Report

Australia's public sector medical indemnity claims 2009-10

18 May 2012
Description

This report presents data on the number, nature and costs of public sector medical indemnity claims for 2005–06 to 2009–10, with a focus on 2009–10 claims.

Public sector medical indemnity claims for 2009–10

A new claim is created when a dollar amount (reserve) is placed against the costs expected to arise from allegations of problems in health service provision. There were 1,620 new public sector claims in 2009–10. The most frequently involved clinician specialties were Emergency medicine (9%), General surgery (8%) and Orthopaedic surgery (6%). The health service contexts most often implicated were Emergency department, General surgery and Obstetrics.

Of the 1,176 claims closed in 2009–10, 43% cost less than $10,000. With 55% of closed claims, the claimant pursuing the claim received a payment. Of those 55%, the claimant was the patient (32%), some party other than the patient (10%) and multiple claimants (13%).

Claims opened between 2005–06 and 2009–10

There were substantially more new claims in 2009–10 (1,620) than in the previous 3 years (about 1,130 to 1,270 claims per year).

Allegations of Neuromusculoskeletal and movement-related harmful effects were reported for a higher proportion of new claims each year from 2006–07 to 2009–10 (21–26%) than allegations of harmful effects to any other body system.

Claims closed between 2005–06 and 2009–10

Fewer claims were closed in 2009–10 (1,176) than in the previous 4 years when between 1,260 and 1,800 claims were closed per year.

The proportion of claims closed for a large amount ($500,000 or more) was higher in 2009–10 (9%) than any of the previous 4 years (4–8%). However, the proportion of claims associated either with severe injury to the patient or the patient’s death was similar to previous years (respectively, 23% compared with 23–26%, and 18% compared with 14–21%).

With 71% of closed claims, one or more allegations of loss to the claimant were recorded for the claim. Of those 71%, the allegations of loss applied only to the patient (62%), only to some party other than the patient (6%) and to both the patient and some other party (3%). In 29% of claims allegations of loss were either nil or unknown. Pain and suffering was the most frequently claimed loss category for patients (3,649 claims, 51%), while for other parties Nervous shock was the most common (329 claims, 5%). Claim size increased noticeably with the number of alleged loss categories.

The average time between when the reserve was placed and the claim was closed increased from about 30 months in 2005–06 to 31 months in 2006–07, 33 months in 2007–08 and 2008–09, and 35 months in 2009–10.

The most common grounds for a claim was an alleged problem in the performance of a Procedure—for instance, a surgical procedure or childbirth delivery—recorded for about one-third (36%) of the claims.

Publication Details
Published year only: 
2012
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