Most medical indemnity claims are small and settled within three years

Most medical indemnity claims are finalised within 3 years, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

The report, Public and private sector medical indemnity claims in Australia 2008-09, found that in 2008-09, around 70% of closed claims were finalised within 3 years of being opened, while 9% took more than five years to be settled.

‘Nearly two-thirds of closed claims were settled for less than $10,000, including 30% where no payment was made’, said Ms Jenny Hargreaves of the AIHW’s Hospitals and Performance Group. Just 4% were settled for $500,000 or more.

About 6% of claims were finalised through a court decision, while 29% of claims were finalised through negotiation. The remaining 65% were discontinued—for example, the claimant withdrew the claim.

‘There were 2,625 new medical indemnity claims opened between July 2008 and June 2009—370 more than during 2007-08,’ Ms Hargreaves said. There were similar numbers of new claims in the public and private sectors.

Allegations of loss were most commonly related to a procedure (28%)—such as failure of surgery or post-operative complications—or were diagnosis-related (21%).

Allegations of harm were most commonly neuromusculoskeletal and movement-related (19%).

General practice and Obstetrics & gynaecology were the two clinician specialities most associated with incidents that led to a claim, accounting for one-third of all claims.

A second report, also released today, takes a closer look at public sector medical indemnity claims.

There were 1,291 new public sector claims in 2008-09. This was fewer new claims than seen in the past four years.

Australia's public sector medical indemnity claims 2008-09 reports that the proportion of claims closed for $100,000 or more doubled from 9% to 19% between 2004-05 and 2008-09.

Between 2004-05 and 2008-09, there was a decline in the proportion of claims associated with temporary harm and an increase in those associated with major harm or the patient’s death.

The health service contexts most often implicated (where known) were Accident and emergency (19%), Obstetrics (16%) and General surgery (14%).

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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