Coverage under the Exceptional Claims Scheme (ECS)

The ECS covers the costs of eligible claims once they exceed an eligible practitioner’s indemnity cover limit.

When practitioners are covered

The ECS only covers doctors and allied health professionals when they are eligible.

What ECS covers

Types of costs covered

The ECS covers:

  • damages amounts to patients
  • legal costs
  • administrative costs related to managing the claim
  • costs incurred by the medical indemnity insurer in managing an incident, which may or may not become a claim.

Amount covered

The ECS only covers costs once they exceed the practitioner’s indemnity cover limit.

Example of amount covered

A practitioner has indemnity cover of up to $20 million.

A patient makes a malpractice claim against the practitioner. The damages amount and other claim costs add up to $100 million.

The insurer covers the first $20 million in claim costs. The ECS covers the remaining $80 million.

What ECS does not cover

The ECS does not provide cover if the claim costs are below or equal to the eligible practitioner’s cover limit. For these claims, the indemnity insurer may be able to access the High Cost Claims Scheme.

Date last updated:

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