What claims are eligible

A ROCS application can only be made against certain medical practitioners. Applications can only be submitted by a representative of an eligible MII or MDO.

Eligible claims

A claim may be eligible under the ROCS if:

  • the MII or MDO were first notified of the claim or facts that may give rise to it on or after 1 July 2004
  • the incident occurred in the course of, or in connection with, the person’s practice as a medical practitioner
  • the incident was covered under the medical practitioner’s indemnity arrangement or agreement.

When the claim is first notified to you, the medical practitioner in the claim must:

  • be covered under ROCS
  • meet 1 or more of the eligibility class.

ROCS eligibility classes

There are 6 eligibility classes for a claims against a medical practitioner under the ROCS.

The medical practitioner must have submitted the relevant supporting document to their MII or MDO. In most cases it’s a completed Statutory Declaration. Some ROCS eligibility classes also require a completed Medical Certificate or Death Certificate.

You can complete and submit the Statutory Declaration or Medical Certificate retrospectively for a claim if you need to.

Read the information below about each eligibility class and what evidence you need to apply for payment under the ROCS.

A medical practitioner who has permanently retired from private medical practice

For claims notified before 1 July 2020, the medical practitioner must be 65 years of age or over.

From 1 July 2020, the medical practitioner can be any age but must have permanently retired from private medical practice.

The following evidence is required to demonstrate the medical practitioner is eligible under this ROCS class:

No Medical Certificate is required to support this eligibility class.

A medical practitioner who has not engaged in private medical practice at any time during the preceding 3 years

In the 3 years prior to be notified of a claim or the incident, the medical practitioner must either:

  • not be engaged in any paid medical practice
  • not practice as a medical practitioner, apart from providing free medical services in private medical practice.

The following evidence is required to demonstrate the medical practitioner is eligible:

No Medical Certificate is required to support this eligibility class.

A medical practitioner who has temporarily or permanently stopped practicing privately due to maternity

The following evidence is required to demonstrate the medical practitioner is eligible:

The Medical Indemnity Act 2002 provides details on maternity leave.

Read the Medical Indemnity Act 2002 on the Federal Register of Legislation website.

A medical practitioner who has permanently stopped practicing due to disability

The following evidence is required to demonstrate the medical practitioner is eligible:

The Medical Indemnity Act 2002 provides details about permanent disability.

Read the Medical Indemnity Act 2002 on the Federal Register of Legislation website.

A person who is deceased or is the legal personal representative of a deceased person who had been a medical practitioner

A Death Certificate is required to demonstrate the medical practitioner is eligible.

If you don’t have the certificate, you can submit a Statutory declaration ROCS - Deceased medical practitioner form.

No Medical Certificate is required for this eligibility class as part of an application to claim.

A medical practitioner who was an overseas medical practitioner and held a temporary visa

A copy of the medical practitioner’s temporary Visa is required to demonstrate they’re eligible.

The temporary visa needs to comply with the Migration Act 1958. They must have nominated their occupation as a medical practitioner. Prior to 18 March 2018 the Visa must be a subclasses 422 medical practitioner and 457 business long stay.

In addition, all of the following need to apply:

  • they must have been recognised by the relevant authority to practice in Australia
  • they must have been engaged in a medical practice in Australia
  • they must not have been prohibited from engaging in medical practice in Australia
  • they must have permanently stopped practicing medicine in Australia
  • they must no longer reside in Australia.

The Migration Act 1958 has more details on temporary visa requirements.

Read the Migration Act 1958 Federal Register of Legislation website.

If you don’t have a copy of the temporary Visa, you can submit the Statutory declaration ROCS - Overseas medical practitioner form.

No Medical Certificate is required for this eligibility class as part of an application to claim.

If you have an eligible claim, read about how to apply for payment under the ROCS.

Page last updated: 30 October 2020