Run-Off Cover Indemnity Scheme (ROCS)

A representative of an eligible MDO or MII can only submit applications.

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
• incident occurred in the course of, or in connection with, the person’s practice as a medical practitioner
• incident was covered under the medical practitioner’s indemnity arrangement or agreement.

When your medical practitioner notifies you about the claim, they must:

• be covered under ROCS
• meet one or more of the eligibility classes.

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

Your medical practitioner must submit the relevant supporting document to their MII or MDO. This is usually a Statutory Declaration form.

For some ROCS eligibility classes a Medical Certificate or Death Certificate must also be submitted.

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

Learn about each eligibility class and the evidence you’ll need to apply for a payment.

1. A medical practitioner who has permanently retired from private medical practice

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

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

To be eligible the medical practitioner must complete and submit the Statutory declaration ROCS - Medical practitioner who has ceased private or all remunerated medical practice due to retirement form (MO031).

You don’t need a Medical Certificate to support this eligibility class.

2. A medical practitioner who hasn’t engaged in private medical practice at any time during the preceding 3 years

In the 3 years before being notified of a claim or the incident, the medical practitioner must:

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

To be eligible the medical practitioner must complete and submit the Statutory declaration ROCS - Medical practitioner who has not engaged in either private or remunerated medical practice during the preceding 3 years form (MO034).

You don’t need a Medical Certificate to support this eligibility class.

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

To be eligible the medical practitioner must complete and submit both the:

• Statutory declaration ROCS - Medical practitioner who has ceased medical practice because of maternity form (MO037)
• Run-Off Cover Indemnity Scheme - Medical certificate maternity form (MO032).

For further information read the Medical Indemnity Act 2002 on the Federal Register of Legislation website.

4. A medical practitioner who has permanently stopped practicing due to disability

To be eligible the medical practitioner must complete and submit both the:

• Statutory declaration ROCS - Medical practitioner who has ceased medical practice because of permanent disability form (MO036)
• Run-Off Cover Indemnity Scheme - Medical certificate permanent disability form (MO056).

For further information read the Medical Indemnity Act 2002 on the Federal Legislation website.

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

To be eligible the legal personal representative of a deceased person must submit either a:

• Death certificate.
• Statutory declaration ROCS - Deceased medical practitioner form (MO033).

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

To be eligible the medical practitioner must submit a copy of the temporary visa.

The temporary visa needs to:

• Comply with the Migration Act 1958. The holder of the temporary visa must have nominated their occupation as a medical practitioner.
• Be prior to 18 March 2018, be either a subclass 422 medical practitioner or a subclass 457 business long stay under the Migration Regulations 1994.

In addition the medical practitioner must apply all of the following:

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

If you don’t have a copy of the temporary visa, the medical practitioner can complete and submit the Statutory declaration ROCS - Overseas medical practitioner form (MO035).

You don’t need a Medical Certificate to support this eligibility class.

You can’t submit a ROCS application for an incident or a series of related incidents if:

• they didn’t occur as part of a person’s practice as a medical practitioner
• the claim wasn’t made against the medical practitioner
• you were notified about them before 1 July 2004
• you aren’t liable to pay in relation to the claim
• they aren’t normally covered in your ordinary course of business.

You can’t claim GST under the ROCS.

You also can’t claim an amount if:

• another party has responsibility to pay it
• it’s an insurer to insurer payment
• the cost wasn’t incurred in relation to the incident
• the judgment or settlement amounts are still within the appeal period or have been appealed or stayed.

You need to use the Medical Indemnity Online Claims (MIOC) service in Health Professionals Online Services (HPOS) to submit an application under the ROCS.

You can access HPOS with an individual Provider Digital Access (PRODA) account or organisation account in PRODA. If you don’t have one, register for PRODA online.

To register to use MIOC, email the Medical Indemnity team.

Once you’re registered, we’ll give you a MIOC User Guide. This guide will explain how you submit the application.

Before you submit the application:

• check you have an eligible claim
• have the relevant Statutory Declaration and Medical Certificate form
• decide if you’re going to request to aggregate payments.

We’ll tell you the outcome of the application by the end of the next month.

We’ll send all correspondence about the application to the MDO’s or MII’s HPOS mailbox.

You need to let us know if any details of the incident or claim change after you submit your application. This includes, but is not limited to:

• if you recover an amount from a third party that relates to the amount we paid you
• if any changes effect the amount that was paid under the Medical Indemnity scheme
• if details of the incident change
• if you withdraw support for the insured person
• if the amount paid is later found to be not payable under the requirements of the scheme.

If you identify an amount to be refunded, you must submit a refund application through the MIOC service in HPOS.

Only an MDO can submit a medical indemnity scheme application for aggregated payments. Applications for aggregated costs can be submitted under the High Cost Claim Indemnity Scheme or the Run-Off Cover Scheme.

To aggregate payments for the same claim, the MII must fill out and sign the Medical indemnity request to aggregate payments for the same claim form (MO008). The MII must send the form to the MDO who must upload the completed signed form with their application.