When doctors covered
ROCS only covers doctors when they are eligible.
What ROCS covers
ROCS cover is based on an eligible doctor’s last cover, including:
- cover for the same types of incidents
- the same terms and conditions.
What last cover means
Last cover usually means the cover a doctor had before they stopped private practice.
Sometimes, it may mean:
- 2 or more policies from different medical indemnity insurers
- a combination of an insurance policy plus discretionary claims-incurred cover from a medical defence organisation (MDO)
- previous ROCS cover plus extra run-off cover the doctor took out to cover gaps in their last insurance policy.
Types of costs covered
If they are in line with the terms and conditions of a doctor’s last cover, ROCS will cover:
- compensation or damages costs for claims made against the doctor
- costs incurred by the insurer in managing or investigating a reported incident (which may or may not become a claim)
- costs related to claims made by the doctor arising from medical practice, such as the cost of legal representation at coronial enquiries.
Amount covered
ROCS covers claim costs up to the limit of the doctor’s last cover.
The Exceptional Claims Scheme (ECS) will cover the claim costs over the doctor’s cover limit if:
- their last cover was at or above the ECS threshold
- they met the other ECS eligibility criteria when they were in private practice.
What ROCS does not cover
ROCS does not cover:
- any free medical services the doctor provides before or after stopping private practice – they should take out appropriate cover for these services
- any public sector work before or after stopping private practice – the public sector employer will cover these services
- loss of income
- personal injury claims
- incidents that were notified while the doctor was not eligible for ROCS.
Why ROCS cover is based on last cover
The Australian Government funds ROCS with a levy on insurance premiums.
It is fair that doctors who had indemnity insurance, and contributed to ROCS through their premiums, continue to receive the same cover.
This also encourages doctors to ensure their insurance offers adequate cover.