC Underwriting and under MIPS' arrangement with CFC, Cyber cover for members excludes cover under the policy for the sections headed Funds transfer fraud, Theft of funds held in escrow, Theft of personal funds, Corporate identity theft, Telephone hacking, Phishing, Technology errors and omissions. See the Cyber Private Enterprise Policy for definitions.

This is a summary only. See the Cyber Private Enterprise Policy available from mips.com.au/publications for comprehensive details of exclusions that apply and full policy terms and conditions.

Personal Accident Policy

The Personal Accident Policy provides cover for death, accident or illness, subject to the terms, condition and limitations of the policy, for all MIPS members (other than Members with a basis of 'non-practising') under age 75. It also covers certain family members (ie spouse and children dependents).

Benefits covered under the Personal Accident Policy include varying lump-sum payments for:

  • accidental bodily injury, sickness or death due to defined events
  • loss of board registration
  • funeral expenses, credit card protection
  • replacement staff recruitment supplement
  • education fund supplement
  • communicable & tropical diseases and permanent disablement (applies to student and recent graduate members only).

The policy does not cover loss of income.

Cover may vary depending on the category of MIPS membership. A summary of application of the policy is set out below:

Who is eligible?

Member Summary of cover under the policy
Non practising or age 75 or over No cover under any policy sections.
Student member Limited sections apply. Cover is limited to communicable and tropical diseases, permanent disability and medical related travel expenses.
Recently graduated (within last 5 years) All sections apply, including cover for communicable and tropical diseases, permanent disability and medical related travel expenses.
All other members Most sections apply. Cover does not apply to communicable and tropical diseases.

This is a summary only. See the Personal Accident Policy in the Members' Insurance Covers Handbook for full policy terms, conditions and exclusions.

What we pay (ie policy limits)

There are limits to the amount paid for claims under the Personal Accident Policy. These are set out in the Table of Benefits of the Personal Accident Policy in the Members' Insurance Covers Handbook.

Travel cover

Cover under the Personal Accident Policy can be extended to include travel cover on application, and subject to approval from MIPS, to eligible MIPS Members. Extension of cover may result in an additional fee to the member.

Benefits of the extension for travel cover under the Personal Accident Policy include:

  • medical and additional expenses
  • loss of baggage, traveller's cheques, travel documents, credit cards and money
  • loss of deposits and cancellation charges
  • kidnap, detention, extortion and ransom
  • extra territorial workers compensation
  • hire car excess expenses
  • personal liability
  • evacuation cover and personal safety.

Eligibility for travel cover

To be eligible for the travel cover under the Personal Accident Policy you must be a current MIPS member and the main purpose of your travel must be to undertake an approved healthcare placement outside Australia. This means that the amount of time on your travels that you will dedicate to your healthcare placement must outweigh the time you devote to personal pursuits or leisure.

For example, if you are undertaking a placement for four weeks followed by a one week holiday, you will be eligible for travel cover for the whole trip (five weeks). However, if you are undertaking a placement for two weeks followed by five weeks holiday, you will not be eligible for any travel cover.

When you apply MIPS will tell you if you are eligible.

Cover is limited to one pre-approved overseas trip per annum, per member. Cover is capped to a trip length of six calendar months. The travel cover does not apply to any travel undertaken in Australia.

Typical examples of eligible travel
Scenario Eligibility
Student member undertaking student placement activities
Recently graduated member undertaking employer indemnified activities
Non-student member providing gratuitous healthcare services

To apply for travel cover, non-student members are required to complete the Cover for Healthcare Services Outside of Australia form and student members are required to complete the Student placements, healthcare activities & travel cover form prior to travel commencing. You can apply online at mips.com.au/forms

Membership features

This summary highlights some of the important features of membership, including the insurance covers. However, this is a summary only. Full details of the insurance covers that are a benefit of MIPS membership can be found in the Members' Insurance Covers Handbook available at mips.com.au/publications or on request by post free of charge.

Your membership classification

You are required to select the membership category that best describes your area of specialisation and training. You must also provide MIPS with all relevant information regarding your practice to assess your practice classification. Members must have appropriate recognised qualifications, training and experience for the healthcare services they provide including appropriate supervision, if required. You are not covered under the Indemnity Insurance or Practice Entity insurance Policies for any healthcare provided outside your membership classification.

Some types of practice require you to have an endorsement placed on your membership that will impact the cost of your membership (eg minor cosmetics). Information regarding membership classification, including endorsements, can be found in the 'Membership classification guide' section of this handbook.

Claims-made policy

Medical indemnity insurance in Australia is provided on a claims-made basis. This approach is different to some other countries, such as the UK, where cover is generally provided on a claims-incurred basis.

Claims-made insurance policies cover claims made in the period of insurance and notified to the insurer in the period of insurance.

This means that you are only covered under these insurance policies if you are a member at the time the claim is made against you and reported to the insurer. You are NOT covered for incidents prior to your retroactive date or previously known to you or matters that have been notified to you or your previous insurer or medical/dental defence organisation.

The MIPS Indemnity and Practice Entity insurance policies, and the Cyber Private Enterprise Policy are claims-made insurance policies.

For these policies, you must notify of any claim made against you or any investigation as soon as reasonably practicable after you first become aware the claim or investigation, in accordance with the terms and conditions of the policy. You are also entitled to notify in writing of any facts that might give rise to a claim as soon as is reasonably practicable after you become aware of those facts. If you do the insurer is not relieved of any liability under the policy simply because the claim occurred after the end of the policy period.

Incident covered under claims made

Claim accepted. The claims occurs after the retroactive date and is reported within the policy period (membership).

Incident not covered under claims made

Claim rejected. While the incident is within the policy period, the claim cannot be accepted as it was notified after the policy (membership) was cancelled.

Retroactive cover (cover for previous practice)

It is common for a claim or complaint to be first made years after the practice was undertaken. It is an AHPRA requirement that you have appropriate retroactive cover (also known as 'tail cover') for otherwise uncovered matters arising from prior practice in Australia.

When you apply for MIPS membership you must nominate a retroactive cover date. The Indemnity Insurance Policy will then cover you for new claims that arise from healthcare practice undertaken after the retroactive cover date set out on your Member Benefit Statement.

Cover is not provided for healthcare undertaken prior to your retroactive cover date or matters previously known to you or your previous indemnity provider(s).

Run-off cover (cover for previous practice when ceasing healthcare in Australia)

When you cease practice in Australia, the potential for claims relating to your past clinical practice continues. To remain covered for claims made after you cease practice you will need to continue your MIPS membership in an appropriate 'run-off' cover membership classification. Refer to the Membership Classification Guide section 'Ceasing practice in Australia' for further information.

If you have ceased practice in Australia (or will cease prior to 30 June), complete the Ceasing Practice Form online at mips.com.au/forms

Returning home?

International healthcare practitioners sometimes overlook the difference between insurance covers for healthcare practice in Australia and their home country and leave Australia without run-off cover. It is important to realise that doing so leaves you vulnerable, as your liability for past practice continues even after you cease practice in Australia. Contact MIPS to obtain 'run-off' cover before you leave Australia.

Premium Support Scheme (PSS)

The PSS is an Australian Government scheme designed to help eligible doctors with the costs of their medical indemnity. MIPS administers this scheme on behalf of the Government. Eligible doctors will see the benefit of the PSS as a reduction in the total membership fee payable.

You may be eligible for the PSS if:

  • your gross medical indemnity costs exceed 7.5% of your estimated gross income generated from private practice gross billings, or
  • you are a procedural medical general practitioner in a rural area (ie Rural, Remote and Metropolitan areas 3-7), or
  • you previously applied and were deemed to be eligible for a subsidy under the Medical Indemnity Support Scheme (ie former MISS participant), or
  • you have retired from private practice ($0 private medical income for the full membership year), but continue to practise in the public sector and your medical indemnity costs include run-off cover for incidents relating to your prior period of private practice.

If you are eligible and choose to participate you will need to provide your estimated gross private medical income. Based on this information you may be advanced an estimated subsidy. If you are advanced a subsidy, it is a Government requirement that you complete a Final Determination Statutory form verifying your 'actual gross private medical income' within 12 months of the relevant PSS subsidy period.

This figure will be used to determine the actual subsidy you are eligible for. Any change to your income may result in either receiving an additional subsidy or repaying part of or the entire subsidy advanced.

Failure to provide the information within the required timeframe will also require any subsidy advanced to be repaid.

Any PSS subsidy advanced to you that you are no longer eligible for must be repaid to MIPS before MIPS will offer an invitation to apply for a renewal of membership. If you fail to repay this subsidy, MIPS is required to notify Medicare Australia which will likely impact any future entitlements to the PSS.

PSS details will be outlined on your Member Benefit Statement.

To assess your eligibility for a PSS subsidy please complete the Premium Support Scheme (PSS) Application form online at mips.com.au/forms

For more information, please visit the Department of Health website and refer to the PSS Frequently Asked Questions at health.gov.au

Making a claim

Claims can be notified as follows:

Cover

Who to lodge with

Indemnity Insurance Policy MIPS
1800 061 113
claims@mips.com.au
mips.com.au/claim
MIPS Protections
Practice Entity Policy
Cyber Private Enterprise Policy CFC Underwriting
1800 803 202
cyberclaims@cfcunderwriting.com
Quote the policy number on the schedule of insurance issued to you
Personal Accident Policy 360 Accident & Health Pty Ltd
Suite 1803, Level 18, 201 Kent Street
Sydney, NSW 2000
+61 (0)2 9047 9803
ahclaims@360uw.com.au

Claims, advisory and protections process

The MIPS process for notifications (other than those under the Cyber Private Enterprise Policy and the Personal Accident Policy) is as follows:

  1. Contact MIPS: Even if you’re not sure an incident will result in a claim or complaint you must contact MIPS. The earlier we know of a potential issue, the better placed we are to offer timely, professional advice and support. Contact 1800 061 113 or claims@mips.com.au or submit an Incident Notification form found at mips.com.au/claim
  2. Assess: The circumstances of all new incidents are assessed and the cost of defending the incident is estimated. This is done by experienced MIPS Professional Services Division staff including qualified clinicians.
  3. Respond: After assessing the incident, you will receive a response from MIPS' Professional Services Division which includes both experienced legal and healthcare professionals.
  4. Provide MIPS further details: If the incident is escalated, eg you receive a letter from AHPRA or a notice of legal action, contact MIPS as early as possible.
  5. Take action: If appropriate, MIPS will initiate appropriate actions to protect your interests.

For claims under the Indemnity Insurance and Practice Entity policies, the insurer may take over and conduct the defence or settlement of any claim or respond to legal proceedings for damages in accordance with the policy terms and conditions. If a claim has been accepted, you must give MIPS the information and assistance required to investigate, settle or defend the claim. You must also cooperate in any action MIPS takes if there is a right to recover any money payable from any other person.

If the matter escalates, MIPS has the authority to appoint lawyers from its panel to represent and defend the interests of a member. Depending on the complexity of a claim, it may take several months or years to resolve if legal proceedings are initiated.

Your full rights and obligations are set out in the Members' Insurance Covers Handbook available at mips.com.au/publications or on request. Also set out is what the insurer will do, and what you must do, in the event of a claim.

Example of a MIPS Members’ Indemnity Policy claim

MIPS member Joanna is a GP working in a suburban clinic. She recently treated a patient, Kevin, for a wrist injury. After an X-ray, she reasoned it was soft-tissue damage and not a fracture. She referred Kevin to a physiotherapist.

Kevin found the physio treatment painful and it did not heal the injury. He returned to Joanna who referred Kevin for a bone-scan at the local hospital. This scan revealed a broken scaphoid bone in the wrist. Kevin's wrist was placed in plaster at the local hospital.

Kevin complained to Joanna and said she should have known about this earlier and should not have referred him to the physio which caused him more pain. Kevin said he would be seeking compensation from Joanna for his pain.

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. 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.

 

Conditions of membership

How to apply for membership

To apply for membership, you must complete a membership application form. You can do this online at mips.com.au/join

When you apply you must nominate a retroactive cover date and provide details of your healthcare practice(s) for which you require cover including previous practice. This information is used to determine your membership classification.

Communicating with MIPS

MIPS communicates with its members by telephone, post, email and online. We will ask for your email address when you apply for membership.

To assist with timely membership responses and our efforts to reduce paper use, our membership correspondence is provided electronically. Any documents we send to your email address are considered to have been received by you 24 hours from when we send them.

If you tell us not to send your membership material and information to you electronically, then we will send them by post to the mailing address you gave us.

You are responsible for making sure the email and mailing address we have for you are up to date. You should advise us of any changes by completing the Change of Details form online at mips.com.au/forms or via my membership online services at mips.com.au/login

Your duty of disclosure

Before you become a member of MIPS or apply to renew, extend, vary or reinstate your membership you must disclose to MIPS anything that you know, or could reasonably be expected to know, that is relevant to MIPS' decision to provide membership to you and the terms and conditions on which membership is offered.

For example, your previous claims history or previously unreported incidents or circumstances from your healthcare activities that could lead to complaints, claims, investigations or legal actions or AHPRA, healthcare board investigations or Health Ombudsman or State and Territory health complaints body complaints against you, must be disclosed.

If you fail to comply with your duty of disclosure this may affect your entitlement to cover under MIPS Protections and the insurance policies. MIPS may be entitled to refuse or withdraw cover under MIPS Protections or cancel your membership, or both.

Further, an insurer may be entitled to reduce its liability under the insurance policy (possibly to nil) or cancel your insurance cover, or both. If your non-disclosure is fraudulent, an insurer may be entitled to void your insurance cover.

Your duty of disclosure does not require you to disclose any matter:

  • that is common knowledge
  • that we know or in the ordinary course of business ought to know
  • where we have waived compliance with your duty of disclosure
  • that diminishes our risk (eg you commence lower risk practice without advising MIPS).

MIPS will consider the information you provide when deciding to accept your application or renewal.

Your membership application

When you apply for membership, renew or vary your membership, you will be required to respond to a series of mandatory questions, which includes providing information about:

  • what membership classification best describes your current and past practice for which you have appropriate qualifications, training and experience
  • details of your registration and practice history
  • your gross annual billings
  • your previous MDO (if applicable)
  • your medical indemnity insurance history.

You must provide us with accurate and complete answers to all questions.

If you do not provide accurate and complete answers to all questions, you may prejudice your entitlement under the insurance covers (see duty of disclosure in the previous section). Also, you may prejudice your other member rights and entitlements.

If you fail to provide accurate and complete answers to any question MIPS asks you, MIPS may, in its discretion, cancel your membership or reduce the protection that applies or is provided to you. Where you have not given accurate or complete answers to any question(s) relevant to that amount of your membership fee(s), MIPS may invoice you for the relevant additional membership fees that would have been levied based on accurate and complete answers.

Keeping us informed

A member must notify MIPS in writing when any of the following occur:

  • any change in practice or the nature of the healthcare you provide and/or the location in which healthcare is provided
  • start and/or cessation of practice
  • cancelling MIPS membership
  • requesting extended reporting period or run-off cover
  • requesting travel cover for student placements
  • requesting cover for practice outside of Australia
  • any change in AHPRA details or registration conditions.

If you do not inform MIPS of a change, it may prejudice your right to member benefits, including insurance cover under the insurance policies. A change may also affect your membership fee. A new Member Benefit Statement will be issued when your membership fee has changed.

Acceptance and renewal of membership

A full membership year is from 1 July to 30 June. Membership commences upon acceptance of a completed application. Alternatively, a later commencement date can be nominated. All MIPS memberships expire on 30 June.

Entitlement to cover under the insurance policies that MIPS obtains for the benefit of its members will cease if membership is not renewed. Renewal is not automatic. Membership is reviewed each year before a Member Benefit Statement, inviting a renewal application, is sent. MIPS may accept or refuse any application for membership or renewal of membership.

If MIPS has concerns about a member's practice or conduct it will invite the member for interview prior to deciding whether to renew their membership.

MIPS will advise a member if their membership is not going to be renewed within a reasonable period so that the healthcare professional has sufficient time to obtain alternative professional indemnity insurance.

Examples of circumstances when membership may be cancelled or not renewed (or not accepted), include the following non-exhaustive list:

  • dishonourable or irregular practice
  • regularly failing to practice to an appropriate standard
  • being subject to review or investigation by AHPRA, Medicare, local drugs & poisons authorities and or other similar regulator(s) of health practitioners
  • repeated similar complaints and frequency or severity of claims/complaints
  • failing to implement risk management strategies recommended by MIPS including failure to attend risk education
  • conduct that is prejudicial to the interests of MIPS, including financial prejudice or reputational risk
  • conduct that has a negative impact on the medical, dental or nuclear medicine professions
  • conduct that adversely affects the cost of insurances which MIPS purchases for the benefit of members
  • any misstatement, misrepresentation or non-disclosure made during the membership application, renewal process or practice change
  • severity or frequency of claims or complaints that are beyond that normally expected of a healthcare craft group
  • self-prescribing of medications or inappropriate prescribing of medications to patients
  • lack of insight or willingness to change practises or rude, aggressive, unethical or unprofessional behaviour to patients and staff including MIPS staff
  • repeated professional conduct complaints
  • complaints regarding boundary transgressions or other unethical behaviour
  • conviction(s) for criminal offences
  • mis-statement of membership classification (including category, basis, level of billings)
  • A pattern of irregularity in conduct of affairs such as meeting financial obligations to MIPS or lapses in membership.

Paying your membership fee

Payment of your membership fee is due when you first join and by 1 July in subsequent years. Payment may be made by cheque, BPAY or credit card.

Members may also elect to pay their membership fee by direct debit in monthly instalments. Payment by monthly instalments does not incur any additional fees but members are required to complete and return a Direct Debit Instalment Request form. Refer to direct debit member agreement for terms and conditions. To establish a direct debit arrangement complete a Direct Debit Instalment Request form available from mips.com.au/forms

If your membership fee payment or other liability to MIPS is in arrears for more than one month, you shall cease to be entitled to any of the benefits of membership of MIPS from the date when the payment or other liability fell due. That means your rights to membership benefits, including MIPS Protections and insurance covers may be prejudiced.

Member Benefit Statement

This is a statement of your membership benefits and membership details, including membership category, basis, endorsement(s), retroactive cover date and practice state for the membership period. This document will become a tax invoice upon payment. If any details are incorrect contact MIPS.

How your membership fee is calculated

MIPS uses a risk assessment approach when calculating membership fees to reflect the contribution required to appropriately cover your risk arising from both current and past practice.

The membership fee is individually calculated based on your membership classification (including location) for your current and past practice for up to three previous membership periods.

The mature membership fee is payable when your membership classification and location are the same for four consecutive years (current and three prior periods). If you amend to a higher risk classification (eg commencing private practice), you can expect to see a stepped increase in your membership fee until you reach a notional mature membership fee.

When you move from a high-risk classification to a low risk classification you can expect to see a stepped decrease in your membership fee until you reach the notional mature membership fee.

The following factors are considered when calculating your membership fee:

  • actuarial advice and recommendations received by MIPS
  • the membership classification that best describes your current and past practice
  • whether you perform procedural or non-procedural healthcare services
  • any endorsements applied to your membership
  • any employer indemnity for healthcare services you provide
  • your billings and/or salary from any non-employer indemnified (private) practice work you undertake
  • your current and prior practice locations
  • your personal claims and registration history
  • your nominated retroactive cover date
  • the approach to management of risk shown by you
  • the number and nature of claims already accepted in previous membership years
  • the membership benefits that are provided to you
  • the cost of the insurance policies arranged by MIPS
  • administration costs associated with providing membership benefits
  • any government taxes or charges such as GST and ROCS levy.

The total costs of membership are determined following consideration of:

  • the current reserves and surplus members' funds retained by MIPS; and
  • expected investment returns from those funds.

See the 'Membership classification guide' in this handbook for detail about how we assess your practice.

Excesses

Any excess that applies to the MIPS Protections or the insurance covers will be calculated by MIPS, or the insurer, by taking into account the factors that are considered in the calculation of the membership fee as set out above.

Policy Excess
Indemnity Insurance Policy No standard excess. An exception may apply to some members.
Practice Entity Policy
Cyber Private Enterprise Policy An excess applies. This is stated on your schedule of insurance if you have applied and been approved for cyber cover.
Personal Accident Policy (including travel cover) An excess may apply to some claims – see policy for details.

In the unlikely event an excess is required for the Indemnity Insurance or Practice Entity policies, the amount of any excess will be shown on your Member Benefit Statement. This excess will apply to each claim under the Indemnity Insurance and Practice Entity policies as well as MIPS Protections.

Any request by MIPS for payment of an excess must be met within 21 days of receipt of the request in writing. If you do not pay or refuse to pay the excess, then MIPS may refuse to provide any payment or further services related to your claim(s). MIPS will provide a tax invoice including evidence of expenses.

Cancelling your membership

Members may cancel membership at any time. You may cancel your MIPS membership within 30 days of membership having commenced (cooling off period), unless you have made an incident notification to, or claim against MIPS, under MIPS Protections or under any of the insurance policies. If you choose to do this the membership fee you paid will be refunded.

If you cancel your membership outside of the cooling off period, MIPS will refund the value of your membership fee from the day of cancellation until 30 June, less an administration fee of 20% of that refund or $50, whichever is greater.

If you pay your membership fee via direct debit instalments and you cancel your MIPS membership you may have an outstanding balance to pay depending on your date of cancellation and current account balance. Please contact MIPS for an estimate prior to cancelling your MIPS membership.

All membership benefits, including MIPS Protections and insurance covers, cease when membership is cancelled. Valid claims or notifications arising from incidents or events prior to cancellation will continue to be managed by MIPS.

Cancellation of membership by MIPS

MIPS may cancel a member's membership if that member does not comply with MIPS' Constitution, such as when their conduct is deemed to be prejudicial to the interest of MIPS. Examples of such conduct that will result in cancellation of membership are provided in the 'Acceptance and renewal of membership' section of this handbook.

All membership benefits, including MIPS Protections and insurance covers, cease immediately when membership is cancelled.

Example of cancellations effective 1 November

Paid in full
Total membership fee $1,200.00
Amount paid -$1,200.00
Unused pro-rata membership fee* -$792.33
Cancellation administration fee** $158.47
Refund due to member $633.87
Paying via direct debit instalment plan
Total membership fee $1,200.00
Amount paid to date*** -$480.00
Account balance $720.00
Unused pro-rata membership fee* -$792.33
Cancellation administration fee** $158.47
Amount payable to MIPS $86.14

*cancellation date to 30 June
**20% of unused portion (minimum of $50)
***4 direct debit instalments payments made

Estimating future liabilities

Each year MIPS receives actuarial advice on MIPS claims costs, operational costs, investment returns and member reserves. This advice includes an analysis of the anticipated costs of the insurance covers arranged by MIPS and requests under MIPS Protections, adjustments to reserves for known matters and pricing recommendations for membership fees.

MIPS Insurance also manages its risk exposure through reinsurance coverage that it obtains from Australian authorised reinsurers.

MIPS ensures that it has adequate financial resources to discharge its future liabilities or make future payments to members by maintaining funds in reserve. MIPS' financial position is shown in its annual reports, available at mips.com.au/publications and shows MIPS’ significant accumulated net assets.

Financial Services Guide

The services described in this Financial Services Guide (FSG) are provided by the Medical Indemnity Protection Society Limited (MIPS) ABN 64 007 067 281 AFSL 301912.

This FSG contains information about who pays for the financial services provided to you, how MIPS deals with complaints and explains any associations or relationships that could influence MIPS.

What financial services does MIPS provide?

MIPS is authorised to:

  • provide financial product advice for general insurance products and mutual risk products to retail and wholesale clients who are members
  • deal in a financial product for retail and wholesale clients who are members by: issuing, applying for, acquiring, varying or disposing of general insurance products and mutual risk products
  • apply for, acquire, vary or dispose of a financial product on behalf of another person in respect of general insurance products and miscellaneous (mutual) risk products
  • operate custodial or depository services other than investor directed portfolio services for retail and wholesale clients.

MIPS is responsible for the financial services it provides and MIPS and its representatives will provide you with the financial services.

General insurance

MIPS has acquired a number of general insurance policies that will provide insurance cover, subject to their terms and conditions, to current MIPS members.

The Indemnity Insurance Policy and the Practice Entity Policy in place for MIPS members are underwritten by MIPS Insurance Pty Limited. MIPS Insurance is a wholly owned subsidiary of MIPS.

The Personal Accident Policy in place for MIPS members is issued by 360 Underwriting Solutions on behalf of Certain Underwriters at Lloyd's.

Cover under these policies is issued by the insurer under a master policy arrangement with MIPS. When MIPS arranges cover under these policies it will be doing so on behalf of MIPS members.

The Cyber Private Enterprise Cover is underwritten by Lloyds' through the coverholder CFC Underwriting. MIPS arranges policies with the insurer on behalf of member practice entities that are eligible to apply.

MIPS Protections

The discretionary risk protections available to current members of MIPS (MIPS Protections) are a miscellaneous risk product.

Custodial services

The insurance policies that MIPS has in place for its members, and the benefits under those policies, are held on trust by MIPS for MIPS members. This is a custodial service provided by MIPS. This service is incidental to the insurance arrangements that MIPS has put in place for its members.

Will I get a statement of advice?

Other than in special circumstances MIPS will not provide advice that takes into account your objectives, financial situation and needs. Because our advice does not take these matters into account, you should consider your own circumstances before choosing MIPS membership.

When will I get a product disclosure statement (PDS)?

You will receive a PDS for each financial product issued to you as a retail client or if you receive personal financial product advice. Each PDS contains information that will enable you to make an informed decision about the financial product. It sets out the significant features of the financial product as well as other information and details required by law to be in a PDS.

What does MIPS charge?

MIPS charges a membership fee for MIPS membership which includes the cost of membership benefits, including insurance covers and MIPS Protections. MIPS does not charge any additional fee or receive any other remuneration for its custodial services. MIPS staff receive market based salaries and are not paid commissions.

What should I do if I have a complaint?

MIPS is committed to dealing openly and efficiently with all member complaints and disputes. If you are not satisfied with our products or services or a decision made in relation to your MIPS membership, please let us know so that we can help. We have developed an internal procedure for this purpose. Access to this process is free.

To help to resolve your compliant effectively and efficiently, it is important that you follow the process outlined below.

1 Contact MIPS

It is possible to resolve the issue simply by communicating the problem to a MIPS staff member. Alternatively, the staff member will refer you to the appropriate contact person at MIPS based on the nature of the issue. This way your complaint reaches the right person. A response is usually provided to you within 5 business days. You can contact us:

1800 061 113
info@mips.com.au
MIPS, PO Box 24240, Melbourne VIC 3001

2  Review by our Internal Dispute Resolution Manager

If you are not satisfied with the outcome of the business review you can request the complaint be referred to the Internal Dispute Resolution Manager for review. The manager will treat your complaint as a dispute and conduct an independent review of the matter. The manager will respond to your complaint within 15 business days, provided we have all the necessary information and have completed our investigations. If we need more information or need to undertake further investigation, we will agree reasonable alternative timeframes with you of up to 45 days. When a decision about your complaint has been made we will notify you of our decision in writing, setting out the reasons for our decision.

You can contact MIPS Internal Dispute Resolution Manager:

1800 061 113
idr@mips.com.au
MIPS Internal Dispute Resolution Manager, PO Box 24240, Melbourne VIC 3001

3  Seek external dispute resolution

We expect our procedures will deal fairly and promptly with your complaint. However, if you remain dissatisfied, you may be able to access the services of the Australian Financial Complaints Authority, an independent external dispute scheme. You can contact AFCA by:

www.afca.org.au
1800 931 678
info@afca.org.au
Australian Financial Complaints Authority, GPO Box 3, Melbourne VIC 3001

What arrangements does MIPS have in place to compensate clients for losses?

MIPS has professional indemnity insurance in place that will cover MIPS for claims made against MIPS in relation to the conduct of MIPS or its representatives in the provision of MIPS financial services. This insurance will also cover MIPS for claims relating to the conduct of representatives who are no longer employees of MIPS.

Privacy

MIPS takes your privacy seriously. How we collect, use, hold and disclose information is governed by the Privacy Act and the Australian Privacy Principles (APPs). MIPS is committed to protecting the privacy of your personal information. Personal information includes any information or opinion, about an identified individual or an individual who can be reasonably identified from information about them. Information or opinion is still treated as personal information whether it is true or not and regardless of whether we have kept a record of it.

How do we hold personal information?

Much of the information we hold will be stored securely and managed by MIPS or specialist external service providers. Some information we hold will be stored in paper files. Personal and sensitive information is currently held in a secure manner in Australia, Canada, France, Germany, Gibraltar, Hong Kong, Singapore, Switzerland, United States of America and United Kingdom.

MIPS uses a range of physical and electronic security measures to protect the security of the personal and sensitive information we hold. For example:

  • access to information systems is controlled through strict identity and access management procedures;
  • appropriate data encryption techniques are applied;
  • employees are bound by internal information security policies and are required to attest to compliance with policies;
  • service agreements with external service providers are required to meet or exceed the minimum requirements outlined by APPs;
  • all employees are required to complete training about information security; and
  • we regularly monitor and review our compliance with internal policies, regulatory and industry guidelines.

Right of access to your information

You have a right to access and correct your personal and sensitive information. Please contact us on 1800 061 113 to request your information. There is no charge for the provision of that personal information. If you request access to sensitive information, there may be a delay in providing this information, for example if the information is related to a claim that is still under consideration.

For more information, see our privacy policy at mips.com.au/privacy

Your membership classification

PDF version

Your MIPS membership classification is made up of your category, practice basis and endorsements. This determines the extent of your practice that is indemnified. For example:

Category: General practitioner
Basis: Gross private billings/salary
Endorsements: Gratuitous services outside of Australia, Minor cosmetics

You should ensure your membership classification best describes the healthcare services you provide currently as well as for any prior practice in your risk history. If your membership classification is incorrect or you do not provide the necessary information for MIPS to determine your membership classification you may prejudice the membership entitlements available to you including insurance covers.

You are not entitled to the benefits of membership, including cover under the Indemnity Insurance Policy, for the provision of healthcare outside your membership classification or where you do not hold appropriate recognised qualifications, training and experience.

The benefits of MIPS membership apply throughout all Australian states and territories. Your practice location should reflect where you generate the majority of your non-employer indemnified (private) practice gross billings/ and or salary in a membership period or where you undertake the majority of your practice (hours) if you are employer indemnified. If you undertake work (eg locums) in multiple locations, you should provide the state where you intend to undertake the majority of your work in a membership period. You may submit all queries regarding your membership classification and/or nature of practice to info@mips.com.au

General requirements

Members must practice within the constraints of any restrictions or practice conditions imposed by AHPRA or its healthcare practitioner boards and comply with guidelines and requirements issued by their registration body and colleges.

There is a general requirement that every member has the appropriate training, qualifications and experience for the healthcare services they provide or supervise and if required have appropriate supervision. This applies even if such services are normally provided by the majority of practitioners in the category.

Members are expected to undertake the provision of healthcare services in a facility that holds appropriate accreditation and have available appropriate resources for the range of services that will be provided.

Changing your practice type or location

You are required to notify MIPS of any change in the nature of healthcare services you provide or practice location as soon as you become aware of the change to ensure you do not prejudice your membership benefits including insurance covers.

Any change to your membership details may result in an amendment (additional fee or refund) to your membership fee.

You may also be required to sign a disclaimer confirming that you have notified or otherwise disclosed to MIPS all material matters when you seek retroactive changes to your membership.

Your category

Your category should reflect your AHPRA registration or the specialty in which you are undertaking an accredited training program (or unaccredited registrar position). Members who hold multiple healthcare registrations or specialties must select a category that appropriately reflects the highest risk practice. Contact MIPS to determine the higher risk category.

Some categories will be determined by the description of the level of practice within your specialty in a non-employer indemnified (private) setting, for example procedural or non-procedural. Where a category includes a list of treatments and procedures these are not intended to be exhaustive and may vary from year to year dependent upon our claims experience, treatment developments and innovations, views of colleges, professional associations and AHPRA, claims expectations and views of insurers and reinsurers.

Some types of practice may be excluded when undertaken in a non-employer indemnified (private) setting. Categories may contain exclusion(s) and you should check these carefully.

Your practice basis

You will be required to provide information regarding the level and type of practice you undertake to determine an appropriate practice basis.

The type of information we require to determine your practice basis includes but is not limited to your level of training, the amount you bill annually for non-employer indemnified (private) services, the type of non-employer indemnified (private) services you undertake or if you are fully employer indemnified for all your practice.

Clinical training / study applies if you are a Healthcare Student or you are undertaking 'pre-registration' activities before obtaining your AHPRA registration.

New graduate applies if you have graduated within the current membership period (ie financial year) and you have not yet commenced a registrar or specialist training program or position. International graduates should not declare as their year of graduation the year they were awarded their AMC certificate, but rather the year they first obtained their equivalent of Australian healthcare qualification (eg MBBS, BDSc, etc).

Non-employer indemnified (private) practice covered under your category is included as long as that practice is commensurate with your training, qualifications and experience with appropriate supervision arrangements in place (if applicable). Cover and benefits will be limited for medical practitioners to practise only as allowed under their Provisional Registration.

This basis excludes non-employer indemnified (private) practice if 'Employer indemnified only' is appended to your basis. This basis is not eligible for the 'Minor cosmetic extension' endorsement.

Recent graduate applies if you have graduated within the last 5 years and you have not yet commenced a registrar or dental specialist training program or position.

Non-employer indemnified (private) practice covered under your category is included as long as that practice is commensurate with your training, qualifications and experience with appropriate supervision arrangements in place (if applicable).

This basis excludes non-employer indemnified (private) practice if 'Employer indemnified only' is appended to your basis. This basis is not eligible for the 'Minor cosmetic extension' endorsement.

Registrar applies if you are undertaking an accredited registrar training program or practise in a non-accredited registrar position.

International practitioners who are undertaking a period of supervised practice prior to obtaining AHPRA recognition as a specialist or undertaking a period of supervised practice as a specialist who may not be working towards AHPRA recognition may also be eligible for the 'Registrar' basis.

This basis extends to additional non-employer indemnified (private) practice outside of your training program or registrar position, covered under your category, as long as that practice does not constitute more than 50% of your hours worked per week (annualised) and is commensurate with your training, qualifications and experience with appropriate supervision arrangements in place (if applicable).

This basis does not apply to obstetric services (other than 'shared care' antenatal consulting), bariatric surgery, spinal surgery and neurosurgery when undertaken in a non-employer indemnified (private) setting.

This basis does not apply to non-employer indemnified (private) practice if 'Employer indemnified only' is appended to your basis. This basis is not eligible for the 'Minor cosmetic extension' endorsement.

Members who already hold, or obtain, an Australian specialist qualification are not eligible for the 'Registrar' basis.

Employer indemnified only applies if you are fully indemnified by your employer for all your healthcare practice regardless of whether you are in a public or private setting. This basis will not provide indemnity for civil claims.

Refer 'Employer indemnified practice' for further information. Refer to 'Run-off basis' if you have 'ROCS past private practice' appended.

Dentist in training applies if you are a general dentist and you have commenced a specialist dental qualification. Cover is provided for additional non-employer indemnified (private) practice outside of your training program, covered under your category, as long as that practice does not constitute more than 50% of your hours worked per week (annualised) and is commensurate with your training, qualifications and experience with appropriate supervision arrangements in place (if applicable).

This basis will exclude non-employer indemnified (private) practice if 'Employer indemnified only' is appended to your basis. This basis is not eligible for the 'Minor cosmetic extension' endorsement.

Members who already hold an Australian specialist qualification are not eligible for the 'Dentist in training' basis.

Gratuitous services only applies if you are no longer undertaking remunerated (paid) healthcare practice in Australia and your membership provides run-off cover for your previous practice. In addition to this, you undertake gratuitous (unpaid) healthcare activities in Australia, such as prescribing and referral services, where you continue to hold appropriate AHPRA registration (where required).

This basis does not apply to remunerated (paid) healthcare activities.

Refer to 'Run-off basis' and 'Ceasing practice in Australia' for further information.

Gross private billings/salary applies if you undertake non-employer indemnified (private) practice and your type of practice means you are ineligible for another basis.

Refer to 'Estimating hours, billings and/or salary' for further information.

Hours per week applies if you are a dental hygienist, prosthetist or therapist or oral health therapist and you undertake non-employer indemnified (private) practice.

Refer to 'Estimating hours, billings and/or salary' for further information.

MIPS Protections Plus applies if you have an indemnity arrangement in place with a provider other than MIPS that meets your AHPRA registration indemnity requirements but wish to access the other benefits of MIPS Membership including:

  • 24/7 advice and support from experienced practitioners
  • MIPS Protections discretionary cover for non-healthcare professional and personal matters arising from your clinical activities
  • Accredited professional development education and resources
  • Personal accident and travel cover
  • other membership benefits

This membership basis excludes indemnity cover for civil claims and you cannot make a claim through the MIPS Members' Indemnity Insurance, or MIPS Members' Practice Entity policies. Cover is not available under the Cyber Private Enterprise Policy.

Non-operating surgeon applies if you are a surgeon and your non-employer indemnified (private) practice is limited exclusively to consultations for example seeing patients for second opinions, clinico-legal assessments and examinations for those purposes.

You may also undertake surgical assisting in this basis.

Refer to 'Run-off basis' and 'Ceasing practice in Australia' for further information.

Non-practising applies if you have ceased all healthcare practice in Australia and your membership provides run-off cover for previous practice. The type of run-off cover you are eligible for will be appended to this basis.

This basis does not provide any cover for employer indemnified practice or volunteer services.

Refer to 'Run-off basis' and 'Ceasing practice in Australia' for further information.

Reciprocal applies if you are practicing in Australia under the MPS/MIPS reciprocal arrangement and you are fully employer indemnified for all your healthcare practice regardless of whether you are in a public or private setting. This basis will not provide indemnity for civil claims.

Refer 'Employer indemnified practice' for further information.

Surgical assisting only applies if you are a specialist (excluding general practitioners) and your non-employer indemnified (private) practice is limited exclusively to surgical assisting.

Run-off cover basis

There are different types of run-off cover, ERP (extended reporting period) or ROCS (Run-Off Cover Scheme), which will depend on your eligibility. A run-off cover basis will be appended to your membership classification.

ERP applies if you have ceased healthcare practice (temporarily or permanently) in Australia.

ERP loyal applies if you have ceased ALL healthcare practice permanently and have been a MIPS member for five continuous years.

ROCS applies if you have met the Australian Government Scheme eligibility criteria.

ROCS past private practice applies if you have met the eligibility criteria for ROCS for past private practice and you continue to work in an employer indemnified position.

Refer 'Ceasing practice in Australia' for further information.

Your endorsements

Some types of practice you undertake may require an 'endorsement' to extend or restrict your coverage.

Minor cosmetics extension is required if you undertake, prescribe or supervise specified minimally invasive office-based cosmetic procedures and the billings relating to those services do not exceed 50% of your annual total gross private billings.

Minor cosmetic procedures include:

  • botulinum toxin (Botox) injections
  • injections of non-permanent dermal fillers (including collagen, fat)
  • superficial chemical peels
  • superficial dermal resurfacing, including laser procedures.

All other cosmetic procedures should be referred for assessment.

Refer 'Cosmetic procedures' for further information.

Spinal surgery extension is required if you are an orthopaedic surgeon and you undertake spinal surgery in a non-employer indemnified (private) setting.

Non specialist undertaking procedural GP activities is required if you are in either the 'Medical officer' or 'General practice' categories and you undertake unsupervised procedural GP activities in a non-employer indemnified (private) setting.

Refer 'GP Procedural' for further information.

Specified dental procedures extension is required if you are a general dentist and you undertake the following 'specified dental procedures' in a non-employer indemnified (private) setting:

  • surgical placement of dental implants
  • bridgework, crowns or veneers in excess of three units on adjacent teeth including inlays and onlays
  • conscious sedation as defined by AHPRA
  • maxillo-facial or dento-alveolar surgery by non-specialists in high risk situations (high-risk situations include severe tooth impaction and where teeth are in close approximation to critical structures such as nerve supply and sinuses).

Contact MIPS if you have concerns regarding what is considered a 'high risk situation'.

If you undertake botulinum toxin (Botox) or non-permanent dermal fillers for cosmetic purposes refer to the 'Minor cosmetic extension' endorsement.

Bariatric surgery extension is required if you are a general surgeon and you undertake bariatric surgery in a non-employer indemnified (private) setting.

This endorsement is also required if you are undertaking locums or volunteering to cover for colleagues where you may have to manage postoperative care of bariatric surgery patients.

Gratuitous services in Australia is required if you are a fully employer indemnified practitioner for all your healthcare practice and you undertake gratuitous services in Australia that are not employer indemnified.

Refer to 'Gratuitous Services' for further information.

Employer indemnified outside of Australia is required if you have been approved for an extension of cover for practice outside of Australia to undertake an employer indemnified placement.

Gratuitous services outside of Australia is required if you have been approved for an extension of cover for practice outside of Australia to provide gratuitous aid work services to disadvantaged locals.

Refer to 'Gratuitous Services' for further information.

  • Indemnity insurance cover is capped at 6 calendar months or 184 days (the same as the travel cover)
  • Excludes matters within the USA, US territories or where US law applies
  • Cover is extended to you and a limit of one employee accompanying you

Sporting & cultural outside of Australia is required if you have been approved for an extension of cover for practice outside of Australia to accompany an Australian sporting or cultural group. Cover will only apply when treating Australian nationals.

Employer indemnified practice

You will receive cover and benefits for employer indemnified practice (unless you are in a non-practising classification).

Employer indemnified practice refers to practice where your employer has agreed to indemnify you (to meet your AHPRA registration indemnity requirements) for any civil claims as a result of your acts, errors and omissions in carrying out your duties. This type of practice is usually undertaken in a public hospital setting however you may also be indemnified by your employer in a private setting.

If you are employed as a contractor, and you have received confirmation from the hospital, clinic or locum agency that you are indemnified for civil claims that arise from your healthcare practice, then your practice is considered to be 'employer indemnified'.

If you are uncertain of your indemnity arrangements, you should seek confirmation from your employer as MIPS cannot provide that confirmation. Medical practitioners employed under contract in the public hospital system may contact the Australian Salaried Medical Officers Federation (ASMOF) for advice regarding the indemnity provided under their contract.

Cover and assistance can be provided by MIPS for a range of matters that may not be covered by your employer and may include:

  • professional disputes with your employer (eg hospital)
  • registration boards’ complaints
  • coroner’s inquests
  • healthcare services commissioners' matters (eg NSW Health Care Complaints Commission, Victorian Health Complaints Commission, Office of the Health Ombudsman Queensland)
  • investigations by state drug and poisons services
  • general assistance and clinico-legal advice on issues such as informed consent, testamentary capacity, whether a death needs to be reported to the coroner, release of medical records etc.

Members may also approach MIPS for assistance if they have concerns that their employer is not meeting or is unable to meet their obligations to them (eg due to conflict of interest).

MIPS will not provide indemnity for civil claims for any employer indemnified practice.

Estimating hours, billings and/or salary

If you undertake non-employer indemnified (private) practice you may be required to provide an estimate of your gross private billings and/or salary or total hours worked per week.

If you are required to provide billings and/or salary for your non-employer indemnified (private) practice, MIPS will require you to estimate the:

  • billings generated by you from all areas of your private practice whether retained by you or otherwise, and before any apportionment or deduction of any expenses and/or tax
  • salary you receive for private practice where billings are not generated under your provider number (or billed by a third party of your behalf).

The salary amount excludes any amount already provided as estimated billings. If you are required to provide your total hours per week we will also request you nominate the percentage of hours that relate to non-employer indemnified (private) practice.

Where indemnity is provided by your employer the hours, billings and/or salary from that practice is not included in the above estimate(s).

Your estimated gross private practice hours, billings or salary will be annualised and applied to all pro-rata periods you require cover for, and a billings/salary or hours band may be appended to your practice basis.

Members are required to notify MIPS as soon as they become aware that their estimated hours, billings and/or salary does not accurately reflect the level of cover required for the membership period. Amending these details may result in an adjustment to your membership fee.

Cosmetic procedures

A cosmetic/aesthetic treatment or procedure is defined as a procedure which has as its primary purpose the alteration of the non-pathological external appearance of a patient.

This does not apply to intra-oral dental procedures such as:

  • teeth whitening/bleaching
  • crowns/veneers.

If you undertake, prescribe or supervise any cosmetic services, you are required to have recognised qualifications, training and experience as well as maintain an appropriate level of indemnity cover, including if the services are undertaken by a third party. If you undertake 'minor cosmetic' procedures as defined by MIPS your membership must be endorsed. Refer 'Endorsements' for a list of procedures.

If you undertake any other cosmetic procedures (unless stated as included within your speciality) or if your cosmetic services will exceed 50% of your annual total gross private billings, you must provide details to MIPS.

All dental practitioners (including allied dental health) are required to comply with any policies or guidelines provided by the Dental Board of Australia. All queries regarding this should be referred directly to AHPRA.

Any additional membership fee charged reflects the very high risk associated with cosmetic work. Actions are more readily defensible where a procedure is performed by a healthcare practitioner who can demonstrate certified satisfactory completion (preferably by formal examination) of accredited postgraduate training.

Shared antenatal care

Shared antenatal care includes uncomplicated low risk pregnancies when the patient has been referred to and accepted as a patient in writing at an early stage of pregnancy by either:

  • a hospital for obstetric management as a public patient or
  • a GP obstetrician or specialist obstetrician for obstetric management as a private patient.

Shared care arrangements require that you have recognised qualifications, training and experience and work collaboratively under the direction (that may include protocols and supervision) of the practitioner or hospital responsible for the patient's obstetric care. You must not become involved, or have the intention of becoming involved, in the induction or management of labour or delivery. The only exception is for public patients in a public setting where you are indemnified by the hospital.

Supervising other practitioners

If you are supervising other practitioners (including students, nurses and trainees) you are required to have the recognised qualifications, training and experience for the services you supervise as well as maintain an appropriate level of indemnity cover for those services.

Appropriate supervision arrangements must be in place and may include both direct supervision and indirect supervision where there continues to be adequate access to communication, oversight, interaction, direction and support after initial instruction has been provided.

Queries regarding supervision arrangements should be directed to info@mips.com.au

Telehealth Services

Telehealth is defined as healthcare provided over the internet, by video conference or telephone to patients in Australia in accordance with AHPRA, college and Medicare requirements.

Cover for telehealth requires the same standard of care as any other provision of healthcare and if the medium is not appropriate for a patient, members are expected not to offer telehealth consultations.

If you undertake non-employer indemnified (private) telehealth services, before MIPS can confirm cover you are required to provide further information for assessment by completing the Practice Assessment Questionnaire form at mips.com.au/forms

Under Australian law, the location of the patient is where the healthcare is considered to be provided. Any communication to patients via an electronic device is likely to constitute telehealth.

The benefits of MIPS membership do not extend to protect you for healthcare provided via telehealth to a patient located outside Australia. Professional registration or licensing may also be required for the jurisdiction in which your patient is physically located.

You should advise patients you are unable to provide telehealth advice if they are located outside of Australia.

Gratuitous services

Gratuitous services are services where you receive no remuneration and patients or others are not charged for your involvement for the services you undertake. This may include services such as prescribing and writing referrals and volunteer services.

In general, gratuitous services are covered when provided in Australia if an appropriate membership classification is selected for the services you expect to provide.

You may require assessment if:

  • you volunteer in a high-risk setting (for example motor or professional sport events) and you are not an emergency medicine specialist.
  • you will undertake unsupervised activities for which you would normally require supervision.
  • you will undertake activities not covered under your membership classification.

An endorsement is required if you are in an employer indemnified only classification and you undertake gratuitous services in Australia.

You must ensure that you hold the appropriate AHPRA registration for undertaking your proposed services.

Clinical Trials

This endorsement will apply if you undertake clinical trials. You must:

  • Hold current AHPRA medical practitioner registration and have appropriate training, experience and qualifications for the healthcare activities undertaken
  • Have an appropriate MIPS membership classification for the healthcare activities undertaken
  • Have obtained ethics approval from a currently registered Human Research Ethics Committee with National Health and Medical Research Council (NHMRC) eg Bellberry
  • Only treat patients located within Australia.

You ONLY need to apply for cover if you do not meet the above criteria, visit mips.com.au/forms to apply.

Ceasing practice in Australia

If you have ceased practice (temporarily or permanently) you will need to maintain run-off cover to ensure that you remain covered for emerging claims from your prior practice in Australia and continue to meet your AHPRA requirements. The type of run-off cover will depend on your individual circumstances.

If you cease practice in Australia (permanently or temporarily) MIPS can offer run-off cover for your past practice in an extended reporting period (ERP) membership classification. The cost of ERP cover is calculated on your individual risk history and will vary for each member. If you have been with MIPS for five continuous years and you are permanently retiring from all healthcare practice you will be eligible for ERP loyal run-off cover which is offered at $50 per annum.

After three years of no private practice in Australia, medical practitioners may become eligible for the Run-off Cover Scheme (ROCS), an Australian Government scheme that offers run-off cover at no cost to eligible practitioners. In some circumstances, such as maternity leave or retirement over the age of 65, medical practitioners may be immediately eligible for ROCS from the date they cease practice. See 'Government assistance schemes' for more information.

If have ceased practice in Australia (or will cease prior to 30 June), complete the Ceasing Practice Form online at mips.com.au/ceasing

Student

A student membership category may apply if:

  • You are a student currently studying a healthcare discipline (medicine, dentistry, oral health or nuclear medicine) at a recognised education provider in Australia.
  • You are currently studying a healthcare discipline (medicine, dentistry, oral health or nuclear medicine) outside of Australia and you will undertake an Australian placement.
  • You are undertaking any other pre-registration healthcare activities prior to obtaining AHPRA registration.

Cover under the MIPS Members' Practice Entity Policy does not apply to the Student membership categories. Unless stated otherwise, students receive limited cover under the MIPS Members' Personal Accident Policy. See the Members' Insurance Covers Handbook for terms and conditions.

Healthcare student

This category is suitable for students currently studying a healthcare discipline (medical, dental science, oral health or nuclear medicine technology) at a recognised education provider in Australia and students currently studying an equivalent healthcare discipline at a recognised education provider outside of Australia undertaking a temporary placement in Australia. It includes cover for activities such as:

  • observation, taking a history or performing the physical examination of a patient
  • writing a patient management plan and interpreting investigations
  • administration and principles of admitting and discharging patients
  • communicating with patients, relatives and staff
  • basic clinical activities (dressing wounds, venepuncture, cannulation, suturing, assisting in surgery)
  • basic dental activities (scale/clean, oral health instruction, simple extractions, restorations).

You are automatically covered for placements/electives/clinical rotations (excluding the US or where US law applies) provided you meet the criteria. There is no need to notify us, cover is automatically provided if the activities undertaken are commensurate with the level of education, training and experience for a healthcare student and you are:

  • appropriately supervised by a registered healthcare practitioner (which includes direct or indirect supervision that provides adequate access to communication, oversight, interaction, direction and support from your supervisor throughout the activity)
  • not being remunerated for the healthcare activities undertaken
  • not undertaking volunteer activities (eg St Johns, charity groups etc)

Cover for a placement that does not meet the above criteria is subject to approval and you can apply at mips.com.au/placement.

Pre-registration practice

This category is suitable for practitioners undertaking healthcare activities, including observerships, prior to obtaining AHPRA registration.

If you have obtained AHPRA registration (or you will have obtained it by the time you commence practice) you are not eligible to select this category.

Members in this category may undertake pre-registration activities under complete supervision of an Australian registered healthcare practitioner but must not provide any healthcare of a type required to be provided by a registered healthcare practitioner or be responsible in any way for patient management. Membership benefits including insurance covers for those undertaking pre–registration placements will extend to supervised healthcare activities (commensurate with their experience) listed below:

  • observation, taking a history or performing a physical examination of a patient
  • writing a patient management plan and interpreting investigations
  • administration and principles of admitting and discharging patients
  • communicating with patients, relatives and staff
  • basic clinical activities (dressing wounds, venepuncture, cannulation, suturing, assisting in surgery)
  • basic dental activities (scale/clean, oral health instruction, simple extractions, restorations).

Practitioners undertaking pre-registration placement activities are required to be appropriately supervised for any healthcare activities they undertake. Appropriate supervision includes direct or indirect supervision that provides adequate access to communication, oversight, interaction, direction and support from your supervisor throughout the activity.

Medical

Non specialists

These categories apply to medical practitioners that hold general, limited or provisional registration only and have not yet commenced an Australian registrar/training program, specialist recognition pathway or registrar position.

When selecting a category, it should reflect where you generate the majority of your non-employer indemnified (private) practice gross billings in a membership period or where you undertake the majority of your practice (hours) if you are employer indemnified only.

Medical officer

This category applies to practitioners who practice in a hospital (or non general practice) setting.

This category limited to unsupervised practice listed under the GP non-procedural category.

An endorsement is required if you are undertaking any services listed under the GP procedural category and/or any minor cosmetic services as defined by MIPS

General practice

This category applies to general registration practitioners who practice in a general practice setting.

This category is limited to unsupervised practice listed under the GP non-procedural category.

An endorsement is required if you are undertaking any services listed under the GP procedural category and/or any minor cosmetic services as defined by MIPS.

Medical

General practitioners

These categories apply to practitioners that hold specialist registration, are vocationally registered or are permitted to practise as a specialist. These categories should also be selected if you are undertaking an accredited registrar training program or practise in a non-accredited registrar position. If you do not meet these criteria refer to category 'General practice' under Non specialists.

GP non procedural

This category applies to general practitioners who undertake treatments, procedures or practice most GPs commonly perform in their rooms. It does not include all the treatments, procedures or practice that GPs could perform in their rooms.

Although such procedures or treatments are usually carried out in a GP's surgery/consulting rooms, they may also be performed in patients' residences, hospitals and other healthcare facilities.

Procedures include:

  • repair of superficial lacerations of skin and subcutaneous tissue
  • removal of superficial skin lesions, tumours and cysts
  • biopsy of skin lesions (including punch biopsies)
  • removal of foreign bodies, including superficial corneal and aural
  • incision and drainage of superficial abscesses
  • eyelid – excision/curettage of chalazion
  • cautery and cryotherapy of superficial skin lesions
  • electrocautery of nose bleeds
  • drainage of thrombosed external haemorrhoids
  • reduction of simple closed joint dislocations
  • treatment of simple fractures – not requiring reduction or anaesthesia
  • local anaesthesia (not including regional blocks)
  • acupuncture (including laser acupuncture)
  • aspiration of and/or intra-articular injections into peripheral joints (not spine)
  • insertion of IUCDs when approved by MIPS (training documentation to be provided)
  • removal of IUCDs
  • avulsion of a toenail (may include wedge resection but excluding total removal of nail bed)
  • Implanon NXT insertion and removal when approved by MIPS (training documentation to be provided)
  • proctoscopy/sigmoidoscopy (without biopsy)
  • syringing of the external auditory canal
  • insertion of urinary catheters
  • venepuncture and simple insertions of IV lines/IV drug therapy
  • allergy testing/desensitisation
  • arterial blood gas estimations
  • blood transfusions
  • surgical assistance
  • skin flaps and grafts when approved by MIPS
  • shared antenatal care in consultation with a hospital or specialist obstetrician or GP obstetrician (see 'shared antenatal care' definition)
  • exercise ECG (with appropriate resuscitation facilities)
  • post mortems
  • lumbar puncture.

This list is not exhaustive. Queries should be directed to info@mips.com.au

An endorsement is required if you undertake any minor cosmetic services as defined by MIPS.

The 'GP non procedural' category does not apply to the following practices when undertaken in a non-employer indemnified setting:

  • obstetric services other than 'shared antenatal care' (see 'Shared antenatal care' definition)
  • perinatal care
  • procedures listed under GP procedural
  • administering and monitoring sedation for procedures such as (but not limited to) gastroscopy and colonoscopy
  • anaesthesia or intravenous/intravascular sedation (other than those performed under local anaesthesia including finger and toe blocks)
  • neurosurgery, bariatric surgery and spinal surgery
  • other procedures normally undertaken by medical specialists unless agreed in writing by MIPS.

After hours deputising services

If you are undertaking after-hours activities, this category applies provided the activities are of a non-procedural GP nature.

Cover can apply for dispensing/supplying medications during after-hours consultations when approved by MIPS.

Skin flaps and grafts

If you are performing small skin flaps and grafts in this category, you should advise MIPS of the size, location, types of patients and purpose of the flaps and grafts to ensure if this category is appropriate. This is to assess the level of risk involved. For example, small flaps on the face of a child are considered higher risk than larger flaps on the upper leg of an adult.

GP procedural

This category applies to general practitioners who perform procedures not covered under the non-procedural category definition and/or procedures usually performed under regional or general anaesthesia or sedation or neurolept-analgesia. This category should be selected even if such procedures are performed without anaesthesia.

Procedures include:

This list is not exhaustive. Queries should be directed to info@mips.com.au

An endorsement is required if you undertake any minor cosmetic services as defined by MIPS.

The 'GP procedural' category does not apply to the following practices when undertaken in a non-employer indemnified setting:

  • obstetric services other than 'shared antenatal care' (see 'Shared antenatal care' definition)
  • perinatal care
  • sedation muscle relaxant or anaesthesia agents such as Diprivan
  • neurosurgery, bariatric surgery and spinal surgery
  • other procedures normally undertaken by medical specialists unless agreed in writing by MIPS.

GP procedural including anaesthetics and/or obstetrics

This category applies to GP obstetricians (DRANZCOG or equivalent) or GP anaesthetists (JCCA or equivalent).

Procedures include:

  • regional anaesthesia (beyond digital blocks)
  • general anaesthesia
  • administering agents other than narcotic/benzodiazepine combinations
  • private obstetric services beyond shared antenatal care in a healthcare facility.

This list is not exhaustive. Queries should be directed to info@mips.com.au

If you are training and undertaking unsupervised obstetrics or anaesthetic services in a non-employer indemnified (private) setting submit your details for assessment to info@mips.com.au

An endorsement is required if you undertake any minor cosmetic services as defined by MIPS.

The 'GP procedural including anaesthetics and/or obstetrics' category does not apply to the following practices when undertaken in a non-employer indemnified setting:

  • any involvement in planned home births
  • neurosurgery, bariatric surgery and spinal surgery
  • other procedures normally undertaken by medical specialists unless agreed in writing by MIPS.

Other medical specialists

These categories apply if you hold the recognised AHPRA specialist registration and practice within the specialty. These categories should also be selected if you are undertaking an accredited registrar training program or practice in a non-accredited registrar position. If you do not meet these criteria refer to category 'Medical officer' under Non specialists.

An endorsement is required if you undertake any minor cosmetic procedures as defined by MIPS unless stated within your category that cover is provided for cosmetic services.

If you have any queries on the category description or if your specialty is not listed contact MIPS.

Anaesthesia

Practice in this category also includes:

  • intensive care medicine
  • pain medicine when approved by MIPS

Cardiothoracic surgery

Cosmetic-proceduralistCosmetic proceduralist

This category applies if:

  • your minor cosmetic services exceed 50% of your annual total gross private billings
  • you are a plastic surgeon, dermatologist, ophthalmologist, otolaryngologist or vascular surgeon and your approved cosmetic services exceed 50% of your annual total gross private billings
  • you are any other type of practitioner and you undertake any cosmetic procedures other than minor cosmetic procedures
  • you have been advised by MIPS.

See 'Cosmetic procedures' definition

Dermatology

This category also applies to dermatologists who perform cosmetic procedures provided those services:

  • fall within the scope of your accredited training; and
  • generate less than 50% of your gross private billings.

If your cosmetic procedures exceed 50% of your total gross private billings or you undertake laser blepharoplasty, meloplasty and similar procedures you will need to select the ‘Cosmetic proceduralist’ category.

Emergency medicine

Practice in this also category includes:

  • anaesthesia
  • intensive care medicine
  • pain medicine when approved by MIPS

General surgery

An endorsement is required if you undertake bariatric surgery in a non-employer indemnified (private) setting. Bariatric surgery, commonly referred to as weight loss surgery, refers to the various surgical procedures performed to treat obesity by modification of the gastrointestinal tract to reduce nutrient intake and/or absorption. This includes surgeons undertaking locums or volunteering to cover for colleagues where they may have to surgically manage postoperative care of bariatric patients.

 

Gynaecology including IVF

This category does not apply to the management or induction of labour in a non-employer indemnified (private) setting. If you undertake these services, you are required to select ‘Obstetrics and gynaecology’.

Gynaecologists who perform ultrasound (including diagnostic O&G imaging) only, should select the Radiology category.

Intensive care medicine

Practice in this category also includes:

  • pain medicine when approved by MIPS

Neurosurgery

Medical administration

This category applies to practitioners that hold specialist registration in medical administration.

This category applies where your practice is restricted to medical administration activities.

This category does not apply to any clinical activities.

Obstetrics and gynaecology

This category applies to the management or induction of labour in a healthcare facility in a non-employer indemnified (private) setting.

This category does not apply to any involvement in planned home births.

Ophthalmology

This category also applies to ophthalmologists who perform cosmetic procedures provided those services:

  • fall within the scope of your accredited basic training; and
  • generate less than 50% of your gross private billings.

If your cosmetic procedures exceed 50% of your total gross private billings or you undertake refractive laser therapy, outside a peer-reviewed university department you will need to select the ‘Cosmetic proceduralist’ category.

Oral and maxillofacial surgery

This category also applies to oral maxillofacial surgeons who perform cosmetic procedures provided those services:

  • fall within the scope of your accredited training; and
  • generate less than 50% of your gross private billings.

If your cosmetic procedures exceed 50% of your total gross private billings you will need to select the ‘Cosmetic proceduralist’ category.

Orthopaedic surgery

An endorsement is required if you undertake spinal surgery in a non-employer indemnified (private) setting.

Otolaryngology head and neck surgery

Otolaryngology head and neck surgery

This category also applies to otolaryngologists (also known as ENT surgeons or otorhinolaryngologists) who also perform cosmetic procedures provided those services:

  • fall within the scope of your accredited basic training; and
  • generate less than 50% of your gross private billings

If your cosmetic procedures exceed 50% of your total gross private billings you will need to select the ‘Cosmetic proceduralist’ category.

Paediatric surgery

Pathology

This category also applies to pathologists who hold physician qualification AND 50% or more of their gross non-employer indemnified (private) billings relate to pathology reporting services.

Physician rehabilitation and occupational

This category includes physicians who undertake:

  • occupational medicine
  • pain medicine when approved by MIPS
  • pre-employment and fitness for work medicals
  • rehabilitation medicine

Physician non procedural

This category includes consultant physicians who practise in the disciplines/perform minimally invasive, lower risk procedures including:

  • bone marrow biopsy
  • cardiology (non-interventional & non-invasive)
  • chemotherapy
  • gastroscopy (excluding ERCP & colonoscopy)
  • geriatric medicine
  • haematology
  • immunology
  • medical oncology
  • nephrology
  • neurology
  • paediatric medicine
  • pain medicine when approved by MIPS
  • proctoscopy
  • renal biopsy
  • respiratory medicine (including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA) and transbronchial lung biopsy)
  • sigmoidoscopy

If you are a physician who also holds a pathology qualification you may also select this category provided pathology reporting activities generate less than 50% of your gross non-employer indemnified (private) billings.

Physician procedural

This category includes physicians who perform invasive procedures including but not limited to:

  • cardiology – interventional (ie cardiac catheterisation)
  • colonoscopy
  • endoscopic retrograde cholangio pancreatography (ERCP)
  • endoscopic procedures
  • liver biopsy
  • pain medicine when approved by MIPS

Plastic surgery

This category also applies to plastic surgeons who perform cosmetic procedures provided those services generate less than 50% of total gross private billings and:

  • fall within the scope of your accredited basic training or
  • are listed as a minor cosmetic service as defined by MIPS.

If your cosmetic procedures exceed 50% of your total gross private billings you will need to select the ‘Cosmetic proceduralist’ category.

Psychiatry

Practice in this category includes:

  • electroconvulsive therapy (ECT)
  • medico-legal reporting
  • pain medicine when approved by MIPS

Radiation oncology

Radiology

Practice in this category also includes:

  • gynaecologists who perform ultrasound (including diagnostic O&G) only

Sport and exercise medicine

Urology

Vascular surgery

This category also applies to vascular surgeons who perform cosmetic procedures provided those services:

  • fall within the scope of your accredited basic training; and
  • generate less than 50% of your gross private billings.

If your cosmetic procedures exceed 50% of your total gross private billings you will need to select the ‘Cosmetic proceduralist’ category.

Dental

These categories apply if you hold the recognised AHPRA general or specialist dental registration and practice within the speciality or you are undertaking a dental specialty training program.

All dental categories (excluding the oral and maxillofacial surgery category) require endorsement if you undertake any minor cosmetic services as defined by MIPS.

Please contact MIPS, if your specialty is not listed or you practice in multiple specialities.

Dental therapist

Dental hygienist

Practice in this category also includes:

  • dental therapy

Oral health therapist

This category applies to practitioners that hold oral health therapist registration with AHPRA.

Dental prosthetist

Dentist

Practice in this category also includes dental specialties where you practice and bill as a non-specialist including:

  • endodontics
  • orthodontics
  • prosthodontics

An endorsement is required in this category if you undertake specified dental procedures as defined by MIPS in a non-employer indemnified (private) setting. See the ‘Endorsements’ section at the start of this ‘Membership classification guide’ for the ‘specified dental procedures’ definition.

Dental specialists

Dento-maxillofacial radiology

Endodontics

Forensic odontology

Oral and maxillofacial surgery

This category also applies to oral and maxillofacial surgeons who perform cosmetic procedures provided those services:

  • fall within the scope of your accredited training; and
  • generate less than 50% of your gross private billings.

If your cosmetic procedures exceed 50% of your total gross private billings you will need to select the ‘Cosmetic proceduralist’ category

Oral medicine

Oral pathology

Oral surgery

Orthodontics

Paediatric dentistry

Periodontics

Prosthodontics

Public health dentistry (Community dentistry)

Special needs dentistry

Other healthcare

Nuclear medicine technologist

This category applies to practitioners that hold nuclear medicine technologist registration with AHPRA.

Contact us


1800 061 113

info@mips.com.au

claims@mips.com.au

Outside Australia

Membership enquiries +61 3 8620 8888
Clinico Legal +61 3 8620 8829

Postal address

PO Box 24240
Melbourne VIC 3001

 

mips.com.au