Report

Public and private sector medical indemnity claims in Australia 2009-10

18 May 2012
Description

This report presents information from the Medical Indemnity National Collection for 2009–10. It describes characteristics and costs for public and private sector medical indemnity claims.

Claims

There were 9,415 medical indemnity claims open at some point between July 2009 and June 2010. This included 2,900 new claims opened during the period, and almost 2,650 claims that were closed during the period. There were more new claims in the public than the private sector (1,620 and 1,280 respectively), but there were more claims closed in the private sector than the public sector (1,471 and 1,176 respectively).

Between 2007–08 and 2009–10 the number of all claims in scope increased from 8,555 to 9,415 and the number of new claims increased from 2,255 to 2,900. However, there were more closed claims in 2007–08 (2,675 claims) and 2008–09 (3,093 claims) than in 2009–10.

Cost and duration

More than half (58%) of closed claims were settled for less than $10,000, including 17% where no payment was made. Just 6% were settled for $500,000 or more. Two-thirds (67%) of closed claims were finalised within 3 years of being opened, compared with 14% that took more than 5 years to be settled.

Just 3% of closed claims were finalised through a court decision, compared with 51% finalised through a negotiated settlement with the claimant. The remaining 46% were discontinued (for instance, following the claimant’s withdrawal of the claim).

The alleged incidents and who was involved

As in previous years, the most common allegation of loss for new claims in 2009–10 related to Procedure—for example failure of procedure or post-operative complications (24% of claims). Procedure was followed by Diagnosis (20% of claims) and Treatment (15% of claims).

The most common allegation of harm was Neuromusculoskeletal and movement-related, accounting for 18% of new claims. The categories Digestive, metabolic and endocrine systems and Death (both 12%), Mental and nervous system and Genitourinary and reproductive (both 9%), were also commonly reported. Similar proportions were recorded for 2007–08 and 2008–09 except that the Digestive, metabolic and endocrine systems category was lower.

Almost three-quarters of allegedly affected patients were adults (74% of new claims), with female patients outnumbering males. In the case of persons aged 1–17 the patient was more often male than female. Where the patient was a baby, almost one-third of new claims (30%) were associated with Mental and nervous system effects.

As in 2007−08 and 2008−09, in 2009–10 the two most commonly recorded clinical specialties were General practice (18% of new claims) and Obstetrics and Gynaecology (9% of new claims)

About 24% of closed claims were associated with mild injury to the claim subject, 27% with moderate injury and 18% with severe injury. Severe injury was recorded for a higher proportion of the claims associated with Diagnostic radiology and Urology (29% and 28% respectively) than the claims associated with other clinician specialties. The claim subject’s death was associated with 12% of closed claims.

Claim size was generally less than $10,000 when the injury was mild (78%) and often less than $10,000 when the injury was moderate (50%), but usually $10,000 or more when the injury was severe (65%).

Publication Details
Published year only: 
2012
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