Majority of medical indemnity claims settled out of court and for less than $10,000

In 2009−10, around 51% of medical indemnity claims were finalised through a negotiated settlement and just 3% through a court decision, according to a report released today by the Australian Institute of Health and Welfare (AIHW). The remaining 46% of cases were discontinued.

The report, Public and private sector medical indemnity claims in Australia 2009-10, also shows that 58% of 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 of claims were finalised within 3 years of being opened, while 14% took more than 5 years to be settled.

There were 2,900 new medical indemnity claims opened between July 2009 and June 2010 and around 2,650 claims that were closed (finalised). There were more new claims in the public sector compared with the private sector, and fewer claims closed in the public sector than in the private sector.

Compared to previous years, there were more new claims in 2009-10 compared to 2007-08 (2,255) and 2008-09 (2,625) and fewer closed claims than in 2007-08 (2,675) and 2008-09 (3,093).

‘As in previous years, the most common allegation for loss in 2009–10 related to a procedure—for example failure of a procedure, or post-operative complications.  Diagnosis and treatment were the next two most common claim categories,’ said AIHW spokesperson Nigel Harding.

The most common allegation of harm was neuromusculoskeletal and movement-related body functions and structures.

Almost three-quarters of allegedly affected patients were adults, with female patients outnumbering males.

Where the patient was a baby, almost one-third of new claims were associated with mental and nervous system effects.

A second report focusing on public sector claims only, also released today by the AIHW, shows there were 1,620 new public sector claims in 2009–10,  substantially more than in each of the previous 3 years (when there were about 1,100–1,300 new claims per year).

‘The proportion of public sector medical indemnity claims closed for a large amount—$500,000 or more—was higher in 2009–10 (9%) than in any of the previous 4 years (4–8%). However, the proportion of claims associated with severe injury to the patient or the patient’s death was similar to previous years’, Mr Harding said.

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.

Canberra, 16 May 2012

Further information: Nigel Harding, AIHW, tel. 02 6244 1025, mob. 0409 307 671