Private sector medical indemnity claims outnumber public sector claims

More private sector than public sector medical indemnity claims were managed by insurers in 2011-12, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

The report, Australia's medical indemnity claims 2011-12, shows there were 1,700 new and 1,700 closed private sector medical indemnity claims in that year.

This compares with about 1,300 new and 1,300 closed claims managed by public sector insurers in in 2011-12 (excluding Western Australia).

'This is the first time private sector claims have been in the majority, even allowing for the absence of public sector claim information from Western Australia in 2010-11 and 2011-12', said AIHW spokesperson Nigel Harding.

Medical indemnity claims arise from allegations of problems in health service provision.

The total number of medical indemnity claims open at some time during the year rose from 7,500 to 10,300 between 2007-08 and 2011-12 (excluding public sector claims in Western Australia).

Of the public sector and private sector claims closed in 2011-12, just over half (54%) cost less than $10,000, a quarter (25%) cost between $10,000 and $100,000, 16% cost between $100,000 and $500,000, and 5% cost $500,000 or more.

As in previous years, most public and private sector closed claims were finalised through a negotiated settlement (49%) or were discontinued (48%). The remaining 3% were finalised through a court decision.

'In 2011-12, as in previous years, claims associated with alleged incidents in public hospitals and day surgeries were often more costly than claims associated with private medical clinics and with private hospitals and day surgeries,' Mr Harding said.

In the public sector, the proportion of new claims associated with the clinical service context of General surgery has continually increased between 2007-08 and 2011-12 from 14% to 21%.

On average, the length of time between an incident and when the claim was opened was about two years, with 3 to 4 years elapsing between the time of the incident and when the claim was closed.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia's health and welfare.


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