Coverage - incidents

Which incidents are now covered in ROCS?
If an incident is notified while I am eligible for ROCS, will ROCS pay for all the costs of the claim?
If an incident is notified while I am not eligible for ROCS, will ROCS pay for any of the costs of the claim?
Can insurers offer me ROCS cover which is different from that offered under my last contract of insurance?
If I find that my last contract of insurance did not cover all of my previous medical practice, can I privately purchase additional run-off cover?
If I am eligible for ROCS and take out additional run-off cover, will this subsequently be covered by ROCS?
Are incidents which were not covered at the time of their occurrence covered in ROCS?
Why does ROCS cover only those incidents that were covered by the doctor’s last contract of insurance?

Coverage - incidents

Which incidents are now covered in ROCS?

The ROCS covers any incident occurring in the course of the doctor’s medical practice which is first reported to the medical indemnity insurer while the doctor is eligible for the ROCS, provided it is covered under a ROCS contract of insurance (based on the doctor’s last contract of insurance).

If an incident is notified while I am eligible for ROCS, will ROCS pay for all the costs of the claim?

Yes, if the incident was covered by your last contract of insurance.

If an incident is notified while I am not eligible for ROCS, will ROCS pay for any of the costs of the claim?

No.

Can insurers offer me ROCS cover which is different from that offered under my last contract of insurance?

No. Insurers may offer you additional cover for free or at a cost, but this will not be ROCS cover and the Australian government will not reimburse the cost of claims.

If I find that my last contract of insurance did not cover all of my previous medical practice, can I privately purchase additional run-off cover?

Yes, but this will not be ROCS cover and the Australian government will not reimburse the cost of claims.

If I am eligible for ROCS and take out additional run-off cover, will this subsequently be covered by ROCS?

Yes, after the expiry of the additional cover.

Are incidents which were not covered at the time of their occurrence covered in ROCS?

Yes. The legislation has been amended (November 2006) so that incidents which were not covered at the time of their occurrence (i.e. because the doctor had no medical indemnity insurance or incomplete cover) will now be included in the ROCS, provided such incidents were covered under the doctor’s last contract of insurance. This affects all ROCS claims first notified since 1 July 2004.

This change improves certainty for doctors and insurers about which incidents are covered in the ROCS. This was necessary as insurers’ records would not have enabled them to identify gaps in coverage with precision. In addition, some of the gaps in insurance cover were brief and inadvertent, and whether coverage was maintained depended on business practices, which varied among insurers. Top of Page

Why does ROCS cover only those incidents that were covered by the doctor’s last contract of insurance?

As the ongoing cost of the ROCS is funded from a levy on medical indemnity insurance premiums, it is reasonable that it should only cover doctors who have had medical indemnity insurance. In the same vein, those who had taken out more comprehensive insurance (at greater cost) should continue to receive the benefit of that cover in retirement.

It is therefore in the doctor’s interest to be certain that his or her insurance offers adequate cover, including cover for all otherwise-uncovered prior events.