Claims under the Allied Health Exceptional Claims Scheme (AHECS)

If an eligible claim is made against an eligible allied health professional, they (or their representative or insurer) can apply for an AHECS payment.

Eligible claims

A claim (or potential claim) must meet certain criteria to be eligible for an AHECS payment.

The claim

The claim (or a group of related claims) must:

  • be against an allied health professional who is eligible
  • exceed the cover of their insurance contract – see amount covered.

If the claim does not exceed their cover, the insurer may be able to access the Allied Health High Cost Claims Scheme.

The incident the claim is about

The incident must:

  • be within the scope of the insurance contract
  • have occurred in Australia or its territories or under certain circumstances (such as aid work) overseas
  • have occurred, in part or in full, during the treatment of a private patient.

Public patient treatment is the responsibility of state and territory governments.

Timing of the incident

The incident must have occurred on or after 1 July 2020.

If it occurred before 1 July 2020, the Exceptional Claims Scheme (ECS) will cover any eligible claims against allied health professionals.

The AHECS started on 1 July 2020. Before this date, the ECS covered allied health professionals.

If a claim is made

If an eligible allied health professional becomes aware of a claim made against them:

  • the allied health professional should contact their indemnity insurer
  • the insurer should assess if the claim will be above the allied health professional’s level of cover
  • they should agree on who will apply for an AHECS payment.

Apply for an AHECS payment

The allied health professional, someone acting on their behalf, or their insurer can apply for an AHECS payment.

The first step is to contact Services Australia.

The medical indemnity team in Services Australia administers the AHECS. They will confirm:

  • if the claim is eligible
  • what needs to be submitted
  • how to do it.

The applicant must contact Services Australia if any claim details change.

Who manages the claim

The indemnity insurer manages the claim.

Who pays for the claim

The allied health professional must pay for any deductible or excess they agreed to in their insurance contract.

Once they have done this, their insurer and the AHECS will make payments for the claim.


In their insurance contract, an allied health professional has agreed to pay an excess of $100,000 for each claim. They have cover of up to $20 million.

A patient makes a claim against the allied health professional. The total claim costs add up to $50 million. The allied health professional must pay the first $100,000 before:

  • their insurer will pay $19.9 million – the remaining amount up to the cover limit
  • the AHECS will pay $30 million – the remaining amount above the cover limit.

How claims will be paid

Services Australia will make the AHECS payment to the person who applied for it.

The person must forward the payment on to discharge the allied health professional's liability. They would usually do this by paying the claimant’s solicitor.

If needed, Services Australia will seek to recover from the person:

  • any overpayments
  • any amount the person failed to forward on.
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