This report presents data on Australia's medical indemnity claims in the public sector, and in the public and private sectors combined, from 2007-08 to 2011-12. The data exclude public sector claims for Western Australia, which did not report its claims data for 2010-11 and 2011-12.
Claims arise from allegations of negligence or breach of duty by health-care practitioners during the delivery of health services. A new claim is created when a reserve amount is placed against the costs expected to arise in closing the claim.
In 2011-12, approximately 1,300 new and 1,300 closed public sector claims were reported. From 2007-08 to 2010-11, there were between 1,100 and 1,550 new claims and between 1,100 and 1,400 closed claims (excluding Western Australia). Including Western Australia's public sector claims, there were between 1,200 and 1,600 new claims and between 1,200 and 1,400 closed claims between 2007-08 and 2009-10.
In the private sector there were about 1,700 new claims and 1,700 closed claims in 2011-12. These claim numbers are larger than the 1,000 to 1,400 new claims and 800 to 1,550 closed claims reported for the private sector between 2007-08 and 2010-11. As a result, the total number of private sector claims in 2011-12 exceeded the total number of public sector claims, whereas in previous years the opposite was true.
Between 2007-08 and 2011-12, total claims open at some time during the year increased from about 7,500 to 10,300 (excluding Western Australia).
Claim costs and circumstances
Of the 1,281 public sector claims closed in 2011-12, 37% cost less than $10,000, 29% cost between $10,000 and $100,000, 25% cost between $100,000 and $500,000, and 10% cost $500,000 or more. From 2003-04 through to 2011-12, the proportion of public sector claims closed for $500,000 or more constantly increased.
Including private sector claims closed in 2011-12, 54% of the 2,978 combined public and private sector claims cost less than $10,000, 25% cost between $10,000 and $100,000, 16% cost between $100,000 and $500,000, and 5% cost $500,000 or more.
Between 2007-08 and 2011-12, the proportion of new public sector claims associated with the clinical service context of General surgery increased, from 14% to 21%. Over the same period, there was also an increase in the proportion of new claims associated with Procedure (for instance, a surgical procedure or childbirth delivery) as the alleged problem, both for public sector claims (26% to 33%) and public and private sector claims combined (24% to 35%).
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. They respectively accounted for 72%, 12% and 11% of claims closed for $100,000 or more.
Length of time between health-care incident and claim closure
On average, the length of time between incident and when the claim was opened was about 2 years, and 3 to 4 years between the health-care incident and when the claim was closed. The proportion of claims closed within 5 years of the incident fluctuated between 70 and 79% for claims with incident years between 2001-02 and 2006-07.