Commonwealth Consolidated Acts Commonwealth Consolidated ActsGeneral
(1) In this Act, unless the contrary intention appears:
"Actuary" means the Australian Government Actuary.
"affected medical practitioner" has the meaning given by section 34ZQ.
"Chief Executive Medicare" has the same meaning as in the Human Services (Medicare) Act 1973 .
(a) means a claim or demand of any kind (whether or not involving legal proceedings); and
(b) includes proceedings of any kind including:
(i) proceedings before an administrative tribunal or of an administrative nature; and
(ii) disciplinary proceedings (including disciplinary proceedings conducted by or on behalf of a professional body); and
(iii) an inquiry or investigation;
and claim against a person includes an inquiry into, or an investigation of, the person's conduct.
Note: Subsection (1A) extends the meaning of claim for the purposes of Division 2B of Part 2 (run-off cover indemnity scheme).
(a) for a UMP support payment payable by a participating member of a participating MDO--has the same meaning as in the Medical Indemnity (UMP Support Payment) Act 2002 ; and
(b) for a run-off cover support payment--has the same meaning as in the Medical Indemnity (Run-off Cover Support Payment) Act 2004 ; and
(c) for a competitive advantage payment--has the same meaning as in the Medical Indemnity (Competitive Advantage Payment) Act 2005 .
"eligible midwife" has the same meaning as in the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010 .
"eligible run-off claim" has the meaning given by section 34ZB.
"exceptional claims indemnity" means an exceptional claims indemnity paid or payable under Division 2A of Part 2.
Note: Amounts payable under the Exceptional Claims Protocol are not covered by this definition.
"Exceptional Claims Protocol" means the protocol (as amended and in force from time to time) determined by the Minister under section 34X.
"externally-administered body corporate" means:
(a) a body corporate that is an externally-administered body corporate within the meaning of the Corporations Act 2001 ; or
(b) a body corporate to which a provisional liquidator has been appointed.
"Federal Register of Legislative Instruments" means the Federal Register of Legislative Instruments established under the Legislative Instruments Act 2003 .
"health care related vocation" means a health care related vocation in relation to which there is at least one State or Territory under the law of which a person must be registered in order to practise.
"health professional" means a person who practises a health care related vocation.
"high cost claim indemnity" means a high cost claim indemnity paid or payable under Division 2 of Part 2.
Note: Amounts payable under the High Cost Claims Protocol are not covered by this definition.
"High Cost Claims Protocol" means the protocol (as amended and in force from time to time) determined by the Minister under section 34AA.
"high cost claim threshold" has the meaning given by section 29.
"Human Services Minister" means the Minister administering the Human Services (Medicare) Act 1973 .
"IBNR Claims Protocol" means the protocol (as amended and in force from time to time) determined by the Minister under section 27A.
"IBNR exposure" has the meaning given by section 8.
"IBNR indemnity" means an IBNR indemnity paid or payable under Division 1 of Part 2.
Note: Amounts payable under the IBNR Claims Protocol are not covered by this definition.
"imposition day" , for a UMP support payment payable by a participating member of a participating MDO, has the same meaning as in the Medical Indemnity (UMP Support Payment) Act 2002 .
(a) any act, omission or circumstance; and
(b) an incident that is claimed to have occurred.
"incident-occurring based cover" has the meaning given by section 7.
"indemnify" has a meaning affected by subsection (2).
"indemnity scheme payment" means:
(a) an IBNR indemnity; or
(b) a high cost claim indemnity; or
(c) an exceptional claims indemnity; or
(d) a run-off cover indemnity.
"insurance business" has the same meaning as in the Insurance Act 1973 .
"insurer" means a person who carries on insurance business.
"insurer-to-insurer payment" means a payment that:
(a) is made by an MDO or insurer to an MDO or an insurer; and
(b) is not made by the MDO or insurer on behalf of another person.
(a) any document issued by an MDO to a person (whether or not the person is already a member of the MDO) that contains a quote for the amount of subscription that is or would be payable by that person for membership of the MDO; and
(b) any document issued by a medical indemnity insurer to a person (whether or not the medical indemnity insurer already provides medical indemnity cover to the person) that contains a quote for the amount of premium that is or would be payable by that person for provision of such cover.
(a) in relation to an amount repayable under section 24--means a penalty payable under section 27; and
(aa) in relation to a debt owed under section 34T--means a penalty payable under section 34W; and
(ab) in relation to a debt owed under section 34ZJ--means a penalty payable under section 34ZM; and
(b) in relation to a medical indemnity payment--means a penalty payable under section 65; and
(c) in relation to an amount that a medical indemnity insurer or an MDO is required to remit to the Chief Executive Medicare under paragraph 66A(4)(b)--means a penalty payable under section 66B.
"legal practitioner" means a person who is enrolled as a barrister, a solicitor, a barrister and solicitor, or a legal practitioner, of:
(a) a federal court; or
(b) a court of a State or Territory.
"MDO" has the meaning given by section 5.
"medical indemnity cover" : a contract of insurance provides medical indemnity cover for a person if:
(a) the person is specified or referred to in the contract, whether by name or otherwise, as a person to whom the insurance cover provided by the contract extends; and
(b) the insurance cover indemnifies the person (subject to the terms and conditions of the contract) in relation to claims that may be made against the person in relation to incidents that occur or occurred in the course of, or in connection with, the practice by the person of a medical profession.
Note 1: A single contract of insurance may provide medical indemnity cover for more than one person.
Note 2: This definition does not apply to references to medical indemnity cover in subsections 52(3B) and (3C): see subsection 52(3D).
"medical indemnity insurer" means:
(a) a body corporate authorised under section 12 of the Insurance Act 1973 that; or
(b) a Lloyd's underwriter within the meaning of that Act who;
in carrying on insurance business in Australia, enters into contracts of insurance providing medical indemnity cover for other persons.
"medical indemnity payment" means:
(a) a UMP support payment payable under Division 1 of Part 3; or
(b) a run-off cover support payment payable under Division 2 of Part 3; or
(c) a competitive advantage payment payable under Division 2A of Part 3.
"medical indemnity payment legislation" means:
(a) the Medical Indemnity (UMP Support Payment) Act 2002 ; or
(b) the Medical Indemnity (Run-off Cover Support Payment) Act 2004 ; or
(c) the Medical Indemnity (Competitive Advantage Payment) Act 2005 .
"medical practitioner" means a person registered or licensed as a medical practitioner under a State or Territory law that provides for the registration or licensing of medical practitioners.
Note: Subsection (6) gives this definition an extended meaning in Division 2B or 4 of Part 2.
"medical profession" includes a health care related vocation.
"medicare benefit" means a medicare benefit payable under Part II of the Health Insurance Act 1973 .
"medicare program" has the same meaning as in the Human Services (Medicare) Act 1973 .
"member" of an MDO has the meaning given by section 6.
"net IBNR exposure" has the meaning given by section 8A.
"participating MDO" has the meaning given by section 11.
"participating member" of a participating MDO means a person who was a member of the MDO on 30 June 2000 (whether or not the person ceased to be a member of the MDO after that date).
"payment" made in relation to a claim has (other than in Division 2A of Part 2) the meaning given by subsections (3) and (4).
"provable" : an amount that an MDO or insurer is liable to pay is provable if:
(a) it is provable in the winding up of the MDO or insurer if the winding up of the MDO or insurer has commenced; or
(b) it would be provable in the winding up of the MDO or insurer if the MDO or insurer were to be wound up.
"public hospital" means a recognised hospital within the meaning of the Health Insurance Act 1973 .
"public patient" has the same meaning as in the Health Insurance Act 1973 .
"qualifying claim certificate" means a certificate issued by the Chief Executive Medicare under section 34E.
"related body corporate" has the same meaning as in the Corporations Act 2001 .
"Run-off Cover Claims and Administration Protocol" means the protocol (as amended and in force from time to time) determined by the Minister under section 34ZN.
"run-off cover credit" has the meaning given by subsection 34ZS(2).
"run-off cover indemnity" means a run-off cover indemnity paid or payable under Division 2B of Part 2.
Note: Amounts payable under the Run-off Cover Claims and Administration Protocol are not covered by this definition.
"Secretary" means the Secretary of the Department.
"subject to appeal" : a judgment or order is subject to appeal until:
(a) any applicable time limits for lodging an appeal (however described) against the judgment or order have expired; and
(b) if there is such an appeal against the judgment or order--the appeal (and any subsequent appeals) have been finally disposed of.
"total run-off cover credit" has the meaning given by section 34ZS.
"UMP" means United Medical Protection Limited.
"unfunded IBNR exposure" : an MDO has an unfunded IBNR exposure on 30 June 2002 if the MDO had, on that day, insufficient readily available assets to cover both its IBNR exposure and all its other liabilities.
"unfunded IBNR factor" for a participating MDO means the factor for the MDO worked out under section 22.
Notifications by practitioners may constitute claims
(1A) A reference in Division 2B of Part 2 to a claim includes a reference to a notification by or on behalf of a person of an incident, or a series of related incidents, if:
(a) at the time of the incident, or one or more of the incidents, the person was a medical practitioner or other health professional; and
(b) the notification is to a medical indemnity insurer or an MDO; and
(c) at the time of the notification:
(i) a contract of insurance with the insurer provided the person with medical indemnity cover; or
(ii) an arrangement with the MDO provided medical indemnity cover (within the meaning of the Medical Indemnity (Prudential Supervision and Product Standards) Act 2003 ) for the person;
and the cover would have indemnified the person in relation to any claim relating to the incident, or series of incidents, if the claim had been made at the time of the notification.
The notification is taken, for the purposes of Division 2B of Part 2, to be a claim against the person.
(2) To avoid doubt, a person may, for the purposes of this Act, indemnify someone else by either:
(a) making a payment; or
(b) agreeing to make a payment.
Note: A person may indemnify someone else by making a payment even if the payment was not preceded by an agreement to pay.
Payments in relation to claims
(3) For the purposes of this Act (other than Division 2A of Part 2):
(a) a payment is made in relation to a claim against a person if and only if the payment is made to:
(i) satisfy or settle the claim; or
(ii) meet legal and other expenses that are directly attributable to any negotiations, arbitration or proceedings in relation to the claim; and
(b) a payment is made in relation to a claim by a person if and only if the payment is made to meet legal and other expenses that are directly attributable to any negotiations, arbitration or proceedings in relation to the claim.
(4) A reference in this Act (other than Division 2A of Part 2) to a payment being made to satisfy or settle a claim against a person includes a reference to a payment that:
(a) is made to reimburse the person for a payment the person has made to satisfy or settle the claim; or
(b) is made to the person so that the person can make a payment to satisfy or settle the claim.
Changes in body corporate names
(5) A reference in this Act to a body corporate by a particular name is a reference to the body corporate that had that name on 30 June 2002.
(6) A reference in Division 2B or 4 of Part 2 to a medical practitioner includes a reference to a person who has been a medical practitioner.