What incidents you can’t seek payment for
You can’t submit an IBNR application for an incident or a series of related incidents if:
- you were notified about them before 1 July 2002
- the insured person didn’t hold incident occurring based cover on 30 June 2002
- they occurred on or after 1 July 2002
- they didn’t occur as part of a person’s practice as a medical professional
- they aren’t normally covered in the person’s ordinary course of business
- you aren’t liable to make a payment in relation to the claim
- it occurred entirely in the provision of treatment to a public patient is in a public hospital.
What amounts you can’t claim
You can’t claim GST under the IBNR.
You also can’t claim an amount if:
- another party has responsibility to pay it
- the cost wasn’t incurred in relation to the incident
- it’s an insurer to insurer payment
- any portion that related to the treatment of a public patient in a public hospital
- the judgment or settlement amounts are still within the appeal period or have been appealed or stayed.