Glossary for Medical and Midwife Indemnity

Some terms used in Medical and Midwife Indemnity insurance claims have specific meanings depending on which scheme they apply to.

The following table has terms, abbreviations and their meanings more commonly used.

Term Meaning
Aggregation An amount formed or calculated by the combination of many separate items. Under ROCS, HCCS and AH HCCS an MDO and MII may be able to aggregate costs for the same claim. You only need to submit 1 application.
AH ECS Allied Health Exceptional Claims Indemnity Scheme.
AH HCCS Allied Health High Cost Claim Indemnity Scheme.
Ahpra The Australian Health Practitioner Regulation Agency.
Ahpra Registration Number The unique registration number allocated by Ahpra to a practitioner for each profession they’re registered in.
Allied health professional A person who practices an allied health profession within the meaning of the Health Practitioner Regulation National Law, other than the medical profession. You can read this legislation on the Ahpra and National Boards website.
Applicant The entity applying under the Medical Indemnity Scheme. Depending on the scheme, the applicant must be a:
  • Medical Defence Organisation (MDO)
  • Medical Indemnity Insurer (MII)
  • person against whom the claim is or was made, or by a person acting on that person’s behalf (applies to ECS, AH ECS and MPIS L2 applications only).
Apportionment The distribution of damages between parties to a claim, proportionate to their legal liability.
Apportionment Certificate We issue this certificate. It is required as part of a MPIS payment application where apportionment has not been specified by a court. When the insurer enters the Apportionment details into the online MPIS payment application it’s taken to be an application for an apportionment certificate.
ARN Application Reference Number. This is our unique identifier allocated to each Medical or Midwife Indemnity application we get.
Claim Handling Fee (CHF) An administrative fee which is payable to the applicant under the ROCS and IBNR Schemes. This is currently 5% of the gross claim amount.
Cost sharing arrangement Any arrangement in which legal costs and/or disbursements are shared between parties to a claim or proceedings.
Date of Incident (DoI) This is the date on which the incident occurred that gave rise to a claim. If a single significant incident date can’t be identified, the claim must reflect the date range of the incidents.
Date of Notification (DoN) The date that the applicant was first notified of the claim or incident(s):
  • by the insured person
  • through a subpoena, statement of contribution from another party or other claim documentation.
Defendant A person against whom the claim was made.
ECS Exceptional Claims Indemnity Scheme.
HCCS High Cost Claim Indemnity Scheme.
IBNR Incurred But Not Reported Indemnity Scheme.
Incident An act, omission or circumstance. Includes an alleged incident.
Initial Application This is the first Medical or Midwife Indemnity payment application submitted for a claim that we’ll assess.
Insured person The member or policy holder for whom the Medical Indemnity application is made.
Insured person’s contract limit The maximum amount payable by the MII under a contract for claims made against a practitioner. Also referred to as policy limit.
Insurance contract A contract whereby an insurer agrees to indemnify the purchaser up to a specified limit in the event of a claim against them.
MDO Medical Defence Organisation. Refer to section 5 of the Medical Indemnity Act 2002 for the full definition on the Federal Register of Legislation website.
Medical Indemnity Online Claiming Service (MIOC) Our online system for submission of Medical Indemnity scheme payment and refund applications.
MII Medical Indemnity Insurer
MPIS Midwife Professional Indemnity Scheme gives financial assistance to eligible insurers who provide indemnity to eligible privately practicing midwives.
Party or parties The person(s) or organisation(s) that make or respond to a claim.
Plaintiff A person or persons who commence civil action in a court.
Policy limit The maximum amount payable by the MII under a contract for claims made against a practitioner.
Private Patient Patients who pay for their hospital costs by private health insurance or their own funds.
PSS Premium Support Scheme.
Public Hospital A recognised hospital within the meaning of the Health Insurance Act 1973 on the Federal Register of Legislation website.
Public patient Has the same meaning as in the Health Insurance Act 1973 on the Federal Register of Legislation website.
QCC We issue Qualifying Claim Certificate to the applicant if they meet requirements of the scheme. If we don’t issue a QCC, we can’t pay the following payments:
  • ECS
  • AH ECS
  • MPIS Level 1 and 2 payments
ROCS Run off Cover Indemnity Scheme.
Series of related incidents A series of incidents that together form the incident which is the basis of the claim. The date of incident is the date range over which the related incidents occurred.
Subsequent Application An additional application submitted for a claim that we have previously assessed.
Third party contribution A payment, made by a party who is not named in the claim, towards damages the insured person is liable for. You can’t claim amounts for which you have received a third party contribution.

You can read more about each term on the Federal Register of Legislation website:

Page last updated: 26 July 2022