Eligibility criteria
ROCS covers doctors who:
- have stopped paid private practice
- had medical indemnity insurance while they were practising.
If an eligible doctor dies, ROCS covers their legal representative or estate.
A doctor is not eligible if they have never had medical indemnity cover.
Immediate eligibility
ROCS cover will start immediately if an eligible doctor:
- retires permanently from private practice
- goes on maternity leave
- retires because of permanent disability
- moves away from Australia after working as a temporary resident doctor on a 422, 457 or temporary visa
- becomes deceased.
Eligibility after 3 years
If a doctor stops private practice for other reasons, they will become eligible after 3 years.
If a doctor must wait 3 years to be eligible for ROCS, they can:
- buy run-off insurance to cover the waiting period – this will become their last cover and is what their ROCS cover will be based on
- be uninsured – this means they personally bear the costs of any legal action against them that relates to their previous medical practice.
Evidence of eligibility
The insurer will let the doctor know if they need supporting evidence. This is usually a statutory declaration form.
Insurers can find out more about evidence of eligibility on the Services Australia website.
Maternity leave
To be eligible immediately because of maternity leave, a doctor must stop all private and public practice.
Maternity leave includes leave for:
- miscarriages or stillbirths
- recovering from pregnancy
- childbirth
- subsequent care of the newborn or other children.
There is no limit to the amount of maternity leave a doctor takes.
When the doctor returns to work
When the doctor starts medical practice again, their eligibility for ROCS cover ends, even if they only work a day or two a week. They will have no cover for current and previous incidents unless they buy indemnity insurance with retroactive cover.
The doctor can become eligible for ROCS again, for example if they go on maternity leave again or retire.
Permanent disability
To be eligible immediately because of disability, the doctor must stop all private and public practice.
The disability must:
- be the result of an injury or illness that is permanent or is likely to be permanent
- mean that the doctor can no longer practice in the specialty they chose and are qualified for.
Temporary resident doctor
Moving away from Australia
To be eligible immediately because of moving away from Australia, an overseas-trained doctor must:
- have worked in private medical practice in Australia on either a:
- subclass 422 visa – medical practitioner
- subclass 457 visa – business (long stay)
- temporary visa, from 18 March 2018
- have a visa that permits the holder to work in medical practice in Australia
- have permanently ended medical practice in Australia
- no longer live in Australia.
Temporary resident doctors who are on other visas but meet the other requirements above are eligible after 3 years.
All temporary resident doctors should contact their insurer before they leave the country to:
- advise them of their departure
- leave a forwarding address
- arrange ROCS cover.
Other reasons for eligibility
Temporary resident doctors can become eligible immediately for other reasons, such as going on maternity leave.
Notices of ROCS cover
Insurers must issue notices of ROCS cover if they are:
- the current or last insurer of a doctor
- aware that the doctor has become eligible for ROCS.
They must tell the doctor:
- the scope of their ROCS cover, including the types of incidents covered
- any other terms and conditions of the cover.
Doctors are eligible if they meet the eligibility criteria, even if they do not receive a notice. Insurers may not become aware of all eligible doctors.
If a doctor has not received a notice of ROCS cover, they should contact their current or last insurer.
ROCS and other schemes
Doctors may also be eligible for the Exceptional Claims Scheme if the cost of a claim against them is higher than their ROCS cover. To find out more, see amount covered.
Leaving ROCS
If a doctor’s ROCS cover ends but they want to continue receiving run-off cover, they should buy separate medical indemnity insurance that includes retroactive cover. They should arrange this before their ROCS cover ends.
If a doctor is no longer eligible
A doctor’s circumstances may change so that they are no longer eligible. ROCS cover will end from the date of the change. The doctor should immediately advise the insurer who issued their notice of ROCS cover.
ROCS will continue to cover any eligible claim that was notified while the doctor was eligible.
If ROCS ends
If the Australian Government ends ROCS, doctors:
- eligible on the end date will continue to receive cover for eligible claims
- who contributed ROCS support payments through their premiums will receive a refund.
Re-entering the workforce
Retired doctors
If retired doctors:
- engage in only paid public practice – they stay eligible for ROCS
- re-enter paid private practice, even if it is only for an hour or two – they become ineligible
- provide services other than medical treatment, such as consulting or being an expert witness – they may become ineligible. They should contact their insurer.
Doctors on maternity leave
Doctors on maternity leave become ineligible for ROCS if they engage in any paid practice (public or private).